Outpatient groin hernia repair: assessment of 9330 patients from the French "Club Hernie" database

Hernia. 2018 Jun;22(3):427-435. doi: 10.1007/s10029-017-1689-5. Epub 2017 Oct 27.


Background: Groin hernia repair (GHR) is one of the most frequent surgical interventions practiced worldwide. Outpatient surgery for GHR is known to be safe and effective.

Aim: To assess the outpatient practice for GHR in France and identify predictive factors of failure.

Method: Forty one surgeons of the French "Club Hernie" prospectively gathered data concerning successive GHR over a period of 4 years within a multicenter database.

Results: A total of 9330 patients were operated on during the period of the study. Mean age was 61.8 (1-100) years old and 8245 patients (88.4%) were males. 6974 GHR (74.7%) were performed as outpatient procedures. In 262 patients (3.6%), the outpatient setting, previously selected, did not succeed. Upon multivariate analysis, predictive factors of ambulatory failure were ASA grade ≥ III (OR 0.42, p < 0.001), bilateral GHR (OR 0.47, p < 0.001), emergency surgery for incarcerated hernia (OR 0.10, p < 0.001), spinal anesthesia (OR 0.27, p < 0.001) and occurrence of an early post-operative complication (OR 0.07, p < 0.001). The more frequent complications were acute urinary retention and surgical site collections. 2094 patients (21.5%) were not selected preoperatively for 1-day surgery.

Conclusion: More than 74% of the patients benefited from outpatient surgery for GHR with a poor failure rate. Predictive factors of outpatient GHR failure were ASA grade ≥ III, bilateral GHR, emergency surgery for incarcerated hernia, spinal anesthesia and occurrence of an early post-operative complication. Ambulatory failures were often related to social issues or medical complications. Outpatient surgery criteria could become less restrictive in the future.

Keywords: Ambulatory; Groin hernia repair; Laparoscopic groin hernia repair; Outpatient.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Ambulatory Surgical Procedures / statistics & numerical data*
  • Child
  • Child, Preschool
  • Databases, Factual / statistics & numerical data
  • Female
  • France / epidemiology
  • Groin / surgery
  • Hernia, Inguinal / epidemiology*
  • Hernia, Inguinal / surgery*
  • Herniorrhaphy / statistics & numerical data*
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Postoperative Complications / epidemiology
  • Risk Factors
  • Treatment Failure
  • Young Adult