Audit of patient experience of day-case inguinal hernia repair

Jaffer, Usman; Elmghrbee, A.; R, Wilding; Cameron, A. E. P.

doi:10.1007/s10029-007-0291-7

Cited by 4 publications

(3 citation statements)

References 11 publications

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“…Few studies looked into the impact of early pain, a problem that is actually non-negligible since it is the main obstacle in ambulatory management. This is important because it has been demonstrated [4] that the incidence and intensity of early pain was one of the predictive factors for the onset of late painful sequelae. Thus, the mesh choice is not irrelevant to the ambulatory management of hernias.…”

Section: Discussionmentioning

confidence: 97%

“…The Lichtenstein operation is currently the most widely used technique [3]. These results may change with the presence of early acute pain (38%) [4] and chronic pain (6-50%) [5], due to many factors. This technique, performed outpatient surgery, is the standard technique used in Anglo-Saxon and Scandinavian countries [4].…”

Section: Introductionmentioning

confidence: 96%

“…However, it is still not widely used in France. The factors limiting this management include non-controlled pain leading to unscheduled admissions in 14% of cases [4]. In addition, 10 days after intervention, 38% of patients still report pain, which could be influenced by the mesh type used [5].…”

Section: Introductionmentioning

confidence: 98%

See 2 more Smart Citations

Influence of mesh type on the quality of early outcomes after inguinal hernia repair in ambulatory setting controlled study: Glucamesh® vs Polypropylene®

Torcivia

Vons

Barrat

et al. 2010

Langenbecks Arch Surg

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 96%

See 1 more Smart Citation

Influence of mesh type on the quality of early outcomes after inguinal hernia repair in ambulatory setting controlled study: Glucamesh® vs Polypropylene®

Torcivia

Vons

Barrat

et al. 2010

Langenbecks Arch Surg

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Day-case inguinal hernia repair in the elderly: a surgical priority

Kurzer¹,

Kark²,

Hussain

2008

Hernia

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Over a thousand ambulatory hernia repairs in a primary care setting

Dhumale¹,

Tisdale²,

Barwell³

2010

annals

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Approximately 100,000 hernia repairs are performed in the UK annually, the vast majority in hospital usually under general anaesthetic. 1 In the early 1990s, the waiting time in the UK for routine elective groin hernia repairs in the NHS had become unacceptably high () with NHS patients waiting times as long as 2 years for an operation. The prolonged wait had a marked effect on patient quality of life and increased the risk of urgent admission and emergency surgery 2,3 resulting in further pressure on operation lists and reducing the availability of in-patient beds for elective major operations. 4,5 In recent years, the pressure on hospital facilities, with increasing waiting times for non-emergency surgery for benign conditions has increased. Alternatives to in-patient and hospital-based surgery have been explored and the feasibility of performing hernia surgery in a general practice setting has already been shown. 6,7 It was in this context that the Probus Surgical Centre in Cornwall, UK was set up in 2005 in order to offer hernia repair to our patients, the main stimulus being to reduce prolonged waiting times. A secondary aim was to relieve the pressure on local hospital waiting lists for other surgical procedures. This article reviews our experience with ambulatory hernia repair in a primary care facility of more than 1000 cases over a period of 3 years. Patients and MethodsAll of the mesh hernia repairs were carried out by one of two general practitioners with a special interest (GPwSI) and tissue repairs by the associate surgeon. Patients were referred by their own GPs and were seen within 4 weeks. Surgical and anaesthetic options were discussed with the patient; if deemed suitable for local anaesthetic repair, they were given detailed written information about the procedure and postoperative management and offered a date for surgery. Age and co-morbidity were not regarded as contraindications as long as the patient had appropriate home support with a responsible adult. Exclusion criteria are listed in Table 1. There are no facilities for conversion to general anaesthesia and all procedures were performed using local anaesthetic only -with no sedation. A suitably PATIENTS AND METHODS A prospective analysis of 1164 patients who underwent abdominal wall hernia repair at Probus Surgical Centre during the study period. The operations were carried out by two GPs with a special interest (GPwSI) and one retired surgeon. The techniques used were a Lichtenstein mesh repair or modified Shouldice repair for inguinal hernias and a primary sutured repair for ventral hernias. All procedures were performed as day-cases under local anaesthesia without sedation. All patients were reviewed routinely at 6 weeks. The primary outcomes of the study were recurrence and patient satisfaction levels, and complications such as infection, haematoma and chronic pain. RESULTS No patient required conversion to general anaesthesia. There were three (0.3%) recurrences. Complication rates were low and similar to those...

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Audit of patient experience of day-case inguinal hernia repair

Abstract: Audit is an important tool in surgical quality assurance for DIH. Small changes in practice with adherence to good protocols can have a marked effect on patients' experience.

Cited by 4 publications

References 11 publications

Influence of mesh type on the quality of early outcomes after inguinal hernia repair in ambulatory setting controlled study: Glucamesh® vs Polypropylene®

Influence of mesh type on the quality of early outcomes after inguinal hernia repair in ambulatory setting controlled study: Glucamesh® vs Polypropylene®

Day-case inguinal hernia repair in the elderly: a surgical priority

Over a thousand ambulatory hernia repairs in a primary care setting

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