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Laparoscopic herniorrhaphy in the geriatric population

J M Velasco1, V L Vallina, D J Esposito

  • 1Department of Surgery, Rush North Shore Medical Center, Skokie, Illinois 60076, USA.

The American Surgeon
|July 9, 1998
PubMed
Summary

Laparoscopic herniorrhaphy is a safe surgical option for elderly patients, showing good recovery and low recurrence rates. This minimally invasive approach offers a viable alternative for hernia repair in this demographic.

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Area of Science:

  • Surgical Innovation
  • Geriatric Surgery
  • Minimally Invasive Procedures

Background:

  • Laparoscopic herniorrhaphy presents a controversial approach for hernia repair, especially in elderly populations.
  • Assessing the safety and efficacy of laparoscopic techniques in older patients is crucial for surgical decision-making.

Purpose of the Study:

  • To review the institutional experience with laparoscopic herniorrhaphy in patients aged 65 years and older.
  • To evaluate outcomes including complications, recurrence rates, and return to normal activity.

Main Methods:

  • Retrospective review of 110 patients aged over 65 undergoing laparoscopic herniorrhaphy between March 1992 and March 1996.
  • Data collected included demographics, American Society of Anesthesiologists (ASA) class, operative details, hospital stay, complications, and follow-up via telephone questionnaire.

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  • Both extra-abdominal and transabdominal preperitoneal approaches were utilized.

    • Main Results:

    • The mean age of patients was 73 years; 34 had bilateral and 20 had recurrent hernias.
    • The overall complication rate was 15%, with urinary retention being the most common (71% of complications).
    • The recurrence rate was 9.7%, not significantly affected by repair type or ASA class. Median return to normal activity was 7 days.

    Conclusions:

    • Laparoscopic herniorrhaphy is a safe and effective procedure for elderly patients.
    • The technique demonstrates acceptable complication and recurrence rates, facilitating a prompt return to normal activities.