scholarly journals The Met Needs for Pediatric Surgical Conditions in Sierra Leone: Estimating the Gap

2017 ◽  
Vol 42 (3) ◽  
pp. 652-665 ◽  
Author(s):  
Carmen Mesas Burgos ◽  
Håkon Angell Bolkan ◽  
Donald Bash-Taqi ◽  
Lars Hagander ◽  
Johan Von Screeb
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Sierra Leone ◽  
Surgical Procedures ◽  
Pediatric Population ◽  
Unmet Need ◽  
Surgical Care ◽  
Common Procedure ◽  
Middle Income ◽  
Facility Survey

Abstract Background In low- and middle-income countries, there is a gap between the need for surgery and its equitable provision, and a lack of proxy indicators to estimate this gap. Sierra Leone is a West African country with close to three million children. It is unknown to what extent the surgical needs of these children are met. Aim To describe a nationwide provision of pediatric surgical procedures and to assess pediatric hernia repair as a proxy indicator for the shortage of surgical care in the pediatric population in Sierra Leone. Methods We analyzed results from a nationwide facility survey in Sierra Leone that collected data on surgical procedures from operation and anesthesia logbooks in all facilities performing surgery. We included data on all patients under the age of 16 years undergoing surgery. Primary outcomes were rate and volume of surgical procedures. We calculated the expected number of inguinal hernia in children and estimated the unmet need for hernia repair. Results In 2012, a total of 2381 pediatric surgical procedures were performed in Sierra Leone. The rate of pediatric surgical procedures was 84 per 100,000 children 0–15 years of age. The most common pediatric surgical procedure was hernia repair (18%), corresponding to a rate of 16 per 100,000 children 0–15 years of age. The estimated unmet need for inguinal hernia repair was 88%. Conclusions The rate of pediatric surgery in Sierra Leone was very low, and inguinal hernia was the single most common procedure noted among children in Sierra Leone.

scholarly journals Estimation of unmet need for inguinal hernia repair among infants in low- and middle-income countries

2016 ◽  
Vol 82 (3) ◽  
pp. 563
Author(s):  
R. Tessler ◽  
S. Gupta ◽  
W. Stehr ◽  
E.A. Ameh ◽  
B. Nwomeh ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Unmet Need ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Routine inguinal hernia repair in the pediatric population: Is office follow-up necessary?

1993 ◽  
Vol 28 (9) ◽  
pp. 1185-1187 ◽  
Author(s):  
J. Koulack ◽  
P. Fitzgerald ◽  
D.A. Gillis ◽  
M. Giacomantonio
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Pediatric Population

scholarly journals The Onstep Method for Inguinal Hernia Repair: Operative Technique and Technical Tips

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Jacob Rosenberg ◽  
Kristoffer Andresen
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Surgical Procedures ◽  
Operative Technique ◽  
Surgical Techniques ◽  
Full Description ◽  
Tips And Tricks ◽  
Promising Technique

Inguinal hernia repair is one of the most common surgical procedures and several different surgical techniques are available. The Onstep method is a new promising technique. The technique is simple with a number of straightforward steps. This paper provides a full description of the technique together with tips and tricks to make it easy and without complications.

scholarly journals Four-Week Pain Profile and Patient Non-Adherence to Pharmacological Pain Therapy After Day Surgery

2020 ◽  
Vol 10 (3) ◽  
Author(s):  
Ina Callebaut ◽  
Steffe Jorissen ◽  
Caroline Pelckmans ◽  
Noor Berends ◽  
Martijn Droogmans ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Postoperative Pain ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Surgical Procedures ◽  
Pain Therapy ◽  
Knee Arthroscopy ◽  
Shoulder Arthroscopy ◽  
Pain Scores ◽  
Average Pain

