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Day hospital for incisional hernia repair: selection criteria
M Donati1, L Gandolfo, A Privitera
1Department of Surgical Sciences and Organ Transplant, Hernia Service, Catania, Italy.
Aim:
The authors report their experience with incisional hernia repair and set criteria for the safe performance of the procedure on a day hospital basis.
Materials And Methods:
From January 1994 to July 2005, 29 day hospital procedures for incisional hernia were performed under local anaesthesia. Selection criteria included: a hernial defect < 10 cm, a reducible hernial sac and negative history for obstructive symptoms. The repair was achieved with a polypropylene plug in defects < 3 cm and a double layer mesh in larger defects.
Results:
All patients were discharged within 7 hours of surgery. Postoperative pain was mild and required hospital analgesia in 30% of cases. Back at home analgesia was needed in only three patients (10%). Six patients (20%) developed a seroma that reabsorbed spontaneously. During a follow-up ranging 6 to 120 months (mean 75), no recurrence has been recorded.
Conclusions:
In selected patients, incisional hernia repair as day hospital procedure is feasible, safe and absolutely effective. The use of polypropylene plugs and meshes accounts for a sound repair with low risk of complications.
