<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT04504461</url>
  </required_header>
  <id_info>
    <org_study_id>5614</org_study_id>
    <nct_id>NCT04504461</nct_id>
  </id_info>
  <brief_title>Ambulatory Laparoscopic Inguinal Hernioplasty: Feasibility and Cost Analysis</brief_title>
  <official_title>Ambulatory Laparoscopic Inguinal Hernioplasty: Feasibility and Cost Minimization Analysis in a South American Hospital</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>Hospital Italiano de Buenos Aires</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
  </sponsors>
  <source>Hospital Italiano de Buenos Aires</source>
  <oversight_info>
    <has_dmc>No</has_dmc>
    <is_fda_regulated_drug>No</is_fda_regulated_drug>
    <is_fda_regulated_device>No</is_fda_regulated_device>
  </oversight_info>
  <brief_summary>
    <textblock>
      Laparoscopic inguinal hernia repair has become one of the elective techniques, attributing&#xD;
      the advantages of minimally invasive procedures to it. However, the high costs related to the&#xD;
      need for hospitalization and materials make them a limitation at the time of its indication.&#xD;
&#xD;
      The objective is to evaluate the feasibility of performing this procedure in an outpatient&#xD;
      surgery center and the cost analysis of an outpatient procedure regarding the same in the&#xD;
      setting of hospitalization.&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      A retrospective analysis was performed on a prospective database in which all patients older&#xD;
      than 18 years were included, in which a laparoscopic inguinal hernioplasty was performed in&#xD;
      the period between August 2015 and June 2018 in the unit of ambulatory surgery of the&#xD;
      Hospital Italiano de Buenos Aires. The same corresponds to an autonomous unit controlled by a&#xD;
      health facility with hospitalization, as established by the Asociación Argentina de Cirugía&#xD;
      in the Organization Guide and procedures in Ambulatory Surgery.&#xD;
&#xD;
      Laparoscopic repair using a transabdominal preperitoneal technique (TAPP) was proposed for&#xD;
      patients with a clinical diagnosis of bilateral inguinal hernia or a recurrent unilateral&#xD;
      hernia operated primarily through the anterior approach following the indications for&#xD;
      laparoscopic surgery proposed by the European Hernia Society&#xD;
&#xD;
      The demographic data of the patients considered for this study were: age, gender, body mass&#xD;
      index (BMI), anesthetic risk according to ASA (American Society of Anesthesiologists) score,&#xD;
      comorbidities, bilateral primary or unilateral recurrent hernia, history of previous&#xD;
      abdominal surgeries and associated midline hernias The details of the surgical procedure and&#xD;
      the ambulatory surgery regimen, as well as possible postoperative complications, were&#xD;
      explained to all patients in the preoperative consultation and an informed consent was&#xD;
      signed.&#xD;
&#xD;
      The anesthetic technique was the same for everyone. The patients were operated under general&#xD;
      anesthesia. Anesthetic induction was performed with propofol 2 mg / kg EV and fentanyl 2 ug /&#xD;
      kg EV. Rocuronium 0.6 mg / kg EV was used to facilitate laryngeal mask placement. The&#xD;
      anesthetic level was maintained with air, oxygen, sevoflorane at 1.5% expired and with&#xD;
      remifentanil (0.25 at 0.5 ug / kg / min) based on the demand of the patient's plan. It was&#xD;
      ventilated mechanically in controlled mode. As intraoperative analgesia, ketorolac 1 mg / kg&#xD;
      according to renal function or diclofenac 1 mg / kg was used in patients with a history of&#xD;
      bronchospasm. This was associated with 8 mg of dexamethasone. Antibiotic prophylaxis during&#xD;
      anesthetic induction was performed with cefazolin 2 gr / kg EV.&#xD;
&#xD;
      In 100% of the cases, the surgical technique used was TAPP. The patient was asked to urinate&#xD;
      prior to the transfer to the operating room to avoid the placement of a urinary catheter.&#xD;
&#xD;
      With the patient in the supine position, pneumoperitoneum was performed by umbilical scar&#xD;
      with closed Veress needle technique. The abdomen was insufflated with a pressure of 12 mmHg.&#xD;
      A 10-mm trocar was placed at the umbilical level and two 5-mm trocars were placed on both&#xD;
