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Same day discharge, surgical training and early complications after open and laparoscopic repair of primary paraumbilical hernia

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Abstract

Aims

The aims of this study were to compare same day discharges and early complications after open and laparoscopic primary paraumbilical hernia (PUH) repair, including the procedures performed by surgical trainees (STs).

Methods

All patients who had open (suture or mesh) and laparoscopic repair of primary PUH in the Day Surgery Unit (DSU) between January 2007 and June 2009 were identified from the hospital database. The database was questioned regarding the grade of operating surgeon, type of surgical repair, day of admission and discharge from the DSU, and a patient’s return to surgical services. Data were stored in Microsoft Excel® (TM 2007). Statistical significance was determined using Fisher’s exact test.

Results

PUH was repaired in 337 patients: 252/337 (74.8 %) had open and 85/337 (25.2 %) had laparoscopic repair. Significantly, more patients were discharged home on the day of surgery after an open repair compared to the laparoscopic repair: open repair 187/252 (74.2 %), laparoscopic repair 35/85 (41.17 %), P = 0.0001. Overall early complications such as wound complications and hospital re-visits were similar in both groups: open repair 6.3 % (16/252), laparoscopic repair 11.7 % (10/85), P = 0.1554. STs performed 142/337 (42.1 %) of the PUH repairs with similar same day discharges from the DSU: STs 64.7 % (92/142), consultant surgeons 66.7 % (130/195), P = 0.7285. The difference in hernia recurrence between open repair 7/252 (2.78 %) and laparoscopic group 0/85 was not significant (P = 0.1985).

Conclusion

Patients with PUH repair were more likely to go home on the day of surgery after open than after laparoscopic repair. This was not affected by the grade of the operating surgeon. Early complications were similar following open and laparoscopic repair of primary PUH.

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References

  1. Arroyo A, Garcia P, Perez F, Andreu J, Candela F, Calpena R (2001) Randomized clinical trial comparing suture and mesh repair of umbilical hernia in adults. Br J Surg 88(10):1321–1323

    Article  PubMed  CAS  Google Scholar 

  2. Sanjay P, Reid TD, Davies EL, Arumugam PJ, Woodward A (2005) Retrospective comparison of mesh and sutured repair for adult umbilical hernias. Hernia 9(3):248–251

    Article  PubMed  CAS  Google Scholar 

  3. Mayo WJVI (1901) An operation for the radical cure of umbilical hernia. Ann Surg 34(2):276–280

    Article  PubMed  CAS  Google Scholar 

  4. Muschaweck U (2003) Umbilical and epigastric hernia repair. Surg Clin North Am 83(5):1207–1221

    Article  PubMed  Google Scholar 

  5. Eryilmaz R, Sahin M, Tekelioglu MH (2006) Which repair in umbilical hernia of adults: primary or mesh? Int Surg 91(5):258–261

    PubMed  Google Scholar 

  6. Arroyo Sebastian A, Perez F, Serrano P, Costa D, Oliver I, Ferrer R et al (2002) Is prosthetic umbilical hernia repair bound to replace primary herniorrhaphy in the adult patient? Hernia 6(4):175–177

    Article  PubMed  CAS  Google Scholar 

  7. White TJ, Santos MC, Thompson JS (1998) Factors affecting wound complications in repair of ventral hernias. Am Surg 64(3):276–280

    PubMed  CAS  Google Scholar 

  8. Bingener J, Buck L, Richards M, Michalek J, Schwesinger W, Sirinek K (2007) Long-term outcomes in laparoscopic vs open ventral hernia repair. Arch Surg 142(6):562–567

    Article  PubMed  Google Scholar 

  9. McCormack K, Scott NW, Go PM, Ross S, Grant AM (2003) Laparoscopic techniques versus open techniques for inguinal hernia repair. Cochrane Database Syst Rev 1:CD001785

    PubMed  Google Scholar 

  10. Venclauskas L, Silanskaite J, Kiudelis M (2008) Umbilical hernia: factors indicative of recurrence. Medicina (Kaunas) 44(11):855–859

    Google Scholar 

  11. Nguyen NT, Lee SL, Mayer KL, Furdui GL, Ho HS (2000) Laparoscopic umbilical herniorrhaphy. J Laparoendosc Adv Surg Tech A 10(3):151–153

