Surgical Outreach in a Tertiary Healthcare Facility: A Prototype for Mass Hernia Repair among Children in Low Resource Setting

Abstract

Hernias are common in children and account for most of the surgical operations performed by the Paediatric surgeons. They often present late in resource-poor countries for a variety of reasons. In these settings, surgical outreaches reduce the burden of hernias. We aim to determine the effectiveness of a tertiary hospital-based surgical outreach for hernia repair in children in a low-resource-setting. We did a prospective study conducted during a surgical outreach carried out over seven days at a tertiary center in Southeast Nigeria. Recruited subjects were physically examined to establish a diagnosis and screened for fitness before surgeries were performed. Data were collected using a structured proforma to information from the patient's case-notes. Data analysis was done using the statistical package for social sciences (SPSS) version 25. There were 77 children with 80 hernia surgeries, 71 (92.2%) males, and 6 (7.8%) females (ratio of 12:1) were involved. The majority (66.2%) were aged 2-12years and were mainly rural dwellers. Right groin hernias were present in 54.5% and 40.3% had left groin hernias. Herniotomy was the main procedure offered (93.5%). The complication rate was 9.1%. Senior registrars in surgery (Senior trainee surgeons) participated in most of the operations. The mean duration of surgery was 34.9 + 17.6 minutes. Surgical outreach in tertiary hospital for hernias in children in resource-poor settings offers the opportunity for mass repairs with good outcomes. It provides a hands-on opportunity for trainee surgeons to improve their mastery of hernia surgery.