      flanks outside the rectus sheath. In the event that the patient presents with an associated&#xD;
      midline hernia, optic trocar was inserted due to hernia defect. It was approached first on&#xD;
      one side and then on the contralateral side. After the opening of the peritoneum, dissection&#xD;
      of the preperitoneal space and reduction of the hernial content, a polypropylene mesh&#xD;
      (Prolene®, Ethicon Johnson &amp; Johnson) of 15 x 12 centimeters was placed covering the&#xD;
      myopectineal orifice from the symphysis pubis medially, until the anterosuperior iliac spine&#xD;
      laterally. In patients with bilateral hernia, two meshes were placed, one on each side&#xD;
      respectively, surpassing the midline. The mesh was fixed with tuckers made of resorbable&#xD;
      material (Securetrap®) or unabsorbable material (Protack®) according to the preference of the&#xD;
      surgeon in charge of the procedure. The peritoneum was closed with continuous suture of slow&#xD;
      absorbable material (Vycril®) or slow reabsorbed barb suture (Stratafix®). Local infiltration&#xD;
      of all wounds was performed with ropivacaine at a dose of 3 mg / kg.&#xD;
&#xD;
      Surgical time was recorded as intraoperative variables, which was defined as minutes from the&#xD;
      preparation of the surgical site to the closure of the skin; the type of hernia according to&#xD;
      Nyhus classification and the presence of intraoperative complications.&#xD;
&#xD;
      At the end of the procedure, the patients were transferred to the recovery room. During the&#xD;
      postoperative recovery an analgesic scheme was stipulated according to need. The rescues were&#xD;
      made according to the evaluation of the nurse and the treating anesthetist and consisted of&#xD;
      the following levels:&#xD;
&#xD;
        -  First level: ketorolac 30 mg EV or diclofenac 75 mg EV. In patients with decreased&#xD;
           glomerular filtration, paracetamol 1000 mg EV was used.&#xD;
&#xD;
        -  Second level: morphine 1 - 3 mg EV. When the requirements of the ambulatory surgery&#xD;
           guide of the Asociación Argentina de Cirugía listed in table N° 1 were fulfilled, the&#xD;
           patient was discharged from hospital. The same was in charge of the responsible surgeon,&#xD;
           who delivered the postoperative indications verbally and in writing, confirming the&#xD;
           understanding of them by the patient and the companion.&#xD;
&#xD;
      The length of stay in the unit was recorded, as well as the need to administer analgesics&#xD;
      during the same and pain according to the visual analog scale (EVA) at discharge.&#xD;
&#xD;
      Feasibility is expressed as the percentage of patients who were referred from the outpatient&#xD;
      surgery unit.&#xD;
&#xD;
      The data about postoperative complications were collected prospectively through ambulatory&#xD;
      controls previously stipulated at 7, 30, 180 and 360 days. They are classified into early (up&#xD;
      to 30 days of the procedure) and late. The first included seroma, surgical site infection and&#xD;
      hematoma; and late trocar hernias, recurrence and postoperative pain. Chronic postoperative&#xD;
      pain is one that persists beyond the third month after the procedure.&#xD;
&#xD;
      In the first ambulatory control consultation at 7 days, patients were asked to rate their&#xD;
      level of satisfaction with the procedure by choosing one of the four categories: not&#xD;
      satisfied, not very satisfied, satisfied and very satisfied For the study of costs in&#xD;
      addition to outpatients, those patients who underwent laparoscopic inguinal hernia in the&#xD;
      inpatient setting during the period analyzed were included in the analysis. In this way, two&#xD;
      branches of study were drawn up, one corresponding to patients operated on an outpatient&#xD;
      basis and the other to patients operated through a hospital regimen.&#xD;
&#xD;
      Being a surgical procedure performed under a different hospital regime, a cost minimization&#xD;
      study was carried out taking the average cost of performing an ambulatory procedure versus&#xD;
      the same requiring admission.&#xD;
&#xD;
      When considering the economic situation of the República Argentina in the time under study&#xD;
      (devaluation of the peso argentino weight of 100% and inflation of approximately 30% per&#xD;
      year), continuous patients operated between December 2016 and April 2017 were taken, which&#xD;
