RecruitingACTRN12625000458437

Improving Access to Hernia Surgery: A Study of Same-Day Procedures in Public Hospitals

Same-Day Abdominal Wall and Groin Hernia Surgery in Adults: A Prospective Cohort Study Evaluating a Public Short-Stay Model

Sponsor

Canterbury Hospital

Enrollment

352 participants

Start Date

Sep 1, 2023

Study Type

Observational

Conditions

Groin Hernia Abdominal wall hernia Inguinal Hernia

Summary

This study aims to evaluate the effectiveness of a dedicated short-stay hernia surgery service for adults undergoing elective repair of abdominal wall or groin hernias. The intervention involves performing laparoscopic or open surgical hernia repairs as same-day procedures, focusing on minimally invasive techniques and intraoperative nerve blocks to support early recovery. The study will assess postoperative outcomes, including complications and quality of life, through structured follow-up at 4 weeks and 12 months. The hypothesis is that same-day hernia surgery will improve access to care and patient outcomes in the public healthcare setting.

Eligibility

Sex: MalesMin Age: 18 YearssMax Age: 75 Yearss

Inclusion Criteria7

Adults aged 18 to 75 years
Diagnosed with an uncomplicated abdominal wall or groin hernia (inguinal, femoral, umbilical, or small ventral hernia)
ASA Physical Status I–II
BMI < 40
Medically suitable for same-day discharge based on anaesthetic assessment
Able to understand and consent to surgery and follow-up
Social supports in place to facilitate recovery at home post-discharge

Exclusion Criteria9

Age > 75 years
Complex hernias (e.g., recurrent, strangulated, incarcerated, or requiring mesh explant)
ASA Physical Status IIIb or higher
BMI > or = 40
Significant comorbidities requiring inpatient monitoring (e.g., unstable cardiovascular or respiratory disease, insulin-dependent diabetes with complications)
Requirement for anticoagulation therapy that cannot be safely managed perioperatively
Inadequate social support at home post-discharge
Inability to understand study procedures or comply with follow-up
Patients undergoing concurrent procedures or requiring overnight admission for other clinical reasons

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Interventions

Participants underwent elective repair of abdominal wall or groin hernias (inguinal, femoral, umbilical, or ventral) through a dedicated short-stay hernia surgery service. This service represents the

Participants underwent elective repair of abdominal wall or groin hernias (inguinal, femoral, umbilical, or ventral) through a dedicated short-stay hernia surgery service. This service represents the standard model of care at our institution and is not an intervention specific to the study. All eligible patients received either laparoscopic or open hernia repair as a planned same-day procedure, with admission and discharge occurring within the same calendar day. The care pathway emphasized minimally invasive techniques and the use of intraoperative nerve blocks to facilitate early recovery and discharge. Patients were selected for this pathway based on predefined clinical criteria, including age between 18 and 75 years, body mass index (BMI) under 40, and a low burden of comorbidities. Participation in the study involved no deviation from standard care. Data were collected as part of routine clinical follow-up at 4 weeks and 12 months postoperatively to assess surgical complications and patient-reported quality of life.