The inguinal hernia management in Costa Rica according to a survey between surgeons: result comparison with 2018 International Groin Hernia Guidelines

Abstract Background Inguinal hernia surgery is a frequent procedure among general surgeons in Costa Rica, but the management and technique are not uniform. The International Guideline for Groin Hernia management was published in 2018 to standardize the inguinal hernia surgery, but the diffusion of the guidelines and its adherence have been extremely varied. Purpose Collect and analyze the current reality regarding groin hernia management in Costa Rica. Secondly evaluate the diffusion and development comparing it to the guideline’s recommendations. Method Questionnaire of 42 single and multiple answer questions according to the topics of the International Guideline directed to general surgeons. Diffusion of the inquiry through surgical and hernia association chats and email. Timeframe June–December 2019. Results 64 surveys were collected, which is a representative number of the general surgeons national college. The most frequent procedure between these was the abdominal wall surgery. Every surgeon did more than 52 groin hernia surgeries in one year, most of them outpatients. The epidural anesthesia was used the most and Lichtenstein’s technique was the most frequently used (64%). 68% of the surgeons know how to perform a minimally invasive inguinal hernia surgery but with variable volumes. 38% of participants considered themselves experts in groin hernia management and 52% did not know the 2018 International Guideline. The recommendations of such guideline are followed only partially. Conclusions The 2018 Hernia Surge International Guidelines have low diffusion among Costa Rican surgeons. The laparoscopic approach is widely accepted but there are no studies to assess the results and the quality. There should be protocols and studies adapted to Costa Rica’s national situation.

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Postoperative condition of patients as a result of treatment of inguinal hernias by laparoscopic and open methods

Paediatric Surgery Ukraine ◽

10.15574/ps.2021.72.30 ◽

2021 ◽

pp. 30-35

Author(s):

V.V. Skyba ◽

◽

A.V. Ivanko ◽

N.V. Voytyuk ◽

V.V. Lysytsia ◽

...

Keyword(s):

Inguinal Hernia ◽

Surgical Treatment ◽

Open Access ◽

Hospital Stay ◽

Laparoscopic Approach ◽

Length Of Hospital Stay ◽

Lower Percentage ◽

Hernia Surgery ◽

Inguinal Hernias ◽

Inguinal Hernia Surgery

Purpose – to analyze condition of patients after surgical treatment of inguinal hernias by laparoscopic and open methods. Materials and methods. A retrospective review of medical histories and outpatient charts of all patients who underwent inguinal hernia surgery at the Kyiv City Clinical Hospital No. 1 from January 2018 to July 2020 was conducted. Results. During the above period of time in our hospital open hernioplasty was performed in 86 patients, laparoscopic hernioplasty – 138 patients. With open hernioplasty, the average duration of surgical treatment was 40±12 minutes. The laparoscopic technique was 35±12 minutes. The length of hospital stay was significantly longer in the group of patients with the open method (48±12 hours) than in the group of laparoscopic plastic surgery (12±3 hours). From the group of patients who underwent open hernioplasty, 62 patients complained of long-term pain syndrome, from the group of laparoscopy – 12 patients. The cosmetic appearance was dissatisfied with 34 patients in the open access group and only 2 patients in the laparoscopic plastic group. Postoperative complications were observed in 34 patients who underwent surgical treatment through open access, and in 15 patients – by laparoscopy. Conclusions. The laparoscopic approach of inguinal hernia surgery is superior to open access, as it reduces the length of hospital stay, postoperative recovery, improves the aesthetic effect of the operation, reduces the frequency of infection of incisions. According to the results of the study, this technique gives a better result in the early postoperative period, a lower percentage of chronic pain and a higher degree of patient satisfaction compared to open access with the same low recurrence rate. Therefore, in our opinion, laparoscopic access to hernioplasty is the optimal method of treatment and can be recommended as a method of choosing inguinal hernia surgery. Postoperative assessment of the quality of life of patients after treatment of inguinal hernia by laparoscopic and open methods. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local ethics committee of all participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: inguinal hernia, laparoscopy, open access surgery, analysis of methods, operation.

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Audit of Referral Patterns for Hernia Repair – Are General Practitioners Aware of the Changing Face of Herniorrhaphy?

Annals of The Royal College of Surgeons of England ◽

10.1308/003588408x261573 ◽

2008 ◽

Vol 90 (2) ◽

pp. 140-141 ◽

Cited By ~ 1

Author(s):

JE Coulston ◽

GL Williams ◽

BM Stephenson

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

General Practitioners ◽

Groin Hernia ◽

Postal Questionnaire ◽

Further Education ◽

General Surgeon ◽

Hernia Surgery ◽

Referral Patterns ◽

Inguinal Hernia Surgery

INTRODUCTION The objective of this study was to examine referral patterns from general practitioners for groin hernia surgery and to assess their knowledge of services available to their patients. PATIENTS AND METHODS An anonymous postal questionnaire was sent to 120 general practitioners (GPs) in the South East Wales region who routinely refer patients for inguinal hernia surgery to the Royal Gwent Healthcare NHS Trust. RESULTS A total of 86 questionnaire replies were returned. There was variation in referral patterns between the GPs with the majority (84%) referring their patients for groin hernia repair to either a general surgeon or as an open referral. Only 14% referred directly to a hernia specialist and none regularly referred to a laparoscopic surgeon. CONCLUSIONS Referral patterns for inguinal hernia surgery do not reflect services provided in secondary care. Further education is required so that a patient's care can be optimised.

