Laparoscopic hiatal hernia repair as same day surgery: Feasi
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•Feasibility of laparoscopic hiatal hernia repair in the same day surgery.
•Good short- term outcomes for same day surgery compared to observation and inpatient setting.
• Reduced costs for same-day surgery compared to observation and inpatient setting.
• Importance of a trained surgical team and application of a series of measures in the preoperative, intraoperative, and postoperative phases to facilitate discharge.
• Implementation of a simple ERAS protocol aimed to decrease perioperative pain and nausea.

Laparoscopic hiatal hernia repair is commonly performed with 1-night hospitalization. The aim was to assess repairs as same-day-surgery (SDS). Costs/short-term outcomes of SDS were compared to hospital-stay less than 24-hours: observation (OBS) and hospital-stay equal to or more than 24-hours: inpatient (INP). Outcomes were assessed by postoperative 30-day ER visits/readmissions.

There were 262 procedures, excluding 50 reoperative repairs, 212 procedures were included: There were 66 SDS, 65 OBS, and 81 INP. SDS vs. OBS: OBS were older, had higher ASA, less type I and more type III and IV hernias. Costs were significantly less in the SDS group with no difference in post-operative ER visits/post-discharge readmissions. SDS vs. INP: INP were older, had higher ASA, less type I and more type III and IV hernias. Costs were significantly less in the SDS group with no difference in post-operative ER visits/post-discharge readmissions. Laparoscopic hiatal hernia repair can be performed as SDS in the majority of elective repairs with good short-term outcomes and reduced cost.

Source:https://www.americanjournalofsurgery.com/article/S0002-9610(20)30576-6/fulltext
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