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Abstract Background Laparoscopic inguinal hernia repair is among the most frequently performed day-case operations. Ambulatory surgery centres alleviate pressures on acute provider hospitals and reduce patient anxiety and nosocomial infection risk. However, concerns remain regarding the safety of these facilities and occurrence of complications that may require inpatient stay. Method In 2020, a dedicated day surgical unit was established in London with no inpatient beds, requiring patients to return home on the day of their operation. A prospective database was established for patients undergoing laparoscopic totally extraperitoneal inguinal hernia repair by one experienced consultant surgeon, with routine follow-up occurring at 3–6 weeks post-operatively. Results 70 patients were operated on between August 2020 and January 2024, 87%male, median age 47 years. ASA grade was 1 or 2 in all patients. There were no major complications, conversions to open, blood transfusions, admissions for overnight stay, emergency admission to hospital within 30 days, or recurrences, with a median length of follow-up of 1.4 years. 68 patients (97%) made a complication-free recovery. Superficial wound infection at the umbilical port, requiring oral outpatient antibiotics, occurred in 2 patients. Conclusion This dataset demonstrates the ability to safely perform laparoscopic inguinal hernia repair in an entirely ambulatory facility with no major complications, no conversions to open and a 0% admission rate in well-selected patients. Ambulatory units place constraints on the surgeons and anaesthetists involved and therefore must occur under strict patient selection and clinical governance. The collection and reporting of prospective safety data helps this process.
Hayward et al. (Wed,) studied this question.