1044 Feasibility of Anterior Abdominal Wall Hernia (Excluding Groin Hernia) Repair Under Local AnaestheticA Naseer, M Elkorety, J Tan, A Rajput, T Bhatti
Abdominal wall herniae (AWH) are usually performed under general anaesthetic, with limited literature on repair under local anaesthetic (LA). Local anaesthetic procedures may require higher surgical expertise which may compromise learning opportunities for trainees. We aim to explore the feasibility of performing AWH repairs under LA by evaluating patient satisfaction, impact on training opportunities and resource implications.
Consecutive patients were counselled for AWH repair under LA and informed consent was obtained, with no exclusions based on BMI, type and size of the hernia. Surgery was performed by a trainee under supervision or a consultant. Ease of agreement to have surgery under LA, apprehension, pain and overall satisfaction with the procedure were assessed using a five-point Likert scale. Procedure duration and time to discharge were compared with the conventional general anesthetic procedures within the unit.
Twenty patients underwent day-case AWH repair under LA. All patients agreed to surgery under LA. Nineteen (95%) patients reported no pain or apprehension during the procedure. Eighteen (90%) were happy or satisfied with the overall experience. Sixteen (80%) procedures were performed by a trainee. There was a median of 23 minutes less for theatre time and 62 min less for recovery time with LA. No postoperative problems were reported.
It is feasible to treat majority of abdominal wall herniae under LA, with high overall patient satisfaction, without compromising training opportunities. There are potential cost-savings by reduced theatre and recovery time utilization.