Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
Surgical Endoscopy
Published in: Surgical Endoscopy 9/2015

01-09-2015

Patient-centered outcomes following laparoscopic inguinal hernia repair

Authors: Michael B. Ujiki, Matthew E. Gitelis, Joann Carbray, Brittany Lapin, John Linn, Steven Haggerty, Chi Wang, Ryota Tanaka, Ermilo Barrera, Zeeshan Butt, Woody Denham

Published in: Surgical Endoscopy | Issue 9/2015

Login to get access

Abstract

Background

Inguinal hernia repair is the most common surgery in the world. Health-related quality of life (HRQOL) outcomes are arguably the most important elements of successful repair. This study is aimed to describe short- and long-term quality of life outcomes in patients undergoing laparoscopic inguinal hernia repair.

Methods

We prospectively followed patients who underwent totally extraperitoneal laparoscopic inguinal hernia repair (TEP) as part of an Institutional Review Board-approved study. HRQOL was measured preoperatively, or 3 weeks, 6 months, and 1 year postoperatively using Short Form 36 Health Survey Version 2 (SF-36v2) and Carolinas Comfort Scale. Postoperative HRQOL scores were compared to baseline using paired t tests.

Results

Between June 2009 and February 2014, 1,175 patients underwent TEP by four surgeons. Of those, 301 patients with 388 hernias were registered in the database and followed by a research coordinator. Mean age was 56.4 ± 15.2 years and 93 % were male. Mean body mass index was 26.1 ± 3.7 kg/m2. Seventy-eight percent presented with pain, the majority of which were described as mild. Hernias were unilateral right-sided in 43 %, left-sided in 28 %, and bilateral in 29 %. Eighty-five percent were primary hernias. Average operative time was 43.5 ± 17.9 min and there were no intraoperative complications. Urinary retention occurred in 6 %. Visual analog scale at discharge was 1.9 ± 1.7. Analgesics were used an average of 2.5 ± 3.4 days and return to activities of daily living and work occurred on postoperative 5.5 ± 4.4 and 5.6 ± 3.9 days. Recurrence occurred in 2.1 %. Significant improvements between baseline and 1 year were found in role limitations due to physical health (81.5 ± 25.6 vs. 91.8 ± 19.4, p = 0.02), social functioning (87.4 ± 21.3 vs. 92.9 ± 15.3, p = 0.02), and pain (78.2 ± 19.7 vs. 86.6 ± 15.9, p = 0.007).

