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Ambulatory Hernia Surgery

  • R. Lorenz
Chapter

Abstract

The chapter will give an overview about the existing literature about ambulatory hernia surgery with definition, history, evidence, international comparison and guidelines.

Already the ambulatory surgery terminology shows some differences internationally. In many countries, the term ambulatory surgery means that the patient spends the night before and after the operation at home.

Outpatient inguinal hernia surgery has become increasingly popular internationally in recent decades. Since 1955 exist various publications about the advantages of outpatient inguinal hernia surgery with faster mobilisation, high patient satisfaction and lower costs.

Most surgeons agree that today the majority of inguinal hernias can be done as a day case if appropriate home care is ensured. There are no restrictions even in endoscopic procedures, in patients over the age of 65 years, in patients with obesity or in the presence of comorbidities.

In many European countries, there has been a steady rise in the proportion of outpatient inguinal surgery operations. The proportion of outpatient hernia operations thus varies between 0 and 80%. In most countries, however this is no systematic recording of all the operations.

Healthcare financing and reimbursement appear to have a decisive influence on outpatient surgery.

We have also analysed the current data from the German hernia registry Herniamed to compare day case hernia cases with hospital cases. There seem to be not any significant differences in complication rates, in pain or in recurrence rates between the two sectors. Overall the analysis permits the conclusion that outpatient inguinal hernia surgery can be performed without significant detriment for the patients.

Notes

Acknowledgment

R. Lorenz declares the following conflicts of interest: C. R. BARD: Consultant for Speakers Bureau, Hands-On Hernia Training Courses.

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Hernia Center 3+CHIRURGENBerlinGermany

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