Follow-up after laparoscopic inguinal hernia repair, can it be done by phone? A prospective study in 300 patients, the PINQ-PHONE.

BACKGROUND

The most important long-term complications after inguinal hernia repair are chronic pain and recurrence. Previous follow-up studies showed that physical examination is the only reliable method of follow-up to detect recurrences. However, physical examination is laborious and time consuming. We designed a telephone questionnaire as a method of follow-up after laparoscopic inguinal hernia surgery; the PINQ-PHONE (Post-INguinal-repair-Questionnaire by telePHONE). The aim of this study is to validate the PINQ-PHONE for detecting both asymptomatic and symptomatic recurrences.

METHODS

This prospective study contained 300 randomly selected patients after laparoscopic inguinal hernia repair. All patients were contacted by telephone and the PINQ-PHONE was carried out. The PINQ-PHONE contains four elements; three questions and a do-it-yourself Valsalva maneuvre. Subsequently, all patients were seen in clinic and physical examination (gold standard) was done.

RESULTS

The majority (96 %) was male and the mean age was 66 (range 26-93) years old. The mean interval between surgery and study inclusion was 58 (range 6-141) months. In five (1.7 %) patients, a recurrence was found. All of them replied positively to one or more elements of the PINQ-PHONE. Two-hundred-fifty-two (84 %) patients replied negatively to all elements and none of them had a recurrence. The overall sensitivity was 1.00 and the overall specificity was 0.86.

CONCLUSION

This study validated the PINQ-PHONE. It is a reliable, practical, and simple method of follow-up after laparoscopic inguinal hernia repair to detect both symptomatic and asymptomatic recurrences.