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Value and patient appreciation of follow-up after endoscopic totally extraperitoneal (TEP) inguinal hernia repair

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Abstract

Purpose

There is some consensus on inguinal hernia surgery follow-up in research settings. However, consensus on regular follow-up is lacking. Therefore, patients and surgeons are unnecessarily burdened and not cost-efficient. Moreover, the purpose of follow-up is barely questioned. This study aims to evaluate follow-up after inguinal hernia repair and determine patient satisfaction.

Methods

This prospective cohort study was executed in a high-volume specialized hernia clinic. All totally extraperitoneal (TEP) repair patients between July and October 2016 were included. Telephone follow-up was performed at 1 day, 6 weeks and 1 year postoperatively. One year postoperatively it was assessed whether patients visited other healthcare organizations, had remaining inguinal complaints, a Post-INguinal-repair-Questionnaire by telephone (PINQ-PHONE) was executed, and appreciation with follow-up was determined.

Results

Respectively, 6 weeks and 1 year postoperatively, 138 (79.3%) and 130 (74.7%) of 174 included patients were reached. One year postoperatively 15 patients (11.5%) had remaining inguinal complaints, of which only four patients (3.1%) had not already reported their symptoms. Nineteen patients (14.6%) presented with self-reported complaints between 6 weeks and 1 year, and no patients went to other hospitals. Respectively, 107 (82.3%), 61 (46.9%) and 117 (90.0%) patients considered follow-up useful at 6 weeks, 1 year and in general. One hundred nineteen patients (91.5%) preferred telephone follow-up to outpatient clinic appointments.

Conclusion

TEP patients value a telephone follow-up time-point, however, long-term follow-up is not considered useful. Patients report postoperative complaints themselves, therefore performing follow-up serves no clinical purpose. The purpose of follow-up is patient satisfaction and registration for quality objectives.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

No financial funding or other sources of support were received.

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Authors and Affiliations

  1. Department of Surgery, Hernia Clinic, Diakonessenhuis, Room Secretariaat Heelkunde, Professor Lorentzlaan 76, Zeist, 3707 HL, Utrecht, The Netherlands

    W. J. Bakker, C. V. van Hessen, G. J. Clevers, E. J. M. M. Verleisdonk & J. P. J. Burgmans

Authors
  1. W. J. Bakker
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  2. C. V. van Hessen
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  3. G. J. Clevers
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  4. E. J. M. M. Verleisdonk
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  5. J. P. J. Burgmans
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Contributions

WB: Study conception and design, data collection, analysis and interpretation of data, drafting of the manuscript. CH: Study conception and design, data collection, critical revision. GC: Study conception and design, critical revision. EV: Study conception and design, critical revision. JB: Study conception and design, interpretation of data, critical revision.

Corresponding author

Correspondence to W. J. Bakker.

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Conflict of interest

Authors WB, CH, GC, EV, JB declare that they have no conflict of interests.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Ethical approval was obtained by the hospitals Ethics Board.

Informed consent

Informed consent was orally obtained by telephone from all individual participants included in the study.

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Bakker, W.J., van Hessen, C.V., Clevers, G.J. et al. Value and patient appreciation of follow-up after endoscopic totally extraperitoneal (TEP) inguinal hernia repair. Hernia 24, 1033–1040 (2020). https://doi.org/10.1007/s10029-020-02220-8

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  • DOI: https://doi.org/10.1007/s10029-020-02220-8

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