Conclusions

TEP results in significant improvement in HRQOL including physical health, social functioning, and pain at 1 year. On average, patients are able to return to activities of daily living and work within a week.
Literature
1.
Bay-Nielsen M, Kehlet H, Strand L, Malmstrom J, Andersen F, Wara P, Juul P, Callesen T (2001) Quality assessment of 26,304 herniorrhaphies in Denmark: a prospective nationwide study. Lancet 358:1124–1128CrossRefPubMed
2.
Rutkow I (1998) Epidemiologic, economic, and sociologic aspects of hernia surgery in the United States in the 1990s. Surg Clin N Am 78:941–951CrossRefPubMed
3.
Palmqvist E, Larsson K, Anell A, Hialmarsson C (2013) Prospective study of pain, quality of life, and the economic impact of open inguinal hernia repair. Br J Surg 100:1483–1488CrossRefPubMed
4.
Magnusson J, Videhult P, Gustafsson U, Nygren J, Thorell A (2014) Relationship between preoperative symptoms and improvement of quality of life in patients undergoing elective inguinal herniorrhaphy. Surgery 155:106–113CrossRefPubMed
5.
Bitzer E, Lorenz C, Nickel S, Dorning H, Trojan A (2008) Patient-reported outcomes in hernia repair. Hernia 12:407–414CrossRefPubMed
6.
Mathur S, Bartlett A, Gilkison W, Krishna G (2006) Quality of life assessment in patients with inguinal hernia. ANZ J Surg 76:491–493CrossRefPubMed
7.
Zieren J, Kupper F, Paul M, Neuss H, Muller J (2003) Inguinal hernia: obligatory indication for elective surgery? A prospective assessment of quality of life before and after plug and patch inguinal hernia repair. Langenbecks Arch Surg 387:417–420PubMed
8.
Lawrence K, Jenkinson C, McWhinnie D, Coulter A (1997) Quality of life in patients undergoing inguinal hernia repair. Ann R Coll Surg Engl 79:40–45PubMedCentralPubMed
9.
Post S, Weiss B, Willer M, Neufang T, Lorenz D (2004) Randomized clinical trial of lightweight composite mesh for Lichtenstein inguinal hernia repair. Br J Surg 91:44–48CrossRefPubMed
10.
Wellwood J, Sculpher M, Stoker D, Nicholls G, Geddes C, Whitehead A, Singh R, Spiegelhalter D (1998) Randomised controlled trial of laparoscopic versus open mesh repair for inguinal hernia: outcome and cost. BMJ 317:103–110PubMedCentralCrossRefPubMed
11.
Barrat C, Seriser F, Arnoud R, Trouette P, Champault G (2004) Inguinal hernia repair with beta glucan-coated mesh: prospective multicenter study (115 cases)—preliminary results. Hernia 8:33–38CrossRefPubMed
12.
Arregui M, Davis C, Yucel O, Nagan R (1992) Laparoscopic mesh repair of inguinal hernia using a preperitoneal approach: a preliminary report. Surg Laparosc Endosc 2:53–58CrossRefPubMed
13.
Singh A, Bansal V, Misra M, Kumar S, Rajeshwari S, Kumar A, Sagar R, Kumar A (2011) Testicular functions, chronic groin pain, and quality of life after laparoscopic and open mesh repair of inguinal hernia: a prospective randomized controlled trial. Surg Endosc 26:1304–1317CrossRefPubMed
14.
Abbas A, Abd Ellatif M, Noaman N, Negm A, El-Morsy G, Amin M, Moatamed A (2012) Patient-perspective quality of life after laparoscopic and open hernia repair: a controlled randomized trial. Surg Endosc 26:2465–2470CrossRefPubMed
15.
Eker H, Langeveld H, Klitsie P, Van’t Riet M, Stassen L, Weidema W, Steyerberg E, Lange J, Bonjer H, Jeekel J (2012) Randomized clinical trial of total extraperitoneal inguinal hernioplasty vs Lichtenstein repair: a long-term follow-up study. Arch Surg 147:256–260CrossRefPubMed
16.
Grant A, Scott N, O’Dwyer P (2004) Five-year follow-up of a randomized trial to assess pain and numbness after laparoscopic or open repair of groin hernia. Br J Surg 91:1570–1574CrossRefPubMed
17.
Memon M, Cooper N, Memon B, Memon M, Abrams K (2003) Meta-analysis of randomized clinical trials comparing open and laparoscopic inguinal hernia repair. Br J Surg 90:1479–1492CrossRefPubMed
18.
Myers E, Browne K, Kavanagh D, Hurley M (2010) Laparoscopic (TEP) versus Lichtenstein inguinal hernia repair: a comparison of quality-of-life outcomes. World J Surg 34:3059–3064CrossRefPubMed
19.