      represents the average of the period under study, as representative samples of each branch.&#xD;
      For each patient, the surgical time, the persistence time in the ambulatory anesthetic&#xD;
      recovery room or the hospitalization room, and the time of postoperative hospitalization were&#xD;
      recorded in a database.&#xD;
&#xD;
      The materials used during surgery and anesthesia were previously standardized so that all the&#xD;
      patients who underwent this procedure used the same resources.&#xD;
&#xD;
      The cost department of the Hospital Italiano de Buenos Aires was responsible for collecting&#xD;
      the costs of each of these patients. They were divided into fixed costs per procedure, per&#xD;
      hour/operating room, per hour in the ambulatory surgery recovery room, per hour in the&#xD;
      recovery room of the central operating room and per day of hospitalization.&#xD;
&#xD;
      The costs were calculated in Argentine Pesos (AP) and converted into US Dollars (USD) taking&#xD;
      into account the exchange rate in January 2017: 1 USD = 16.30 PA.&#xD;
&#xD;
      The categorical data were described as percentages and the quantitative data as mean and&#xD;
      standard deviation or median and interquartile range according to the observed distribution.&#xD;
      To compare means of quantitative variables, Student's t-test or Mann-Whitney U test was used&#xD;
      according to the observed distribution. Chi-square or Fisher's test was used for the rest of&#xD;
      the variables. A p &lt;.05 was considered significant.&#xD;
&#xD;
      Regression models were constructed to adjust for confounding potentials.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Completed</overall_status>
  <start_date type="Actual">August 1, 2015</start_date>
  <completion_date type="Actual">July 30, 2019</completion_date>
  <primary_completion_date type="Actual">June 30, 2018</primary_completion_date>
  <study_type>Observational</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <observational_model>Cohort</observational_model>
    <time_perspective>Retrospective</time_perspective>
  </study_design_info>
  <primary_outcome>
    <measure>Incidence of surgical Complications</measure>
    <time_frame>Patients follow up is 12 month</time_frame>
    <description>Incidence of seroma, Incidence of hematoma, % of reoperation, incidence of wound infection</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Costs of the procedure</measure>
    <time_frame>One month after surgery</time_frame>
    <description>Cost of laparoscopic hernioplasty in ambulatory surgery center. Cost of laparoscopic hernioplasty when required hospital stay</description>
  </primary_outcome>
  <number_of_groups>2</number_of_groups>
  <enrollment type="Actual">116</enrollment>
  <condition>Inguinal Hernia</condition>
  <arm_group>
    <arm_group_label>Laparoscopic Inguinal Hernioplasty. Ambulatory</arm_group_label>
    <description>Laparoscopic Inguinal Hernioplasty performed in ambulatory surgery center</description>
  </arm_group>
  <arm_group>
    <arm_group_label>Laparoscopic Inguinal Hernioplasty. Hospital Stay</arm_group_label>
    <description>Laparoscopic Inguinal Hernioplasty that have to stay at least 24 hours at the hospital</description>
  </arm_group>
  <intervention>
    <intervention_type>Other</intervention_type>
    <intervention_name>Analysis of feasibility and costs</intervention_name>
    <description>Analyze the feasibility and costs of performing laparoscopic inguinal hernioplasty in an ambulatory surgery center</description>
    <arm_group_label>Laparoscopic Inguinal Hernioplasty. Ambulatory</arm_group_label>
    <arm_group_label>Laparoscopic Inguinal Hernioplasty. Hospital Stay</arm_group_label>
  </intervention>
  <eligibility>
    <study_pop>
      <textblock>
        Patients older than 18 with no major comorbidities that required a laparoscopic inguinal&#xD;
        hernioplasty&#xD;
      </textblock>
    </study_pop>
    <sampling_method>Non-Probability Sample</sampling_method>
    <criteria>
      <textblock>
        1. Inclusion Criteria:&#xD;
&#xD;
               -  Patients older than 18 years old&#xD;
&#xD;
               -  Laparoscopic inguinal hernioplasty as the pincipal surgery&#xD;
&#xD;
          2. Exclusion Criteria:&#xD;
&#xD;
               -  Patients with, high anesthetic risk (decompensated ASA III and ASA IV)&#xD;
&#xD;
               -  Morbid obesity (higher BMI 40),&#xD;
