A Description of 110,808 Patients Who Underwent 131,639 Inguinal Hernia Repairs Within an Integrated Healthcare System Over the Past Decade

Abstract

Introduction: The aim of this study was to describe a US cohort of patients who underwent inguinal hernia repair within an integrated healthcare system (IHS) and to report incidence of outcomes. Methods: All patients aged ≥18 years who underwent first inguinal hernia repair by a surgeon, regardless of case volume and surgical subspecialty, were identified (2010-2020). Patient characteristics, demographics, and surgical characteristics were described using frequencies, proportions, means, and standard deviations. Crude incidence rates for 90-day emergency department (ED) visits and readmission are reported. Cumulative incidence of ipsilateral reoperation and overall mortality was calculated using survival analysis. Results: A total of 110,808 patients underwent 131,629 inguinal hernia repairs during the study years; procedures were performed by 897 surgeons at 36 hospitals in the US. Annual volume exceeded 10,000 procedures per year. Most repairs were open (65.4%), followed by laparoscopic (33.5%) and robotic (1.1%). 32.3% were bilateral repairs. Overall, 8.2% of patients had an ED visit and 2.2% had a readmission. Incidence of reoperation at 5- and 10-years of follow-up was 2.4% (95% confidence interval [CI]=2.3-2.5) and 3.4% (95% CI=3.3-3.6), respectively; reoperation rates were similar across surgical groups. Mortality at 1-year follow-up was 0.4% (95% CI=0.4-0.5%), 1.5% (95% CI=1.4-1.6), and 0.6% (95% CI=0.3-1.2) for laparoscopic, open, and robotic approaches, respectively. Conclusion: With this study and future studies, we hope to better define patients undergoing inguinal hernia repair and identify risk factors for complication and gain a better understanding of the risks and benefits of the procedure.