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

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

Author information

Clinique de Chirurgie Digestive et Endocrinienne (CCDE), Institut des Maladies de l'Appareil Digestif (IMAD), Hôtel Dieu, CHU Nantes, Place Ricordeau, 44093, Nantes Cedex 1, France.
Chirurgie générale et Digestive, Clinique Mutualiste de l'Estuaire, Cité sanitaire, 11 boulevard Georges Charpak, 44606, Saint Nazaire, France.
Chirurgie Générale et Digestive, CMC Georges Bizet, 23 rue Georges Bizet, 75116, Paris, France.
Unité de Chirurgie Viscérale et Digestive, Hôpital Privé d'Antony, 1, Rue Velpeau, 92160, Antony, France.
EA 4725 SPHERE « methodS in Patient-centered outcomes & HEalth ResEarch » , Université de Nantes, Nantes, France.
Plateforme de Biométrie, Département Promotion de la Recherche Clinique, CHU Nantes, Nantes, France.



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.


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


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


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.


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.


Ambulatory; Groin hernia repair; Laparoscopic groin hernia repair; Outpatient


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