Background: Nowadays, complicated and painful surgical procedures are encouraged to be carried out in an ambulatory setting. Objectives: The current study aimed to assess 4-week postoperative pain profiles of 4 painful ambulatory surgical procedures. We analyzed the prevalence of and reasons for non-adherence and partial adherence of patients to a predefined treatment schedule after the ambulant surgery. Methods: The current study analyzed data from a large randomized trial by evaluating the effect of postoperative pain medication on acute postoperative pain at home during the first 4 postoperative days (POD) in patients scheduled for ambulatory hemorrhoid surgery, shoulder or knee arthroscopy, and inguinal hernia repair. Postoperative pain intensity was assessed at POD 0, 1, 2, 3, 4, 7, 14, and 28 via the Numeric Rating Scale (NRS). Adherence was assessed on POD 1, 2, 3, and 4. Results: Median average pain scores were above an NRS of 3 during the first postoperative week after shoulder arthroscopy and even above 4 during the first postoperative week after hemorrhoid surgery. 26% of patients undergoing shoulder arthroscopy and hemorrhoid surgery still had moderate pain 1 week after surgery. Median average pain scores were below an NRS of 3 during the whole study period after inguinal hernia repair and knee arthroscopy. 24.61% of patients did not use the study medication as prescribed, 5.76% of whom were non-adherent, and 18.85% were partially adherent. Conclusions: Each type of ambulant surgery has its unique postoperative pain profile. New strategies should be developed for pain therapy at home, particularly after the ambulatory arthroscopic shoulder surgery and hemorrhoid surgery. Non-adherence is uncommon if they are provided with a multimodal analgesic home kit together with clear verbal, written instructions, and intensive follow-up.

Inguinal Hernia in the Premature Infant: Management of a Common Problem

2002 ◽  
Vol 21 (7) ◽  
pp. 39-44 ◽  
Author(s):  
Angela Burd ◽  
Randall Burd
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Premature Infant ◽  
Inguinal Hernia Repair ◽  
Premature Infants ◽  
Nursing Care ◽  
Surgical Procedures ◽  
Survival Rates ◽  
Inguinal Hernias

Inguinal hernia repair is one of the most common surgical procedures performed on premature infants. Improved survival rates in the NICU have led to an increase in the incidence of premature infants with inguinal hernias. The NICU nurse, often the first to notice an inguinal hernia in a premature infant, should understand the etiology, basic pathophysiology, and nursing care for this condition.

scholarly journals Perioperative mortality rates in low-income and middle-income countries: a systematic review and meta-analysis

2018 ◽  
Vol 3 (3) ◽  
pp. e000810 ◽  
Author(s):  
Joshua S Ng-Kamstra ◽  
Sumedha Arya ◽  
Sarah L M Greenberg ◽  
Meera Kotagal ◽  
Catherine Arsenault ◽  
...  
Keyword(s):  
Systematic Review ◽  
Surgical Procedures ◽  
Low Income ◽  
Meta Analysis ◽  
Surgical Care ◽  
Low Income Countries ◽  
Perioperative Mortality ◽  
Middle Income ◽  
Middle Income Countries ◽  
Wide Range

IntroductionThe Lancet Commission on Global Surgery proposed the perioperative mortality rate (POMR) as one of the six key indicators of the strength of a country’s surgical system. Despite its widespread use in high-income settings, few studies have described procedure-specific POMR across low-income and middle-income countries (LMICs). We aimed to estimate POMR across a wide range of surgical procedures in LMICs. We also describe how POMR is defined and reported in the LMIC literature to provide recommendations for future monitoring in resource-constrained settings.MethodsWe did a systematic review of studies from LMICs published from 2009 to 2014 reporting POMR for any surgical procedure. We extracted select variables in duplicate from each included study and pooled estimates of POMR by type of procedure using random-effects meta-analysis of proportions and the Freeman-Tukey double arcsine transformation to stabilise variances.ResultsWe included 985 studies conducted across 83 LMICs, covering 191 types of surgical procedures performed on 1 020 869 patients. Pooled POMR ranged from less than 0.1% for appendectomy, cholecystectomy and caesarean delivery to 20%–27% for typhoid intestinal perforation, intracranial haemorrhage and operative head injury. We found no consistent associations between procedure-specific POMR and Human Development Index (HDI) or income-group apart from emergency peripartum hysterectomy POMR, which appeared higher in low-income countries. Inpatient mortality was the most commonly used definition, though only 46.2% of studies explicitly defined the time frame during which deaths accrued.ConclusionsEfforts to improve access to surgical care in LMICs should be accompanied by investment in improving the quality and safety of care. To improve the usefulness of POMR as a safety benchmark, standard reporting items should be included with any POMR estimate. Choosing a basket of procedures for which POMR is tracked may offer institutions and countries the standardisation required to meaningfully compare surgical outcomes across contexts and improve population health outcomes.

