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Laparoscopic Repair of Para-Esophageal Hernia Using Absorbable Biosynthetic Mesh

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Day case laparoscopic herniorraphy. A NICE procedure with a long learning curve.

M Lim¹, C J O'Boyle, C M S Royston

¹Division of Oesophagogastric and Minimally Invasive Surgery, Hull Royal Infirmary, Anlaby Road, Kingston upon Hull, HU3 2JZ, UK.

Surgical Endoscopy

|June 24, 2006

Summary

Day case laparoscopic herniorraphy is safe and effective, with trainee surgeons achieving consultant-level operating times after approximately 40 procedures. Patient satisfaction remains high, supporting this surgical approach.

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Area of Science:

Minimally Invasive Surgery
Surgical Outcomes
Ambulatory Surgery

Background:

Laparoscopic herniorraphy (LH) is increasingly utilized for hernia repair.
Evaluating day case LH and the influence of surgical trainees is crucial for optimizing performance.

Purpose of the Study:

To assess the safety and efficacy of day case laparoscopic herniorraphy.
To determine the impact of surgeon experience, particularly trainees, on surgical outcomes.

Main Methods:

Prospective study of ambulatory laparoscopic transabdominal preperitoneal herniorraphies.
Data collected from a dedicated day surgical unit between March 1996 and October 2003.
Comparison of operating times between consultant surgeons and higher surgical trainees.

Main Results:

840 procedures in 706 patients performed by trainees and consultants.
Trainee operating times were longer but approached consultant times after 40 procedures.
High patient satisfaction (95%), minimal pain/nausea, and low complication rates (0.1%).
93% of patients discharged within 8 hours.

Conclusions:

Laparoscopic herniorraphy is a safe and suitable day case procedure.
Surgical experience significantly influences operating time, with trainees reaching consultant benchmarks.
LH is recommended despite initial longer operating times for trainees.