¿Se puede incluir la técnica laparoscópica extraperitoneal para el tratamiento de la hernia inguinal en un programa de cirugía mayor ambulatoria sin ingreso?
CAN EXTRAPERITONEAL LAPAROSCOPY BE EMPLOYED IN THE TREATMENT OF INGUINAL HERNIA IN A PROGRAM OF AMBULATORY MAJOR SURGERY?
Introduction. Laparoscopic treatment of inguinal hernias usually involves general anesthesia and a hospital stay. We assessed the possible utility of this technique in a day surgery unit using regional anesthesia. Patients and method. The outcomes of 30 patients who underwent totally extraperitoneal laparoscopic inguinal hernia surgery in an ambulatory setting with regional anesthesia were analyzed. The surgical technique is described in detail. Results. The mean operative time was 40 minutes (range: 20 to 65 minutes) and the mean length of the stay in the unit was 6 hours (range: 4 to 8 hours). None of the patients had to be admitted to the hospital. The mean length of the hospital stay was 6 hours (range: 4 to 8 hours). The only complication was a case of hematoma. Eight patients required analgesia while in the day unit and only 4 continued to need it after the first 24 postoperative hours. The degree of patient satisfaction was considered to be excellent in 86.6% of cases. The patients returned to their normal daily activities after a mean interval of 3.5 days and to work after 12.5 days. Conclusions. Preperitoneal laparoscopic surgery can be performed under regional anesthesia in an outpatient setting, within an ambulatory major surgery program, with excellent results and acceptance on the part of the patient.
Hernia inguinal, Hernioplastia laparoscópica extraperitoneal, Cirugía mayor ambulatoria, Anestesia regional
Inguinal hernia, Extraperitoneal laparoscopic hernia repair, Ambulatory major surgery, Regional anesthesia