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Day case hernia repair: weak evidence or practice gap?

Anje Scarfe1, Joanna Duncan1, Ning Ma1

  • 1Research, Audit and Academic Surgery, Royal Australasian College of Surgeons, North Adelaide, South Australia, Australia.

ANZ Journal of Surgery
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Summary

Same day hernia surgery is safe and effective for most patients, reducing hospital stays. Increasing day surgery rates can improve healthcare affordability and sustainability in Australia.

Keywords:
costsday surgeryherniahernia repairmedical care

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Area of Science:

  • Surgical outcomes
  • Healthcare management

Background:

  • Significant variation exists in hospital stay lengths after hernia surgery.
  • Analysis of private insurer data highlighted these disparities.

Purpose of the Study:

  • To review factors influencing the effectiveness of day surgery for adult inguinal, femoral, and umbilical hernia repair.
  • To compare same-day hernia surgery with procedures requiring an overnight stay.

Main Methods:

  • Systematic literature search across PubMed, Embase, and Cochrane Library.
  • Inclusion of studies and clinical practice guidelines (CPGs).
  • Multi-phase screening and selection of relevant research.

Main Results:

  • Limited evidence indicates same-day hernia surgery is as safe and effective as overnight stays.
  • All identified CPGs recommend same-day procedures for most patients.
  • 3-8% of patients were ineligible for day procedures due to medical reasons, though unsuitable patient characteristics require further investigation.

Conclusions:

  • Day surgery for groin hernia repair is a safe and effective option for the majority of patients.
  • Increasing day surgery rates presents an opportunity for more sustainable and affordable hernia care.
  • Stakeholder collaboration within the private healthcare system is crucial for enhancing day surgery adoption.