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Comparing functional outcomes in minimally invasive versus open inguinal hernia repair using the army physical fitness test

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Abstract

Purpose

The advantages of minimally invasive inguinal hernia repair (MIHR) over open hernia repair (OHR) continue to be debated. We compared MIHR to OHR by utilizing the Army Physical Fitness Test (APFT) as an outcome measure.

Methods

The APFT is a three-component test scored on a normalized 300 point scale taken semiannually by active-duty military. We identified 1119 patients who met inclusion criteria: 588 in the OHR group and 531 in the MIHR group. Changes in APFT scores, time on post-operative duty restrictions (military profile), and time interval to first post-operative APFT were compared using regression analysis.

Results

Postoperatively, no APFT score change difference was observed between the OHR or MIHR groups (− 7.3 ± 30 versus − 5.5 ± 27.7, p = 0.2989). Service members undergoing OHR and MIHR underwent their first post-operative APFT at equal mean timeframes (6.6 ± 5 months versus 6.7 ± 5.1, p = 0.74). No difference was observed for time in months spent on an official temporary duty restriction (military profile) for either OHR or MIHR (0.16 ± 0.16 versus 0.15 ± 0.17, p = 0.311). On adjusted regression analysis, higher pre-operative APFT scores and BMI ≥ 30 were independently associated with reduction in post-operative APFT scores. Higher-baseline APFT scores were independently associated with less time on a post-operative profile, whereas higher BMI (≥ 30) and lower rank were independently associated with longer post-operative profile duration. Higher-baseline APFT scores and lower rank were independently associated with shorter time intervals to the first post-operative APFT.

Conclusion

Overall, no differences in post-operative APFT scores, military profile time, or time to first post-operative APFT were observed between minimally invasive or open hernioplasty in this military population.

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Funding

No funding was obtained for this study.

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Authors and Affiliations

  1. Department of Surgery, Womack Army Medical Center, NC, Fort Bragg, USA

    J. D. Bozzay, J. D. Ritchie, S. R. Brown & A. J. Kaplan

  2. Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, USA

    J. D. Bozzay, J. D. Ritchie, S. R. Brown & A. J. Kaplan

  3. Department of Research, Womack Army Medical Center, Fort Bragg, NC, USA

    D. A. Nelson

  4. Department of Military and Emergency, Medicine, F. Edward Hébert School of Medicine, Consortium for Health and Military Performance, Uniformed Services University, Bethesda, MD, USA

    D. R. Clifton, D. B. Edgeworth & P. A. Deuster

  5. Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA

    D. R. Clifton & D. B. Edgeworth

Authors
  1. J. D. Bozzay
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  2. D. A. Nelson
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Correspondence to J. D. Bozzay.

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This was a retrospect and de-identified study. No patient consent was obtained nor deemed necessary by our Institutional Review Board. No animals were used for this study.

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This was a retrospect and de-identified study. No patient consent was obtained nor deemed necessary by our Institutional Review Board.

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Bozzay, J.D., Nelson, D.A., Clifton, D.R. et al. Comparing functional outcomes in minimally invasive versus open inguinal hernia repair using the army physical fitness test. Hernia 27, 105–111 (2023). https://doi.org/10.1007/s10029-022-02650-6

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  • DOI: https://doi.org/10.1007/s10029-022-02650-6

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