Dhankhar D, Sharma N, Mishra T, Kaur N, Singh S, Gupta S (2014) Totally extraperitoneal repair under general anesthesia versus Lichtenstein repair under local anesthesia for unilateral inguinal hernia: a prospective randomized controlled trial. Surg Endosc 28:996–1002CrossRefPubMed
20.
Kallianpur A, Parshad R, Dehran M, Hazrah P (2007) Ambulatory total extraperitoneal inguinal hernia repair: feasibility and impact on quality of life. JSLS 11:229–234PubMedCentralPubMed
21.
Pokorny H, Klingler A, Scheyer M, Fugger R, Bischof G (2006) Postoperative pain and quality of life after laparoscopic and open inguinal hernia repair: results of a prospective randomized trial. Hernia 10:331–337CrossRefPubMed
22.
Heniford B, Walters A, Lincourt A, Novitsky Y, Hope W, Kercher K (2008) Comparison of generic versus specific quality-of-life scales for mesh hernia repairs. JACS 206:638–644
23.
Neumayer L, Giobbie-Hurder A, Jonasson O, Fitzgibbons R Jr, Dunlop D, Gibbs J, Reda D, Henderson W (2004) Open mesh versus laparoscopic mesh repair of inguinal hernia. N Engl J Med 350:1819–1827CrossRefPubMed
24.
Hawn M, Itani K, Giobbie-Hurder A, McCarthy M Jr, Jonasson O, Neumayer L (2006) Patient-reported outcomes after inguinal herniorrhaphy. Surgery 140:198–205CrossRefPubMed
25.
Wauschkuhn C, Schwarz J, Boekeler U, Bittner R (2010) Laparoscopic inguinal hernia repair: gold standard in bilateral repair? Results of more than 2800 patients in comparison to the literature. Surg Endosc 24:3026–3030CrossRefPubMed
26.
Winslow E, Quasebarth M, Brunt L (2004) Perioperative outcomes and complications of open vs laparoscopic extraperitoneal inguinal hernia repair in a mature surgical practice. Surg Endosc 18:221–227CrossRefPubMed
27.
Koch C, Grinberg G, Farley D (2006) Incidence and risk factors for urinary retention after endoscopic hernia repair. Am J Surg 191:381–385CrossRefPubMed
28.
Staerkle R, Buchli C, Villiger P (2009) Patient satisfaction, hernia recurrence rate, and chronic pain 10 years after endoscopic total extraperitoneal inguinal hernia repair. Surg Laparosc Endosc Percutan Tech 19:405–409CrossRefPubMed
29.
Inaba T, Okinaga K, Fukushima R, Ikeda Y, Yamazaki E, Koide T, Horikawa M, Inoue T, Ogawa E (2012) Chronic pain and discomfort after inguinal hernia repair. Surg Today 42:825–829CrossRefPubMed
30.
Alfieeri S, Amid P, Campanelli G, Izard G, Kehlet H, Wijsmuller A, Di Miceli D, Doglietto G (2011) International guidelines for prevention and management of post-operative chronic pain following inguinal hernia surgery. Hernia 15:239–249CrossRef
31.
Reinpold W, Nehls J, Eggert A (2011) Nerve management and chronic pain after open inguinal hernia repair: a prospective two phase study. Ann Surg 254:163–168CrossRefPubMed
32.
Ali S, Zendejas B, Yadav S, Hernandez-Irizarry R, Lohse C, Farley D (2013) Predictors of chronic groin discomfort after laparoscopic totally extraperitoneal inguinal hernia repair. JACS 217:72–78
Metadata
Title
Patient-centered outcomes following laparoscopic inguinal hernia repair
Authors
Michael B. Ujiki
Matthew E. Gitelis
Joann Carbray
Brittany Lapin
John Linn
Steven Haggerty
Chi Wang
Ryota Tanaka
Ermilo Barrera
Zeeshan Butt
Woody Denham
Publication date
01-09-2015
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 9/2015
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-014-4011-y

Other articles of this Issue 9/2015

Surgical Endoscopy 9/2015 Go to the issue

OriginalPaper

Concomitant cholecystectomy during laparoscopic sleeve gastrectomy

Dynamic Manuscript

Indocyanine green as a near-infrared fluorescent agent for identifying parathyroid glands during thyroid surgery in dogs

OriginalPaper

Short and long-term outcomes of a randomised controlled trial of vertical periumbilical wound versus transverse left iliac fossa wound for specimen retrieval in laparoscopic anterior resections

OriginalPaper

20 years later: laparoscopic fundoplication durability

OriginalPaper

The effect of ergonomic laparoscopic tool handle design on performance and efficiency

OriginalPaper

Technique of last resort: characteristics of patients undergoing open surgery in the laparoscopic era