Hrishikesh P Salgaonkar, Sujith Wijerathne, Davide Lomanto. NATIONAL UNIVERSITY HOSPITAL SINGAPORE
Background: Elderly population comprises a major proportion of population in developed countries. This leads to an unprecedented impact on the health care system. Inguinal hernia repair is a commonly carried out operation in elderly population with significant health care cost. Advanced age today is no longer considered a contraindication for laparoscopy. In fact recent literature shows a reduced risk of surgical site infections with laparoscopic surgery in elderly patients in addition to established benefits of any minimal invasive approach.
Methods: From January 2013 to April 2016 all patients 65 years and above who underwent laparoscopic repair of inguinal hernia were prospectively studied. A retrospective review of prospectively collected data was done. Total 130 patients underwent laparoscopic repair. Data measured included patient demography, associated co-morbid conditions, operative technique and time, intra and postoperative complications, hospital stay and recovery.
Results: In all 130 (5 females and 125 males) patients underwent laparoscopic inguinal hernia repair. 73 patients had bilateral and 57 unilateral hernia. Mean patient age was 72.7 years (range 65-93 years). Most common co-morbid conditions were hypertension (50), hyperlipidemia(30), diabetes mellitus(19), ischaemic heart disease(13), cerebro-vascular disease(5), chronic kidney disease(4) and asthma(4). Average operative time was 64.61 minutes in unilateral and 90.08 minutes in bilateral hernias. 14 patients were operated on a day care basis. In the remaining 116 patients mean hospital stay was 1.24 days (range 1-9 days). Mean follow up was 7.69 months. There were no major intra-operative complications. Seroma (11 patients) was the most common post-operative complication, followed by bruising (5), hematoma (2) and superficial wound infection (1). Patients with hematoma formation were on aspirin/warfarin, both managed conservatively.
Conclusion: Laparoscopic inguinal hernia repair in experienced hands is a safe and feasible operation in elderly population who are fit to withstand general anesthesia. It offers all the well-established benefits of a minimally invasive approach, such as early recovery after surgery, shorter hospital stay, reduced pulmonary complications and risk of wound infection.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 80813
Program Number: P040
Presentation Session: Poster (Non CME)
Presentation Type: Poster
