Choosing Repair Technique for Groin Hernias with Patients’ Preferences and Recommendations of Guidelines

Hakan Kulacoglu

Department of Surgery, Ankara Hernia Center, Ankara, Turkey

^*Correspondance to: Hakan Kulacoglu 

 PDF  Full Text DOI: 10.25107/2474-1647.1836

Abstract

Background: Groin hernia is the most frequent type of abdominal wall hernias. Numerous repair techniques are in use however mesh augmentation is the most frequent. Tailored approach in inguinal hernia repair is the best way today. Ideally, the choice of repair technique should be a joint decision of patient and surgeon. In this paper 185 consecutive patients in 2-year period were analyzed regarding preference for groin hernia repair techniques.Materials and
Methods: All patients are fully informed by the surgeon in the hernia center. Surgeon explains the characteristics of the patient’s hernia, and tells best possible choices for this hernia according to the guidelines. Patients’ preference is always of importance, it may not be appropriate for the hernia or the patient’s medical condition in some cases. Repair technique is eventually chosen a result of a mutual evaluation. In this study, patients operated by a part-time worker single surgeon between fall 2015 and fall 2017 were evaluated.Results: One hundred and eighty-five patients were included (176 male and 9 female). Average age was 28 (19-85). One hundred and forty patients were treated with open approach (%75); Tissuesuture repair was performed in three of them. Forty-five patients underwent endoscopic repair. Thirty-nine patients underwent simultaneous bilateral hernia repairs. Endoscopic repair rate in bilateral groin hernias was 72%. Five male patients who admitted with a unilateral hernia and were diagnosed with a concomitant contra-lateral hernia in physical examination did not accept simultaneous LE repair and underwent unilateral open repair. The reason was high cost of LE repairs in 3 cases and fear of general anesthesia in two. One female patient with bilateral femoral hernia did not prefer LE repair because of cost. Ninety-five per cent of the patients were managed in concordance with guidelines and evidence based medicine.Conclusion: Tailored approach for the treatment of groin hernias is possible in the vast majority of the cases. It seems easy and useful to present treatment options to the patients and make a joint decision together.

Keywords

Hernia; Groin hernia, Inguinal hernia, Femoral hernia; Hernia repair; Mesh; Guideline; Endoscopic repair; Open repair

Cite the article

Kulacoglu H. Choosing Repair Technique for Groin Hernias with Patients’ Preferences and Recommendations of Guidelines. Clin Surg. 2017; 2: 1836.