International Journal of Abdominal Wall and Hernia Surgery (Jan 2021)

Ambulatory laparoscopic inguinal hernioplasty: Feasibility and cost minimization analysis

  • Natalia J Sanchez,
  • Fernando Cetolini,
  • Rodolfo Scaravonati,
  • Sebastian Roche,
  • Claudio Brandi,
  • Santiago Bertone

DOI
https://doi.org/10.4103/ijawhs.ijawhs_32_21
Journal volume & issue
Vol. 4, no. 4
pp. 181 – 187

Abstract

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BACKGROUND: In recent years, laparoscopic inguinal hernia repair has become one of the elective techniques, attributing the advantages of minimally invasive procedures to it. However, the high costs related to the need for hospitalization and materials make them a limitation at the time of its indication. OBJECTIVE: Evaluate the feasibility of performing this procedure in an outpatient surgery center and the cost analysis of an outpatient procedure regarding the same in the setting of hospitalization. Retrospective cohort study of feasibility and minimization cost. METHODS: A retrospective analysis was carried out on a prospective database in which all patients were included in those who underwent laparoscopic inguinal hernioplasty on an outpatient basis between August 2015 and June 2018. Feasibility is expressed as the percentage of patients who were referred from the outpatient surgery unit. A cost minimization study was conducted taking the average cost of performing an ambulatory procedure versus the same procedure requiring a day of hospitalization. This work has been reported in line with the CHEERS criteria. RESULTS: 116 patients were operated as outpatients, of which 109 were men (93.96%). The median age was 56.5 years (RIQ 19). 102 patients (87.93%) were operated on due to bilateral inguinal hernia, and 14 of them (12.07%) due to recurrent unilateral hernia, adding a total of 218 inguinal hernioplasties. The mean operative time in bilateral interventions was 112 minutes (DS 24) and in the unilateral recurrences it was 79 minutes (DS 13). 114 patients were discharged from the outpatient unit with 98.3% feasibility. The average postoperative stay was 2.53 h (DS 1). The average cost of ambulatory inguinal hernioplasty was $17725.1 vs $27297.3 in hospitalization. The same implies a cost reduction of 35%. CONCLUSIONS: Laparoscopic inguinal hernioplasty is a feasible and safe technique to perform on an outpatient basis. It provides a significant reduction in the costs of the procedure.

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