AB067. SOH25_AB_201. Inguinal hernia repairs: a retrospective national cohort study in the Republic of Ireland

Background: Inguinal hernias repairs (IHR) contribute significantly to the general surgical workload. Laparoscopic approaches, despite steeper learning curves, offer shorter recovery times and lower risk of chronic pain. This study aims to qualify the current landscape in IHR in the Republic of Ireland (ROI), and to examine outcomes between both approaches.

Methods: All IHRs performed in the ROI between 1/2017 to 9/2024 were identified retrospectively from the National Quality Assurance and Improvement System (NQAIS) database. Anonymised patient characteristics and quality indices were extracted for analysis.

Results: A total of 20,845 IHR, 72% open a 28% laparoscopic, were performed across 39 public hospitals. Patients undergoing open IHR were significantly older (3.89, P<0.001), had a significantly longer length of stay (LOS) (0.227, P<0.001) and were more likely to be readmitted within 7 (P=0.04) and 30 days (P=0.04). LOS in low volume centres was significantly longer than high volume centres (P<0.001). Patients in high volume centres were less likely to have an emergency admission in 1 year (P<0.001). Regression analysis demonstrated that older patients, emergency repairs and higher American Society of Anaesthetists (ASA) grades to be independently associated with having an open as opposed to laparoscopic IHR.

Conclusions: Despite advances in laparoscopy, open IHR remain the predominant treatment approach in the ROI. Older, more co-morbid patients and those undergoing emergency repairs are far more likely to have an open IHR.

Keywords: Inguinal hernia; hernia; totally extra-peritoneal repair; transabdominal pre-peritoneal repair; laparoscopic inguinal hernia repair