The Socio-Economic aspects of Laparoscopic Approach in the Treatment of Inguinal Hernia by Mesh in Cameroon

Abstract

Background: In Sub-Saharan Africa (SSA), economic conditions often do not always permit the use of modern surgical techniques, especially for hernia treatment.

Prospective, randomized clinical trial of laparoscopic totally extraperitoneal inguinal hernia repair using conventional versus custom-made (mosquito) mesh performed in Cameroon: a short-term outcomes

“…There is mounting evidence that mesh placement is an important component of effective hernia repair in adults [7]. Mesh placement allows for tension-free repair, a low number of recurrences, results in less pain, and faster return to work, which is even more important in less-economically privileged populations than in richer communities, who usually benefit from better social coverage [4,6]. Mesh placement can be performed either by open approach or by laparoscopic technique.…”

“…When excluding 2 patients who needed conversion for external causes, the perioperative financial benefit of using a MM in laparoscopic TEP appears obvious. In the literature, the economic value and clinical non-inferiority of MM has been demonstrated in a number of publications [4,21]. Prices of low-cost MM at 1/1000 the price of commercial mesh have been reported [22].…”

“…The cost-determining factor and therefore the main limiting hurdle for wide distribution remains the disposable material, such as staplers and implants. Our recent study indicated that TEP with MM was feasible, costeffective, with good outcomes in an economically underprivileged hospital setting [4].The purpose of the current study was to provide high level evidence that the use of inexpensive prosthetic material (MM) actually allowed to extend the field of indications of allegedly expensive procedures such as laparoscopic TEP procedure to poor areas of the world.…”