&#xD;
               -  Sleep apnea with indication of use of CPAP (Continuous Positive Airway Pressure)&#xD;
&#xD;
               -  Medicated psychiatric disease,&#xD;
&#xD;
               -  Drug-dependent patient&#xD;
&#xD;
               -  Patients with an inadequate social environment-&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>18 Years</minimum_age>
    <maximum_age>N/A</maximum_age>
    <healthy_volunteers>No</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Scaravonati</last_name>
    <role>Principal Investigator</role>
    <affiliation>Hospital Italiano de Buenos Aires</affiliation>
  </overall_official>
  <location>
    <facility>
      <name>Hospital Italiano de Buenos Aires</name>
      <address>
        <city>Ciudad de Buenos Aires</city>
        <zip>1199</zip>
        <country>Argentina</country>
      </address>
    </facility>
  </location>
  <location_countries>
    <country>Argentina</country>
  </location_countries>
  <reference>
    <citation>Jenkins JT, O'Dwyer PJ. Inguinal hernias. BMJ. 2008 Feb 2;336(7638):269-72. doi: 10.1136/bmj.39450.428275.AD. No abstract available.</citation>
    <PMID>18244999</PMID>
  </reference>
  <reference>
    <citation>Neumayer L, Giobbie-Hurder A, Jonasson O, Fitzgibbons R Jr, Dunlop D, Gibbs J, Reda D, Henderson W; Veterans Affairs Cooperative Studies Program 456 Investigators. Open mesh versus laparoscopic mesh repair of inguinal hernia. N Engl J Med. 2004 Apr 29;350(18):1819-27. doi: 10.1056/NEJMoa040093. Epub 2004 Apr 25.</citation>
    <PMID>15107485</PMID>
  </reference>
  <reference>
    <citation>Payne JH Jr, Grininger LM, Izawa MT, Podoll EF, Lindahl PJ, Balfour J. Laparoscopic or open inguinal herniorrhaphy? A randomized prospective trial. Arch Surg. 1994 Sep;129(9):973-9; discussion 979-81. doi: 10.1001/archsurg.1994.01420330087016.</citation>
    <PMID>8080380</PMID>
  </reference>
  <reference>
    <citation>Simons MP, Aufenacker T, Bay-Nielsen M, Bouillot JL, Campanelli G, Conze J, de Lange D, Fortelny R, Heikkinen T, Kingsnorth A, Kukleta J, Morales-Conde S, Nordin P, Schumpelick V, Smedberg S, Smietanski M, Weber G, Miserez M. European Hernia Society guidelines on the treatment of inguinal hernia in adult patients. Hernia. 2009 Aug;13(4):343-403. doi: 10.1007/s10029-009-0529-7. Epub 2009 Jul 28.</citation>
    <PMID>19636493</PMID>
  </reference>
  <reference>
    <citation>Miserez M, Peeters E, Aufenacker T, Bouillot JL, Campanelli G, Conze J, Fortelny R, Heikkinen T, Jorgensen LN, Kukleta J, Morales-Conde S, Nordin P, Schumpelick V, Smedberg S, Smietanski M, Weber G, Simons MP. Update with level 1 studies of the European Hernia Society guidelines on the treatment of inguinal hernia in adult patients. Hernia. 2014 Apr;18(2):151-63. doi: 10.1007/s10029-014-1236-6. Epub 2014 Mar 20. Erratum In: Hernia. 2014 Jun;18(3):443-4.</citation>
    <PMID>24647885</PMID>
  </reference>
  <reference>
    <citation>McCloud JM, Evans DS. Day-case laparoscopic hernia repair in a single unit. Surg Endosc. 2003 Mar;17(3):491-3. doi: 10.1007/s00464-002-9093-2. Epub 2002 Nov 6.</citation>
    <PMID>12415338</PMID>
  </reference>
  <verification_date>August 2020</verification_date>
  <study_first_submitted>August 5, 2020</study_first_submitted>
  <study_first_submitted_qc>August 5, 2020</study_first_submitted_qc>
  <study_first_posted type="Actual">August 7, 2020</study_first_posted>
  <last_update_submitted>November 27, 2020</last_update_submitted>
  <last_update_submitted_qc>November 27, 2020</last_update_submitted_qc>
  <last_update_posted type="Actual">December 1, 2020</last_update_posted>
  <responsible_party>
    <responsible_party_type>Sponsor</responsible_party_type>
  </responsible_party>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Hernia, Inguinal</mesh_term>
  </condition_browse>
  <patient_data>
    <sharing_ipd>Undecided</sharing_ipd>
    <ipd_description>I have not decided yet. Maybe some data could be share to other researchers</ipd_description>
  </patient_data>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT04504461
org study id: 5614
nct id: NCT04504461
lead sponsor: 
has dmc: No
is fda regulated drug: No
is fda regulated device: No
Laparoscopic inguinal hernia repair has become one of the elective techniques, attributing
      the advantages of minimally invasive procedures to it. However, the high costs related to the
      need for hospitalization and materials make them a limitation at the time of its indication.

