Outpatient endoscopic totally extraperitoneal inguinal hernioplasty

Abstract

Background: Endoscopic totally extraperitoneal inguinal hernioplasty (TEP) has become an established treatment for the repair of inguinal hernia but its application as an outpatient procedure has not been widely adopted. The present study was undertaken to audit the outcomes of outpatient TEP.

Patients and methods: From March 2001 to May 2003, 102 consecutive patients with 114 inguinal hernias underwent outpatient TEP. The mean age of the study population was 55 years with a male to female ratio of 100:2. Perioperative details and postoperative outcomes were prospectively evaluated and analyzed.

Results: All TEP were successfully performed. Ninety-nine patients (97%) were discharged uneventfully on the day of operation. Three patients were admitted because of ECG changes (n = 2) and dizziness (n = 1). A single patient was readmitted on postoperative day (POD) 1 because of wound pain and vomiting. All these patients recovered uneventfully. One-third of the patients did not require any analgesia during the postoperative period. Postoperative morbidity included asymptomatic seroma (n = 12), mild scrotal bruising (n = 2), and fever (n = 1). These morbidities resolved spontaneously without the need for surgical intervention. Ninety-five patients (93%) resumed normal outdoor activities within one week.

Conclusions: Outpatient TEP was safe and effective with a success rate of 97%. Postoperative pain was mild and more than 90% of the patients resumed normal outdoor activities within a week. Outpatient TEP may emerge to become the preferred method for the management of inguinal hernia.