Repair of small primary ventral hernias in the outpatient department: a prospective pilot study
Asmatullah Katawazai, Göran Wallin, Gabriel SandblomAbstract
Introduction
Planned repairs of primary ventral hernias are often delayed due to constrained operating theatre capacity, leading to prolonged symptoms and potential risk of incarceration/strangulation. The aim of this study was to evaluate the feasibility, perioperative tolerance, and short-term outcomes of repairing small primary ventral hernias under local anesthesia in the outpatient department (OPD) using suture repair.
Methods
This prospective, single-arm study was conducted at the Hernia Center, Region Örebro Län, Sweden, 2023–2025. Adults with primary ventral hernia <2 cm and BMI ≤30 kg/m2 were eligible. The Outpatient Department Repair (OPD-R) was performed under local anesthesia without the conventional operating theatre resources. Pain (VAS) and anxiety (VAS-A) were assessed intraoperatively and postoperatively, with follow-up at one week, one month, and six months.
Results
Thirty-seven patients underwent OPD-R. Age ranged from 32 to 79 years. Mean hernia defect size was 1.2 cm (range 0.3–1.9). Perioperative pain was low (mean VAS 1.0), immediate postoperative pain was low (mean VAS 0.2), and pain decreased over time with near-zero pain at six months (mean VAS 0.05). Mean perioperative anxiety (VAS-A) was 8.5/100 with variability across patients. All procedures were completed in the outpatient setting and patients were discharged without need for postoperative admission or observation. Patient satisfaction was high (mean 8.6/10), and postoperative pain/discomfort was low (mean 2.3/10; range 1–6).
Discussion
Outpatient department repair of selected small primary ventral hernias under local anesthesia is feasible and well tolerated in this pilot cohort. Larger studies, including comparative designs, are needed to evaluate long-term outcomes and recurrence.