Impact of operative time and surgeon satisfaction on the long-term outcome of hernia repair.

PURPOSE: The aim of this study was to assess the impact of the degree of difficulty and quality of hernia repair, as perceived by the surgeon, and operative time on the reoperation rate.
METHODS: All hernia repairs performed during the period 1994–1995 at the Department of Surgery, University Hospital of Lund, Sweden, were recorded prospectively. The degree of difficulty and the degree of difficulty in relation to the preoperative expectation of the surgeon were graded on a three-degree scale, the final outcome graded as optimal or suboptimal, and the time required to perform the hernia repair was recorded. Recurrence repairs prior to 1998 were traced in a retrospective review of the patient notes. The Swedish Hernia Register was checked for reoperations from 1998 and later.
RESULTS: Altogether, 184 hernia repairs were recorded during the study period, including 14 repairs on women. The mean age of the patients was 58 years and the standard deviation was 15 years. Subsequent reoperation for recurrence was identified in 21 (11.4%) of these patients. The operative time correlated significantly with the surgeon's perception of the degree of difficulty (P < 0.05). Operative time less than 20 min (n = 4) was significantly associated with increased risk for reoperation (P < 0.05). The degree of difficulty, the degree of difficulty in relation to preoperative expectation, and the assessment of the final outcome were not associated with the risk for reoperation.
CONCLUSIONS: Although neither the grade of difficulty nor the surgeon's perception of the quality of repair significantly predicted the final outcome, the risk for reoperation increased if the repair was performed rapidly.