Complications - Inguinal hernia repair using TEP technique

  1. Risk factors

    Evidence-based risk factors for complications and reoperations in inguinal hernia surgery have been defined:

    1. Age >80 years: High mortality risk with existing comorbidities; more seromas, urinary retention, and readmissions. Even at age > 60 years, more urinary retention and complications.

    2. ASA III and higher: More complications and reoperations, increased mortality risk.

    3. Female gender: Increased risk of pain.

    4. Obesity: Tendency towards more complications.

    5. COPD: More complications, increased mortality in outpatient surgery.

    6. Diabetes mellitus: Independent risk factor for postoperative complications.

    7. Anticoagulation/antiplatelet agents: 4-fold increased risk of postoperative bleeding. Even after discontinuation of anticoagulant medication, the risk of rebleeding is significantly increased.

    8. Immunosuppression/corticosteroid medication: Increased risk of recurrence.

    9. Liver cirrhosis: Significant increase in complication rates.

    10. Nicotine abuse: Significant increase in general and surgical complication risk.

    11. Bilateral inguinal hernia: Increased perioperative risk, therefore no prophylactic operation on a healthy side.

    12. Increased complication rate in recurrent procedures and femoral hernias.

    13. Preoperative pain frequently leads to acute and then chronic groin pain postoperatively.