title: Umbilical hernia in adults: day case local anaesthetic repair.
abstract: BACKGROUND
  The waiting times for elective surgery of Umbilical hernia (UH) in adults are unacceptably long in some cases. During this period, irreducibility and strangulation are possible. We operate on adult patients under local anaesthesia (LA) as day cases to avoid this delay and describe our experience in this paper.
  
  
  OBJECTIVE
  The aims of our study were to look at the age and sex distribution, body weight, type and amount of local anaesthetic used, morbidity, admission and readmission rates, and waiting times of adult patients operated on for UH under LA.
  
  
  METHODS
  It was a retrospective study covering a 4 year period from July 1996 to June 2000 including all adult patients undergoing the above procedure under the care of a single consultant general surgeon. A standard Mayo repair using non absorbable material was used without a mesh or a drain.
  
  
  RESULTS
  32 patients with UH were operated on under LA, 23 males and 9 females with a median age of 51 years (range 20 to 86 years). The body weight ranged from 63 to 120 (median 87) kg. The average duration of the procedure was 30 (range 22-40) minutes. Sedation was needed in 4 patients. Two patients developed wound infections, one superficial and one deep. There was no mortality. The median period of follow-up was 24 (range 4-48) months and there was no recurrence. The median waiting time for the operation was 6 weeks.
  
  
  CONCLUSIONS
  Day case local anaesthetic repair of UH in adults seems to be safe and feasible with an acceptable morbidity. Suture repair in the right patient has excellent results and the waiting times are acceptable.
authors.affiliation: Department of Surgery, Morriston Hospital, Swansea, SA6 6NL, United Kingdom. vinodmenon@btinternet.com
authors.forename: V S
authors.initials: VS
authors.lastname: Menon
authors.forename: T H
authors.initials: TH
authors.lastname: Brown
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures / Q000009:adverse effects* / Q000706:statistics & numerical data; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000627:therapeutic use*; D001835:Body Weight; D005260:Female; D006554:Hernia, Umbilical / Q000601:surgery*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D011183:Postoperative Complications; D012189:Retrospective Studies; D017678:Sex Distribution; D013997:Time Factors; D014850:Waiting Lists
chemical_list: D000779:Anesthetics, Local