OC-107 IMPLEMENTATION OF LAPAROSCOPIC INGUINAL HERNIA REPAIR IN A LOCAL HOSPITAL. 2 YEARS’ EXPERIENCE AND CHALLENGES

Abstract

Abstract Background More than 30 years have passed since the first laparoscopic inguinal hernioplasty but nowadays less than 5% of patients are currently operated by this technique as recent Spanish national data suggest. Objective To present our experience 2 years after implementation of laparoscopic inguinal hernioplasty in our local hospital and highlight the challenges we faced. Methods Our hospital deals with a high volume of abdominal wall surgery and has more than 20 years experience in ambulatory surgery. A multidisciplinary clinical pathway was implemented. Strict selection criteria were established and pelvitrainer sessions were done. Results From January 2021 until December 2022, 196 laparoscopic repairs were performed: 167 transabdominal preperitoneal (TAPP), 29 totally extraperitoneal (TEP). The main challenge was the learning curve. 5 surgeons with experience in laparoscopic surgery were trained. Until now 2 completed their learning curve for TAPP and began training in TEP approach while the others still need senior assistance. The duration of laparoscopic hernioplasty, the need for deep relaxation and the increased carbon dioxide absorption were the biggest concerns for the Anesthesia team. The cost of new materials could be afforded, even though different sutures and types of mesh fixation devices were used until getting the non-invasive one. Surgical outcomes were good, with few minor complications. Moreover the outpatient rate could be maintained but the average time in waiting list for laparoscopic approach was increased. Conclusion The implementation of a laparoscopic hernioplasty program is feasible and safe but faces many challenges, especially due to long learning curve.