      The objective is to evaluate the feasibility of performing this procedure in an outpatient
      surgery center and the cost analysis of an outpatient procedure regarding the same in the
      setting of hospitalization.
A retrospective analysis was performed on a prospective database in which all patients older
      than 18 years were included, in which a laparoscopic inguinal hernioplasty was performed in
      the period between August 2015 and June 2018 in the unit of ambulatory surgery of the
      Hospital Italiano de Buenos Aires. The same corresponds to an autonomous unit controlled by a
      health facility with hospitalization, as established by the Asociación Argentina de Cirugía
      in the Organization Guide and procedures in Ambulatory Surgery.

      Laparoscopic repair using a transabdominal preperitoneal technique (TAPP) was proposed for
      patients with a clinical diagnosis of bilateral inguinal hernia or a recurrent unilateral
      hernia operated primarily through the anterior approach following the indications for
      laparoscopic surgery proposed by the European Hernia Society

      The demographic data of the patients considered for this study were: age, gender, body mass
      index (BMI), anesthetic risk according to ASA (American Society of Anesthesiologists) score,
      comorbidities, bilateral primary or unilateral recurrent hernia, history of previous
      abdominal surgeries and associated midline hernias The details of the surgical procedure and
      the ambulatory surgery regimen, as well as possible postoperative complications, were
      explained to all patients in the preoperative consultation and an informed consent was
      signed.