    Article  PubMed  CAS  Google Scholar 

  12. Gonzalez R, Mason E, Duncan T, Wilson R, Ramshaw BJ (2003) Laparoscopic versus open umbilical hernia repair. JSLS 7(4):323–328

    PubMed  Google Scholar 

  13. Hilling DE, Koppert LB, Keijzer R, Stassen LP, Oei IH (2009) Laparoscopic correction of umbilical hernias using a transabdominal preperitoneal approach: results of a pilot study. Surg Endosc 23(8):1740–1744

    Article  PubMed  Google Scholar 

  14. Martin DF, Williams RF, Mulrooney T, Voeller GR (2008) Ventralex mesh in umbilical/epigastric hernia repairs: clinical outcomes and complications. Hernia 12(4):379–383

    Article  PubMed  CAS  Google Scholar 

  15. Wright BE, Beckerman J, Cohen M, Cumming JK, Rodriguez JL (2002) Is laparoscopic umbilical hernia repair with mesh a reasonable alternative to conventional repair? Am J Surg 184(6):505–508 (discussion 508–509)

    Article  PubMed  Google Scholar 

  16. Bisgaard T, Kehlet H, Bay-Nielsen M, Iversen MG, Rosenberg J, Jørgensen LN (2011) A nationwide study on readmission, morbidity, and mortality after umbilical and epigastric herniarepair. Hernia 15(5):541–546 (Epub 2011, May 3)

    Article  PubMed  CAS  Google Scholar 

  17. Kulacoglu H, Yazicioglu D, Ozyaylali (2012) Prosthetic repair of umbilical hernias in adults with local anesthesia in a day-case setting: a comprehensive report from a specialized hernia center. Hernia 16(2):163–170 (Epub 2011 Oct 22)

    Article  PubMed  CAS  Google Scholar 

  18. Othman IH, Metwally YH, Bakr IS, Amer YA, Gaber MB, Elgohary SA (2012) Comparative study between laparoscopic and open repair of paraumbilical hernia. J Egypt Soc Parasitol 42(1):175–182

    PubMed  CAS  Google Scholar 

  19. Molloy D, Kaloo PD, Cooper M, Nguyen TV (2002) Laparoscopic entry: a literature review and analysis of techniques and complications of primary port entry. Aust N Z J Obstet Gynaecol 42(3):246–254

    Article  PubMed  Google Scholar 

  20. LeBlanc KA, Elieson MJ, Corder JM III (2007) Enterotomy and mortality rates of laparoscopic incisional and ventral hernia repair: a review of the literature. JSLS 11(4):408–414

    PubMed  Google Scholar 

  21. Parsons BA, Blencowe NS, Hollowood AD, Grant JR (2011) Surgical training: the impact of changes in curriculum and experience. J Surg Educ 68(1):44–51 (Epub 2010 Nov 5)

    Article  PubMed  Google Scholar 

  22. Blencowe NS, Parsons BA, Hollowood AD (2011) Effects of changing work patterns on general surgical training over the last decade. Postgrad Med J 87(1034):795–799 (Epub 2011 Oct 7)

    Article  PubMed  CAS  Google Scholar 

  23. Fernandez E, Williams DG (2009) Training and the European Working Time Directive: a 7 year review of paediatric anaesthetic trainee caseload data. Br J Anaesth 103(4):566–569

    Article  PubMed  CAS  Google Scholar 

  24. Menon VS, Brown TH (2003) Umbilical hernia in adults: day case local anaesthetic repair. J Postgrad Med 49(2):132–133

    PubMed  CAS  Google Scholar 

  25. Kurzer M, Belsham PA, Kark AE (2004) Tension-free mesh repair of umbilical hernia as a day case using local anaesthesia. Hernia 8(2):104–107

    Article  PubMed  CAS  Google Scholar 

  26. Alkhoury F, Helton S, Ippolito RJ (2011) Cost and clinical outcomes of laparoscopic ventral hernia repair using intraperitoneal nonheavyweight polypropylene mesh. Surg Laparosc Endosc Percutan Tech 1(2):82–85

    Article  Google Scholar 

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Shaikh, I., Willder, J.M. & Kumar, S. Same day discharge, surgical training and early complications after open and laparoscopic repair of primary paraumbilical hernia. Hernia 17, 505–509 (2013). https://doi.org/10.1007/s10029-013-1052-4

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  • DOI: https://doi.org/10.1007/s10029-013-1052-4

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