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Litigation claims following laparoscopic and open inguinal hernia repairs

Hernia ◽

10.1007/s10029-020-02173-y ◽

2020 ◽

Vol 24 (5) ◽

pp. 1113-1120

Author(s):

R. Varley ◽

C. Lo ◽

B. Alkhaffaf

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Vascular Injury ◽

Laparoscopic Hernia Repair ◽

Laparoscopic Approach ◽

Laparoscopic Group ◽

Hernia Surgery ◽

Visceral Injury ◽

Inguinal Hernia Surgery ◽

The Uk

Abstract Purpose Groin hernia repair is the most frequently performed general surgical operation in the UK. Complications from laparoscopic and open repair are well recognised; however, potential differences are yet to be considered in relation to litigation. Methods Administrative data were obtained and analysed from the NHS Litigation Authority for inguinal hernia-related claims from 1995 to 2016. Claims identified as using an open or laparoscopic approach were compared. Results 880 claims were made, 760 had been settled. 88 laparoscopic and 241 open procedures were identified; 65% laparoscopic and 63% open hernia claims were found to be in favour of the claimant. Payouts totalled to 4.1GBP/4.8EUR/5.3USD million and 9.4GBP/11.0EUR/12.1USD million for laparoscopic (mean 82,824GBP/96,579EUR/106,453USD) and open (mean 66,796GBP/77,892EUR/85,852USD) approaches, respectively. The most common reasons for claim initiation were visceral/vascular injury (54%) in the laparoscopic group, and testicular complications or chronic pain (35%) in the open group. Additional procedures were necessary for 48% and 44% of laparoscopic and open claims, respectively. The highest average payouts were associated with visceral injury, (laparoscopic 116,482GBP/135,820EUR/149,715USD; open 199,103GBP/232,246EUR/255,905USD) and vascular injury (laparoscopic 88,624GBP/103,369EUR/113,892USD; open 64,460GBP/75,163EUR/82,870USD). Additional procedures resulted in an average payout of 93,352GBP/108,917EUR/120,008USD (laparoscopic) and 60,408GBP/70,506EUR/77,657USD (open). The most common additional procedures were corrective visceral/vascular repairs, orchidectomy and recurrent hernia repair. Conclusions The rate of litigation for clinical negligence in inguinal hernia surgery in the UK is increasing. Whilst there has been a recent increase in laparoscopic hernia repair claims, the volume and burden of claims related to open procedures remain greater.

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General surgeons' approach to laparoscopic inguinal hernia surgery and training expectations in Turkey: A web-based survey

Annals of Medical Research ◽

10.5455/annalsmedres.2019.03.134 ◽

2019 ◽

pp. 1

Author(s):

Murat Ferhatoglu ◽

Taner Kivilcim ◽

Abdulcabbar Kartal ◽

Alp Gurkan ◽

Ali Filiz ◽

...

Keyword(s):

Inguinal Hernia ◽

Hernia Surgery ◽

Web Based ◽

Laparoscopic Inguinal Hernia ◽

Inguinal Hernia Surgery ◽

General Surgeons ◽

Training Expectations ◽

And Training

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Paediatric Day Care Inguinal Hernia Surgery in a General Hospital: A Prospective Study on Change in Practice

Journal of Nepal Paediatric Society ◽

10.3126/jnps.v30i3.3913 ◽

1970 ◽

Vol 30 (3) ◽

pp. 128-131 ◽

Cited By ~ 1

Author(s):

JN Shah ◽

N Subedi

Keyword(s):

Inguinal Hernia ◽

Prospective Study ◽

General Hospital ◽

Day Care ◽

General Surgeon ◽

Hernia Surgery ◽

Inguinal Hernia Surgery ◽

Routine Work ◽

One Year ◽

A Prospective Study

Introduction: This prospective study was undertaken to observe the prospects of daycare inguinal hernia surgery in general hospital setup in a developing country like Nepal and to assess the advantages, acceptability and safety of this approach. Methodology: The study was carried out prospectively for one year from March 2009- Feb 2010. Before surgery, children were examined in surgical referral clinic (SRC). Parents were given verbal and written instructions for pre-operative fasting. Operations were carried out under intravenous anesthesia without intubation by experienced consultant general surgeon or by registrar under supervision. Children were observed in recovery area till conscious. Once awake, the children were handed over to parents for further observation till fully conscious and could tolerate liquid. Oral Paracetamol and homecare instructions were given to parents. Appointment slip was given for follow up visit in SRC within 3-5 days. Results: There were 90 children, male 81 (89%), age 2 months to 13 years. Right inguinal hernias were 62 (70%). There were no major complications, mortality or readmission. Saving in terms of less disruption of routine work at home and office was more appreciated by parents. Conclusion: We conclude that day care inguinal hernia surgery in children in our setup is safe, economic well accepted by child and parent's both. Key words: Children; Day case hernia surgery; Paediatric inguinal hernia DOI: 10.3126/jnps.v30i3.3913J Nep Paedtr Soc 2010;30(3):128-131

