Our Summary

This research paper looked at the cost and short-term results of performing laparoscopic hiatal hernia repair surgery in a day (same-day surgery or SDS) compared to keeping the patient in hospital for less than 24 hours (observation or OBS) or more than 24 hours (inpatient or INP).

The study involved 262 procedures and after excluding 50 reoperative repairs, 212 procedures were included in the study: 66 were SDS, 65 were OBS and 81 were INP. The OBS and INP groups were older and had more complicated hernias (type III and IV) compared to the SDS group. The cost of performing the surgery on the same day was significantly lower with no increase in the number of emergency visits or readmissions after discharge from hospital.

The researchers concluded that most elective laparoscopic hiatal hernia repairs can be performed as same-day surgery, yielding good short-term results and lower costs.

FAQs

  1. How does the cost of same-day surgery (SDS) for laparoscopic hiatal hernia repair compare to inpatient (INP) and observation (OBS) procedures?
  2. Does performing laparoscopic hiatal hernia repair surgery on the same day increase the number of emergency visits or readmissions?
  3. What were the conclusions of the research regarding the efficacy and cost-efficiency of same-day surgery for laparoscopic hiatal hernia repair?

Doctor’s Tip

A doctor might tell a patient undergoing laparoscopic hernia repair that, based on research, it is possible to have the surgery as a same-day procedure with good outcomes and lower costs. It is important to follow post-operative care instructions and attend follow-up appointments to ensure a successful recovery.

Suitable For

Typically, patients who are recommended for laparoscopic hernia repair are those with uncomplicated hernias, such as type I or II hiatal hernias. These patients are usually younger and healthier, with a lower risk of complications during and after surgery. In this study, the researchers found that patients with more complex hernias (type III and IV) were more likely to be kept in the hospital for observation or as inpatients, rather than being discharged on the same day.

Overall, patients who are good candidates for laparoscopic hernia repair are those who are medically stable, have a lower risk of complications, and have a hernia that is suitable for minimally invasive surgery. These patients are more likely to have successful outcomes and lower healthcare costs with same-day surgery.

Timeline

Before laparoscopic hernia repair:

  • Patient undergoes a consultation with a surgeon to discuss the procedure and determine if they are a candidate for laparoscopic hernia repair.
  • Pre-operative tests and evaluations are conducted to ensure the patient is healthy enough for surgery.
  • Patient may be instructed to fast before the surgery and stop taking certain medications.
  • On the day of surgery, patient arrives at the hospital or surgical center and is prepared for the procedure.

After laparoscopic hernia repair:

  • Patient is monitored closely in the recovery room for a few hours after the surgery.
  • Patient may experience some pain, discomfort, and bloating in the days following the surgery.
  • Patient is usually discharged home the same day of the surgery, unless there are complications that require them to stay longer in the hospital.
  • Patient is advised to rest and avoid strenuous activities for a few weeks after the surgery.
  • Follow-up appointments are scheduled to monitor the healing process and ensure there are no complications.

What to Ask Your Doctor

  1. Is laparoscopic hernia repair the best option for my specific hernia?

  2. What are the potential risks and complications associated with laparoscopic hernia repair?

  3. What is the success rate of laparoscopic hernia repair in terms of long-term outcomes?

  4. How experienced are you in performing laparoscopic hernia repair procedures?

  5. Will I need to stay in the hospital after the surgery, or can it be done as a same-day procedure?

  6. What is the expected recovery time after laparoscopic hernia repair?

  7. Are there any specific post-operative care instructions or restrictions I need to follow?

  8. Will I need any follow-up appointments after the surgery?

  9. Are there any factors that may increase the likelihood of needing a longer hospital stay or experiencing complications after the surgery?

  10. Are there any alternative treatment options for my hernia that I should consider before proceeding with laparoscopic hernia repair?

Reference

Authors: Gutierrez R, Neill CO, Khanna A, Miller A, Banki F. Journal: Am J Surg. 2020 Dec;220(6):1438-1444. doi: 10.1016/j.amjsurg.2020.09.009. Epub 2020 Sep 6. PMID: 33004143