Inguinal hernia repair

A hernia usually presents as a painful lump in the groin, often associated with a large strain but it may also be asymptomatic and coincidentally discovered on routine examination. The incidence of hernia increases with age but a large number affected are working men and they can be severely disabled by the condition. Inguinal hernia is a common condition and 763 hernia operations were carried out in Government hospitals in Malta and Gozo during 1997.peer-reviewe

Day case hernia repair: a 3-year audit of patient recruitment

Objective: To audit the recruitment process of patients undergoing day case hernia repair at our Day Surgery Centre and to identify potential areas for further development and expansion of the current clinical service. Design: A retrospective study. Subjects: A total of 1,268 patients underwent hernia repair at our unit from December 1995 to December 1998. Four hundred and eighty-nine patients were initially selected for day case hernia repair but 210 patients were subsequently excluded after pre-anaesthetic assessment. Main outcome measure: Reasons for exclusion from day surgery were classified into patient's preference, social, surgical and medical factors. Results: Growth of day case hernia repair has remained static in the past 3 years. Social grounds (61%) was the most common reason cited for unsuitability for day case hernia repair after pre-anaesthetic assessment. Conclusion: To achieve a full utilization of day case hernia repair service, we recommend modification of day case selection criteria, improvement of patients' acceptance of day surgery by education, promotion of clinicians' awareness of day surgery and a close monitoring of inpatient booking lists. With the escalating health costs in Hong Kong, the development of day case hernia repair represents the future.published_or_final_versio

Study of feasibility of laparoscopic inguinal hernia surgery in taiping hospital

The history of inguinal hernia repair (IHR) has gone through many stages of development from the ancient era until today. Inguinal hernia repair is one of the commonest surgical procedure worldwide, irrespective of socioeconomic status or country. Today, with the advancement of laparoscopic surgeries, inguinal hernia has been listed as one of the preferred surgical condition repaired by laparoscopic approach. Nowadays, despite its known complications, advantages and disadvantages, Laparoscopic Inguinal Hernia Repair (LIHR) is widely accepted as the better option of treatment as compared to open approach of inguinal hernia repair (IHR)

Incisional hernia repair after caesarean section: a population based study

BACKGROUND Incisional hernias occur at surgical abdominal incision sites but the association with caesarean section (CS) has not been examined. AIM: To determine whether CS is a risk factor for incisional hernia repair. MATERIAL and METHODS: Population-based cohort study in Australia using linked birth and hospital data for women who gave birth from 2000 to 2011. (n=642,578) Survival analysis was used to explore the association between CS and subsequent incisional hernia repair. Analyses were adjusted for confounding factors including other abdominal surgery. The main outcome measure was surgical repair of an incisional hernia. RESULTS: 217,555 women (33.9%) had at least one CS and 1,554 (0.2%) had an incisional hernia repair. The frequency of incisional hernia repair in women who had ever had a caesarean section was 0.47%, compared to 0.12% in women who never had a caesarean section. After controlling for different follow up lengths and known explanatory variables, the adjusted hazard ratio (aHR) was 2.73 (95%CI 2.45-3.06, P <0.001). Incisional hernia repair risk increased with number of caesarean sections: women with two CS had a threefold increased risk of incisional hernia repair, which increased to 6 fold after five CS (aHR=6.29, 95%CI 3.99-9.93, P<0.001) compared to women with no CS. Prior abdominal surgery including other hernia repair also increased the risk of incisional hernia repair (all p<0.001). CONCLUSIONS: There was a strong association between maternal CS and subsequent incisional hernia repair, which increased as the number of CSs increased, but the absolute risk of incisional hernia repair was low.We thank the New South Wales (NSW) Ministry of Health for access to the population health data and the NSW Centre for Health Record Linkage for linking the data sets. This work was supported by an Australian National Health and Medical Research Council (NHMRC) Centre for Research Excellence Grant (1001066). CLR is supported by a NHMRC Senior Research Fellowship (#APP1021025)

