Groin hernia repair is performed increasingly more often as an outpatient procedure across the world. However, the rates are extremely different and vary between below 10% and above 90%. The outpatient procedure appears to negatively impact the proportion of laparo-endoscopic repairs. To date, only very few studies have compared inpatient vs outpatient groin hernia repair.
All outpatient and inpatient primary elective unilateral groin hernia repairs performed between 2010 and 2019 were identified in the Herniamed Registry and their treatment and outcomes compared.
The 737 participating hospitals/surgeons performed a total of 342,072 primary elective unilateral groin hernia repairs from 2010 to 2019. The proportion of outpatient repairs was 20.2% in 2013 and 14.3% in 2019. Whereas the proportion of laparo-endoscopic repairs among the inpatient cases was 71.9% in 2019, the last year for which data are available, it was only 34.3%.for outpatient repairs. In outpatient groin hernia repairs, the rates of patients aged ≥ 60 years, with ASA score III and IV and risk factors were highly significantly lower. Given this rigorous patient selection for outpatient groin hernia repair, a more favorable perioperative outcome was achieved. At 1-year follow-up there were no significant differences in the pain and recurrence rates.
With an appropriate patient selection, outpatient primary elective unilateral groin hernia repair can be performed with acceptable risks and good outcomes. Since to date no studies have compared inpatient vs outpatient groin hernia repair, the impact of a higher rate of outpatient groin hernia repair cannot currently be evaluated.
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Conflict of interest
Dr. Köckerling reports grants to fund Herniamed from Johnson & Johnson, Norderstedt, Karl Storz, Tuttlingen, pfm medical, Cologne, Dahlhausen, Cologne, B Braun, Tuttlingen, MenkeMed, Munich, Bard, Karlsruhe. Personal fees from Bard, Karlsruhe, outside the submitted work. All other authors have nothing to disclose.
Only cases of routine hernia surgery were documented in the Herniamed Registry and all patients have signed a special informed consent declaration agreeing to participate. The Herniamed Registry has ethical approval (BASEC Nr 2016-00123, 287/2017BO2).
Human and animal rights
This article does not contain any study with animals performed by any of the authors.
All patients with routine hernia surgery documented in the Herniamed Registry have signed an informed consent declaration agreeing to participate.
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Köckerling, F., Lorenz, R., Reinpold, W. et al. What is the reality in outpatient vs inpatient groin hernia repair? An analysis from the Herniamed Registry. Hernia 26, 809–821 (2022). https://doi.org/10.1007/s10029-021-02494-6