      The anesthetic technique was the same for everyone. The patients were operated under general
      anesthesia. Anesthetic induction was performed with propofol 2 mg / kg EV and fentanyl 2 ug /
      kg EV. Rocuronium 0.6 mg / kg EV was used to facilitate laryngeal mask placement. The
      anesthetic level was maintained with air, oxygen, sevoflorane at 1.5% expired and with
      remifentanil (0.25 at 0.5 ug / kg / min) based on the demand of the patient's plan. It was
      ventilated mechanically in controlled mode. As intraoperative analgesia, ketorolac 1 mg / kg
      according to renal function or diclofenac 1 mg / kg was used in patients with a history of
      bronchospasm. This was associated with 8 mg of dexamethasone. Antibiotic prophylaxis during
      anesthetic induction was performed with cefazolin 2 gr / kg EV.

      In 100% of the cases, the surgical technique used was TAPP. The patient was asked to urinate
      prior to the transfer to the operating room to avoid the placement of a urinary catheter.

      With the patient in the supine position, pneumoperitoneum was performed by umbilical scar
      with closed Veress needle technique. The abdomen was insufflated with a pressure of 12 mmHg.
      A 10-mm trocar was placed at the umbilical level and two 5-mm trocars were placed on both
      flanks outside the rectus sheath. In the event that the patient presents with an associated
      midline hernia, optic trocar was inserted due to hernia defect. It was approached first on
      one side and then on the contralateral side. After the opening of the peritoneum, dissection
      of the preperitoneal space and reduction of the hernial content, a polypropylene mesh
      (Prolene®, Ethicon Johnson & Johnson) of 15 x 12 centimeters was placed covering the
      myopectineal orifice from the symphysis pubis medially, until the anterosuperior iliac spine
      laterally. In patients with bilateral hernia, two meshes were placed, one on each side
      respectively, surpassing the midline. The mesh was fixed with tuckers made of resorbable
      material (Securetrap®) or unabsorbable material (Protack®) according to the preference of the
      surgeon in charge of the procedure. The peritoneum was closed with continuous suture of slow
      absorbable material (Vycril®) or slow reabsorbed barb suture (Stratafix®). Local infiltration
      of all wounds was performed with ropivacaine at a dose of 3 mg / kg.

      Surgical time was recorded as intraoperative variables, which was defined as minutes from the
      preparation of the surgical site to the closure of the skin; the type of hernia according to
      Nyhus classification and the presence of intraoperative complications.

      At the end of the procedure, the patients were transferred to the recovery room. During the
      postoperative recovery an analgesic scheme was stipulated according to need. The rescues were
      made according to the evaluation of the nurse and the treating anesthetist and consisted of
      the following levels:

        -  First level: ketorolac 30 mg EV or diclofenac 75 mg EV. In patients with decreased
           glomerular filtration, paracetamol 1000 mg EV was used.

        -  Second level: morphine 1 - 3 mg EV. When the requirements of the ambulatory surgery
           guide of the Asociación Argentina de Cirugía listed in table N° 1 were fulfilled, the
           patient was discharged from hospital. The same was in charge of the responsible surgeon,
           who delivered the postoperative indications verbally and in writing, confirming the
           understanding of them by the patient and the companion.

      The length of stay in the unit was recorded, as well as the need to administer analgesics
      during the same and pain according to the visual analog scale (EVA) at discharge.

      Feasibility is expressed as the percentage of patients who were referred from the outpatient
      surgery unit.

      The data about postoperative complications were collected prospectively through ambulatory
      controls previously stipulated at 7, 30, 180 and 360 days. They are classified into early (up
      to 30 days of the procedure) and late. The first included seroma, surgical site infection and
      hematoma; and late trocar hernias, recurrence and postoperative pain. Chronic postoperative
      pain is one that persists beyond the third month after the procedure.

      In the first ambulatory control consultation at 7 days, patients were asked to rate their
      level of satisfaction with the procedure by choosing one of the four categories: not
      satisfied, not very satisfied, satisfied and very satisfied For the study of costs in
      addition to outpatients, those patients who underwent laparoscopic inguinal hernia in the
      inpatient setting during the period analyzed were included in the analysis. In this way, two
      branches of study were drawn up, one corresponding to patients operated on an outpatient
      basis and the other to patients operated through a hospital regimen.

      Being a surgical procedure performed under a different hospital regime, a cost minimization
      study was carried out taking the average cost of performing an ambulatory procedure versus
      the same requiring admission.