Incisional hernia repair after caesarean section: a population based study

BACKGROUND Incisional hernias occur at surgical abdominal incision sites but the association with caesarean section (CS) has not been examined. AIM: To determine whether CS is a risk factor for incisional hernia repair. MATERIAL and METHODS: Population-based cohort study in Australia using linked birth and hospital data for women who gave birth from 2000 to 2011. (n=642,578) Survival analysis was used to explore the association between CS and subsequent incisional hernia repair. Analyses were adjusted for confounding factors including other abdominal surgery. The main outcome measure was surgical repair of an incisional hernia. RESULTS: 217,555 women (33.9%) had at least one CS and 1,554 (0.2%) had an incisional hernia repair. The frequency of incisional hernia repair in women who had ever had a caesarean section was 0.47%, compared to 0.12% in women who never had a caesarean section. After controlling for different follow up lengths and known explanatory variables, the adjusted hazard ratio (aHR) was 2.73 (95%CI 2.45-3.06, P <0.001). Incisional hernia repair risk increased with number of caesarean sections: women with two CS had a threefold increased risk of incisional hernia repair, which increased to 6 fold after five CS (aHR=6.29, 95%CI 3.99-9.93, P<0.001) compared to women with no CS. Prior abdominal surgery including other hernia repair also increased the risk of incisional hernia repair (all p<0.001). CONCLUSIONS: There was a strong association between maternal CS and subsequent incisional hernia repair, which increased as the number of CSs increased, but the absolute risk of incisional hernia repair was low.We thank the New South Wales (NSW) Ministry of Health for access to the population health data and the NSW Centre for Health Record Linkage for linking the data sets. This work was supported by an Australian National Health and Medical Research Council (NHMRC) Centre for Research Excellence Grant (1001066). CLR is supported by a NHMRC Senior Research Fellowship (#APP1021025)

Factors Influencing Choice of Inguinal Hernia Repair Technique

Background: Inguinal hernia repair surgery is one of the most frequently performed surgical procedures worldwide. This study sought to highlight factors that may influence decisions concerning inguinal hernia repair techniques.Methods: This descriptive crosssectional study was carried out in September 2014 among surgical trainees and surgeons.Data collected included: qualification of the operating doctor, level at which practical training on inguinal hernia repair occurred, awareness of the various inguinal hernia repair methods, inguinal hernia repair method(s) used for the past three (most recent) inguinal hernia operations and reasons for using that /those repair method(s).Results: Fifteen surgeons and sixty surgical trainees were recruited. Awareness levels and practical training were highest in the modified Bassini and Lichtenstein repair techniques. Experienced peers play a major role in training on the various repair techniques. The modified Bassini technique is preferred in emergency inguinal hernia repair; conversely, open mesh repair (Lichtenstein and PHS/plug) is preferred in elective cases. Reasons influencing choice of repair technique include training on the technique among others.Conclusion: Multiple factors affect the choice of inguinal hernia repair technique some of which are based on evidence while others are attributed to availability of resources and training (or lack thereof).Key words: Inguinal Hernia, Surgical Technique, Choice of Techniqu

A multicenter prospective study of patients undergoing open ventral hernia repair with intraperitoneal positioning using the monofilament polyester composite ventral patch : interim results of the PANACEA study

This study assessed the recurrence rate and other safety and efficacy parameters following ventral hernia repair with a polyester composite prosthesis (Parietex™ Composite Ventral Patch [PCO-VP])

Laparoscopic ventral hernia repair is safe and cost effective

Background: Ventral hernia repair is increasingly performed by laparoscopic means since the introduction of dual-layer meshes. This study aimed to compare the early complications and cost effectiveness of open hernia repair with those associated with laparoscopic repair. Methods: Open ventral hernia repair was performed for 92 consecutive patients using a Vypro mesh, followed by laparoscopic repair for 49 consecutive patients using a Parietene composite mesh. Results: The rate of surgical-site infections was significantly higher with open ventral hernia repair (13 vs 1; p = 0.03). The median length of hospital stay was significantly shorter with laparoscopic surgery (7 vs 6 days; p = 0.02). For laparoscopic repair, the direct operative costs were higher (2,314 vs 2,853 euros; p = 0.03), and the overall hospital costs were lower (9,787 vs 7,654 euros; p = 0.02). Conclusions: Laparoscopic ventral hernia repair leads to fewer surgical-site infections and a shorter hospital stay than open repair. Despite increased operative costs, overall hospital costs are lowered by laparoscopic ventral hernia repai