P-056 Elective Open Inguinal Hernia Repairs- Are We Disclosing All the Risks?

Abstract

Introduction and Aim Elective open inguinal hernia repairs are one of the most common procedures carried out in the NHS with over 78000 operations per year. There are many risks associated with this procedure and so obtaining informed consent is imperative to patient care and patient choice. The aim of this study is to compare the quality of consent forms for elective open inguinal hernia repairs to the guidance provided by the Royal College of Surgeons (RCS) and the British Hernia Society (BHS). Method 60 patients (50 male, 10 female) undergoing elective open inguinal hernia repair between 01/09/2021–20/12/2021 were identified retrospectively. Their consent forms were audited against modified guidelines from RCS and BHS. The grade of the consenting surgeon was also noted. Results Sepsis (95%), recurrence (85%), and chronic pain (82%) were the most consented risks. Least consented serious risks were persistent numbness (47%), nerve injury (47%), and mesh infection (40%). Notable disparities existed between rates of consent and grade of surgeon: 64% of registrars consented for nerve injury compared to 9% of SHOs and 82% of SHOs consented for haematoma compared to 20% of consultants. Conclusion Serious risks such mesh infection and nerve injury were often missed from consent forms. There is inconsistency in consented risks between different grades of surgeon. A standardised consent form would improve consent consistency and potentially reduce rate of litigation for doctors and the trust. Comprehensive pre-made consent forms were therefore designed to better facilitate a standardised approach to the consenting process.