Ambulatory surgery, also known as outpatient or same-day surgery, is an operation that allows a person to go home on the same day that the surgical procedure is performed. According to 2010 information released from the Society of American Gastrointestinal Endoscopic Surgeons, approximately 600,000 hernia repair operations are performed annually in the United States. Many are performed by the conventional "open" method, while others are performed via a minimally-invasive laparoscopy. About 90 percent of these operations are ambulatory surgeries.
Hernias
A hernia is an opening or weakness in the wall of a muscle, tissue, or membrane that normally holds an organ in place. While hernias can occur throughout the body, the most common location is the abdomen. According to the American College of Surgeons, more than 70 percent of all abdominal hernias are inguinal hernias. Inguinal hernias occur when soft tissue---usually part of the intestine---protrudes through the weak point in the lower abdominal wall. Inguinal hernias can occur any time from infancy to adulthood, and are more common in males than females.
Symptoms
The primary symptom is a bulge or swelling near the groin. The bulge is more noticeable when standing upright. Hernias usually cause an ache or pain in the abdomen that tends to worsen with heavy lifting or coughing. Some inguinal hernias don't cause any symptoms, but are discovered during a routine physical exam.
Surgical Repair
According to the National Institutes of Health, there are two types of hernia operations: open and laparoscopic. In the conventional herniorrhaphy, referred to as "open" surgery, the surgeon makes an incision in the groin, moves the hernia back into the abdomen, and reinforces the muscle wall with stitches. The area of muscle weakness is reinforced with a synthetic mesh or screen to provide additional support---a procedure called hernioplasty.
In laparoscopic surgery, the surgeon makes several small incisions in the lower abdomen and inserts a laparoscope---a thin tube with a tiny video camera attached to one end. The camera sends a magnified image from inside the body to a monitor, providing a close-up view of the hernia and surrounding tissue. While viewing the monitor, the surgeon repairs the hernia using synthetic mesh.
Recovery
Recovery varies depending on the size of the hernia, the technique used, and the age and health of the patient. The National Institutes of Health reports that complications from inguinal hernia surgery are rare, but include general anesthesia complications, hernia recurrence, bleeding, wound infection, a painful scar and injury to internal organs.
Advantages/Disadvantages
Studies comparing open surgery to lapraroscopic surgery have found no significant differences in long term outcomes. Open surgery is performed primarily using local or spinal anesthetics. Because lapraroscopic repairs must be done under general anesthesia, there may be an increased risk of complications. Advantages of minimally invasive surgery include decreased risk of infection, less bleeding, less discomfort and scarring after surgery and a quicker return to normal activities--most people are back to work within a few days.
