Tailor-made approach for ambulatory open groin hernia repair: our experience of over 7000 cases

Current guidelines recommend both anterior and posterior approaches for groin hernia repair; however, open preperitoneal techniques remain underrepresented due to the limited availability of large-scale data. This study evaluated the perioperative and short-term outcomes of a tailored open groin hernia repair strategy in an ambulatory setting.

This retrospective single-center study included all adult patients who underwent open groin hernia repair between April 2003 and November 2021 at a specialized ambulatory clinic in Japan. Repair techniques were individualized according to hernia morphology and patient characteristics, incorporating anterior and preperitoneal approaches. Perioperative variables, complications, chronic pain, and recurrence were analyzed descriptively using the SPSS software program.

A total of 7,424 patients with 7,516 groin hernia lesions were included in the analysis. Indirect hernias accounted for 73.8% of the lesions, and preperitoneal repair was the most frequently performed procedure (60.9%). Most procedures were performed under local anesthesia (70.7%). The mean operative time was 52.7 ± 13.5 min. Postoperative complications occurred in 0.34%, reoperation in 0.07%, and unplanned admission in 0.13%. Chronic pain was observed in three patients in the study. Recurrence occurred in 0.41% of patients at a mean follow-up of 68.1 ± 65.8 months.

Tailored open groin hernia repair can be safely implemented in a high-volume ambulatory setting, supporting individualized open strategies beyond the conventional Lichtenstein technique.