Use of the ORBEYETM Exoscope in General Surgery: The Advent of Video-Assisted Open Surgery

2020 ◽  
pp. 155335062096534
Author(s):  
Francesco Corcione ◽  
Vania Silvestri ◽  
Giovanni Merola ◽  
Michele Dambra ◽  
Ruggero Lionetti ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
High Resolution ◽  
Adverse Effects ◽  
Hernia Repair ◽  
Surgical Procedures ◽  
General Surgery ◽  
Gold Standard ◽  
Open Surgery ◽  
Subtotal Gastrectomy ◽  
Ivor Lewis

Background. Microsurgery has quickly become the “gold standard” approach for vascular surgical steps during neurosurgery. However, despite its advantages, the microscope has not been widely adopted in general surgery. A new 3D‐surgical exoscope, the ORBEYETM, has been developed and introduced to some surgical specialties. Herein, we present our preliminary experience with the ORBEYETM exoscope as applied to a number of general surgical procedures. Method. Throughout February 2020, 7 patients had undergone varying surgical procedures at our institute utilizing the ORBEYETM in some of specific procedural steps where the surgeons felt that the surgery would benefit from more enhanced magnification. Upon completion, all the surgeons who had taken part in the procedure were asked if they had experienced any nausea, dizziness, or eyestrain during its use. Results. The ORBEYETM was employed in a number of surgical steps for the following procedures: throughout an inguinal hernia repair, during a duodeno-cephalo-pancreatectomy, for a subtotal gastrectomy, during para-aortic mass dissection, and during Ivor Lewis procedure. None of the surgeons involved in the procedures reported experiencing any nausea, dizziness nor eyestrain, nor any other physical discomforts. Conclusion. To the best of our knowledge, ours is the very first report on the employment of the ORBEYE exoscope during general surgery. Our experience assures us that this highly ergonomic technology with its high-resolution 4K 3D optical system allows the surgeon to perform safe and precise surgery in several dedicated steps in which adequate magnification is required with no adverse effects to the surgeon or the surgical procedure itself.

scholarly journals Transabdominal Preperitoneal (TAPP) Inguinal Hernia Repair

2022 ◽  
Author(s):  
Giovambattista Caruso ◽  
Giuseppe Evola ◽  
Salvatore Antonio Maria Benfatto ◽  
Mariapia Gangemi
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Surgical Procedures ◽  
Laparoscopic Approach ◽  
Day Surgery ◽  
Invasive Approach ◽  
Critical View Of Safety ◽  
Transabdominal Preperitoneal ◽  
Laparoscopic Surgical Procedures

The inguinal hernia repair is one of the most frequent surgical procedures: in the world, even year, at least 20.000.000 inguinal hernia repair procedures are performed. Although the laparoscopic approach is widely recognized as a valid treatment for many diseases and some laparoscopic surgical procedures have become gold standard techniques (e. g. cholecystectomy, appendectomy, gastro-esophageal junction surgery), the minimally invasive approach for groin hernia treatment is still very controversial today, but in the last few years, it tends to become the standard practice for 1 day surgery. We present here the technique of laparoscopic Transabdominal Preperitoneal approach (TAPP). The surgical technique is described step-by-step, including surgical details and the new concept of “inverted Y” to achieve the “critical view of safety” for laparoscopic inguinal hernia repair.

scholarly journals Double standards in healthcare innovations: the case of mosquito net mesh for hernia repair

2020 ◽  
pp. bmjinnov-2020-000535
Author(s):  
Mark Skopec ◽  
Alessandra Grillo ◽  
Alvena Kureshi ◽  
Yasser Bhatti ◽  
Matthew Harris
Keyword(s):  
Hernia Repair ◽  
Low Income ◽  
Low Cost ◽  
Surgical Care ◽  
Biomechanical Properties ◽  
Double Standard ◽  
Healthcare Sector ◽  
Mosquito Net ◽  
Middle Income ◽  
Middle Income Countries

With over two decades of evidence available including from randomised clinical trials, we explore whether the use of low-cost mosquito net mesh for inguinal hernia repair, common practice only in low-income and middle-income countries, represents a double standard in surgical care. We explore the clinical evidence, biomechanical properties and sterilisation requirements for mosquito net mesh for hernia repair and discuss the rationale for its use routinely in all settings, including in high-income settings. Considering that mosquito net mesh is as effective and safe as commercial mesh, and also with features that more closely resemble normal abdominal wall tissue, there is a strong case for its use in all settings, not just low-income and middle-income countries. In the healthcare sector specifically, either innovations should be acceptable for all contexts, or none at all. If such a double standard exists and worse, persists, it raises serious questions about the ethics of promoting healthcare innovations in some but not all contexts in terms of risks to health outcomes, equitable access, and barriers to learning.

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