Accepted for/Published in: JMIR Perioperative Medicine
Date Submitted: Sep 19, 2019
Open Peer Review Period: Sep 19, 2019 - Nov 14, 2019
Date Accepted: Sep 22, 2020
(closed for review but you can still tweet)
Perioperative tablet-based telemonitoring after abdominal wall hernia surgery: Pilot prospective observational cohort study
ABSTRACT
Background:
Hernia repairs account for millions of general surgical procedures each year all over the world, with a notable shift to outpatient settings over the last decades. As technical possibilities like smartphones, tablets, and different kinds of probes are becoming more and more available, such systems have been evaluated in various clinical settings. However, there have been few studies conducted in the surgical field, especially in general surgery.
Objective:
We aimed to assess the feasibility of a tablet-based follow-up to monitor activity levels after repair of abdominal wall hernias and to evaluate a possible reduction of adverse events by their earlier recognition.
Methods:
Patients scheduled for elective surgical repair of minor abdominal wall hernias (e.g., inguinal, umbilical, or trocar hernias) were equipped with a telemonitoring system including a tablet, a pulse-oximeter and an actimeter for a monitoring phase of seven days before and thirty days after surgery. Descriptive statistical analyses were calculated as presented in our results.
Results:
We enrolled 16 patients with a mean ± standard deviation (SD) overall age of 48.75 ± 16.27 years. Preoperative activity levels were reached on postoperative day (POD) 12 with median (interquartile range, (IQR)) 2242 (0-4578) steps, after plunging on the day of surgery. The median (IQR) proportion of available activity measurements over the whole study period of 38 days was 69% (56-81). We saw gradually sinking of the proportion of available data in all parameters during the postoperative course. Six out of ten patients (60%) regained preoperative activity levels within three weeks after surgery. Overall, patients rated the usability of the system as easy to relatively easy.
Conclusions:
Tablet-based follow-up is feasible after surgical repair of minor abdominal wall hernias, with good adherence rates during the first couple of weeks after surgery. Thus, it could be a useful tool to supplement or even replace traditional outpatient follow-up in selected general surgical patients.
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