      When considering the economic situation of the República Argentina in the time under study
      (devaluation of the peso argentino weight of 100% and inflation of approximately 30% per
      year), continuous patients operated between December 2016 and April 2017 were taken, which
      represents the average of the period under study, as representative samples of each branch.
      For each patient, the surgical time, the persistence time in the ambulatory anesthetic
      recovery room or the hospitalization room, and the time of postoperative hospitalization were
      recorded in a database.

      The materials used during surgery and anesthesia were previously standardized so that all the
      patients who underwent this procedure used the same resources.

      The cost department of the Hospital Italiano de Buenos Aires was responsible for collecting
      the costs of each of these patients. They were divided into fixed costs per procedure, per
      hour/operating room, per hour in the ambulatory surgery recovery room, per hour in the
      recovery room of the central operating room and per day of hospitalization.

      The costs were calculated in Argentine Pesos (AP) and converted into US Dollars (USD) taking
      into account the exchange rate in January 2017: 1 USD = 16.30 PA.

      The categorical data were described as percentages and the quantitative data as mean and
      standard deviation or median and interquartile range according to the observed distribution.
      To compare means of quantitative variables, Student's t-test or Mann-Whitney U test was used
      according to the observed distribution. Chi-square or Fisher's test was used for the rest of
      the variables. A p <.05 was considered significant.

      Regression models were constructed to adjust for confounding potentials.
observational model: Cohort
time perspective: Retrospective
measure: Incidence of surgical Complications
time frame: Patients follow up is 12 month
description: Incidence of seroma, Incidence of hematoma, % of reoperation, incidence of wound infection
measure: Costs of the procedure
time frame: One month after surgery
description: Cost of laparoscopic hernioplasty in ambulatory surgery center. Cost of laparoscopic hernioplasty when required hospital stay
arm group label: Laparoscopic Inguinal Hernioplasty. Ambulatory
description: Laparoscopic Inguinal Hernioplasty performed in ambulatory surgery center
arm group label: Laparoscopic Inguinal Hernioplasty. Hospital Stay
description: Laparoscopic Inguinal Hernioplasty that have to stay at least 24 hours at the hospital
intervention type: Other
intervention name: Analysis of feasibility and costs
description: Analyze the feasibility and costs of performing laparoscopic inguinal hernioplasty in an ambulatory surgery center
arm group label: Laparoscopic Inguinal Hernioplasty. Ambulatory
arm group label: Laparoscopic Inguinal Hernioplasty. Hospital Stay
study pop: 
sampling method: Non-Probability Sample
criteria: 
gender: All
minimum age: 18 Years
maximum age: N/A
healthy volunteers: No
last name: Scaravonati
role: Principal Investigator
affiliation: Hospital Italiano de Buenos Aires
facility: 
country: Argentina
citation: Jenkins JT, O'Dwyer PJ. Inguinal hernias. BMJ. 2008 Feb 2;336(7638):269-72. doi: 10.1136/bmj.39450.428275.AD. No abstract available.
PMID: 18244999
citation: Neumayer L, Giobbie-Hurder A, Jonasson O, Fitzgibbons R Jr, Dunlop D, Gibbs J, Reda D, Henderson W; Veterans Affairs Cooperative Studies Program 456 Investigators. Open mesh versus laparoscopic mesh repair of inguinal hernia. N Engl J Med. 2004 Apr 29;350(18):1819-27. doi: 10.1056/NEJMoa040093. Epub 2004 Apr 25.
PMID: 15107485
citation: Payne JH Jr, Grininger LM, Izawa MT, Podoll EF, Lindahl PJ, Balfour J. Laparoscopic or open inguinal herniorrhaphy? A randomized prospective trial. Arch Surg. 1994 Sep;129(9):973-9; discussion 979-81. doi: 10.1001/archsurg.1994.01420330087016.
PMID: 8080380
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responsible party type: Sponsor
mesh term: Hernia, Inguinal
sharing ipd: Undecided
ipd description: I have not decided yet. Maybe some data could be share to other researchers