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P116 “KIGNSNORTH MODIFIED SCORE” FOR OPEN INGUINAL HERNIA REPAIR COMPLICATIONS PREDICTION. POINTHER STUDY

British Journal of Surgery ◽

10.1093/bjs/znab395.109 ◽

2021 ◽

Vol 108 (Supplement_8) ◽

Author(s):

Alejandro Bravo-Salva ◽

Alba Gonzalez-Martin ◽

Margarita Salva-Puigserver ◽

Clara Tellez-Marques ◽

Joan Sancho-Insenser ◽

...

Keyword(s):

Inguinal Hernia ◽

Postoperative Complications ◽

Hernia Repair ◽

Abdominal Wall ◽

Inguinal Hernia Repair ◽

Groin Hernia ◽

University Hospital ◽

Wound Complications ◽

Hernia Surgery ◽

Inguinal Hernia Surgery

Abstract Aim Aim of our study is to analysis of postoperative outcomes (30 days) after elective unilateral open anterior inguinal hernia repair and prove correlation to modified Kingsnorth (MK) score classification system. Material and Methods Prospective registered (NTC 04806828) study of all consecutive unilateral open anterior groin hernia repair performed at a University Hospital General Surgery Department from January 2019 to December 2020. Data was stored at National Spanish Groin Hernia Registry (EVEREG). All patients were preoperatively classified using MK score. Statistical analysis of postoperative complications and their relation to preoperative modified Kingsnorth scale was performed. Results 403 patients were included. 61% were performed as ambulatory surgery. 15.7% had more than 5-8 MK punctuation. A total of 62 patients had postoperative complications, 81% of all complications were classified as Clavien I. Higher Surgery duration was directly related to higher MK (Pearson's correlation 0.291; P < 0.0001score.) Statistically significant relationship with the presence of higher rate of complications were a KN score of 5-8 (OR 2.7; 95% CI 1.07-4.82; P = 0.03) whereas performance of surgery by an abdominal wall surgery specialist had less complications (OR 0.28; 95% CI 0.08-0.92; P = 0.03) Conclusions MK classification predicts surgical wound complications on patients who undergo a primary unilateral inguinal hernia surgery. A KN score of 5-8 had a higher probability of wound complications. When surgery was performed by a specialist in abdominal wall surgery, less postoperative complications were observed.

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Sensory disturbances and neuropathic pain after inguinal hernia surgery

Scandinavian Journal of Pain ◽

10.1016/j.sjpain.2010.01.004 ◽

2010 ◽

Vol 1 (2) ◽

pp. 108-111 ◽

Cited By ~ 2

Author(s):

Niklas Magnusson ◽

Mats Hedberg ◽

Johanna Österberg ◽

Gabriel Sandblom

Keyword(s):

Inguinal Hernia ◽

Hernia Surgery ◽

Ilioinguinal Nerve ◽

Tep Repair ◽

Anaesthetic Agents ◽

Inguinal Hernia Surgery ◽

Total Extraperitoneal ◽

Sensory Disturbances ◽

One Year ◽

Pain Descriptors

AbstractObjectivesThe aim of this study was to explore how the handling of nerves affects the risk for developing sensory disturbances (SDs) following groin hernia surgery.Patients and methodsAll patients 18 years or older undergoing surgery for inguinal hernia at Mora Hospital, Sweden, during an eight-month period in 2006, were eligible for inclusion. The surgical procedure was recorded prospectively according to a standardised protocol. One year postoperatively all patients were requested to answer the Inguinal Pain Questionnaire as well as a set of 18 sensory and affective pain descriptors. They were also invited to clinical examination including sensory testing.ResultsOf the 157 hernia repairs in Mora during the period of study, 128 repairs in 116 patients, were registered prospectively according to the study protocol. Laparoscopic total extraperitoneal (TEP) repair was performed in 36 (28%) of the patients. Ninety-two (79%) patients, including five patients operated bilaterally, underwent postoperative examination. SDs were found in 33 (34%) of the groins examined. No descriptor was found that significantly predicted the presence of altered examination findings. No significant association between the intraoperative handling of nerves and SD was seen. In the TEP-group, no SDs were seen. Infiltration of local anaesthetic agents and blockade of the ilioinguinal nerve prior to surgery were found to be significantly associated with SD more than 2 cm away from the scar (both p < 0.05). The presence of SD was not associated with significant pain.ConclusionsSDs are common after open hernia surgery, but are not associated with persistent postoperative pain.

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