Perioperative Tablet-Based Telemonitoring After Abdominal Wall Hernia Surgery: Pilot Prospective Observational Cohort Study.

Alexander Gräfitsch,Philipp Kirchhoff,Ralph F Staerkle,Savas D Soysal,Philippe M Glauser,Henry Hoffmann

doi:10.2196/15672

Abstract

BackgroundHernia repairs account for millions of general surgical procedures performed each year worldwide, with a notable shift to outpatient settings over the last decades. As technical possibilities such as smartphones, tablets, and different kinds of probes are becoming more and more available, such systems have been evaluated for applications in various clinical settings. However, there have been few studies conducted in the surgical field, especially in general surgery.ObjectiveWe aimed to assess the feasibility of a tablet-based follow up to monitor activity levels after repair of abdominal wall hernias and to evaluate a possible reduction of adverse events by their earlier recognition.MethodsPatients scheduled for elective surgical repair of minor abdominal wall hernias (eg, inguinal, umbilical, or trocar hernias) were equipped with a telemonitoring system, including a tablet, pulse oximeter, and actimeter, for a monitoring phase of 7 days before and 30 days after surgery. Descriptive statistical analyses were performed.ResultsWe enrolled 16 patients with a mean overall age of 48.75 (SD 16.27) years. Preoperative activity levels were reached on postoperative day 12 with a median of 2242 (IQR 0-4578) steps after plunging on the day of surgery. The median proportion of available activity measurements over the entire study period of 38 days was 69% (IQR 56%-81%). We observed a gradual decrease in the proportion of available data for all parameters during the postoperative course. Six out of ten patients (60%) regained preoperative activity levels within 3 weeks after surgery. Overall, patients rated the usability of the system as relatively easy.ConclusionsTablet-based follow up is feasible after surgical repair of minor abdominal wall hernias, with good adherence rates during the first couple of weeks after surgery. Thus, such a system could be a useful tool to supplement or even replace traditional outpatient follow up in selected general surgical patients.

Highlights

BackgroundAs health care costs are rising worldwide, member states of the European Union spend on average 10% of their annual gross domestic products on health care [1]
General surgical procedures are a significant contributor to these expenditures; for example, approximately 20 million inguinal hernia repairs are performed annually worldwide [3]
The International Association for Ambulatory Surgery encourages that various procedures, including groin hernia repairs, be performed in an outpatient setting [5,6]

Summary

Introduction

BackgroundAs health care costs are rising worldwide, member states of the European Union spend on average 10% of their annual gross domestic products on health care [1]. Hernia repairs account for millions of general surgical procedures performed each year worldwide, with a notable shift to outpatient settings over the last decades As technical possibilities such as smartphones, tablets, and different kinds of probes are becoming more and more available, such systems have been evaluated for applications in various clinical settings. Conclusions: Tablet-based follow up is feasible after surgical repair of minor abdominal wall hernias, with good adherence rates during the first couple of weeks after surgery. Such a system could be a useful tool to supplement or even replace traditional outpatient follow up in selected general surgical patients

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