Advertisement

Hernia

pp 1–5 | Cite as

Inguinal hernia repair in Nigeria: a survey of surgical trainees

  • B. O. IsmailaEmail author
  • B. T. Alayande
  • E. O. Ojo
  • A. Z. Sule
Original Article
  • 27 Downloads

Abstract

Purpose

Africa’s inguinal hernia burden is high with large numbers of untreated hernias. Mesh repair is recommended in developed countries, but the best repair in developing countries is unknown. Little is known about knowledge and practice of surgeons in Nigeria performing inguinal hernia repair. Surgical trainees can provide this information.

Methods

A questionnaire-based survey was administered to surgical trainees from all over Nigeria who had attended the West African College of Surgeons’ integrated revision course in Jos, on their practice and recommendations concerning elective inguinal hernia repair.

Results

One hundred and nine surgical trainees (90.8%) consisting of 78 (71.6%) registrars and 30 (27.5%) senior registrars responded. Thirty-two (29.4%) used antibiotics routinely for inguinal hernia surgery. Ceftriaxone was the most widely used antibiotic (45%). Ninety-two (84.4%) respondents will perform this surgery as day case. Forty (36.7%) respondents stated modified Bassini repair as their preferred method of repair. Mesh repair was recommended by 93 (85.3%) respondents while 65 of 100 respondents (65%) recommended laparoscopic surgery. Of 103 respondents, 93 (90.3%) had performed inguinal hernia repair and 34 (33%), mesh repair. For 56 (51.4%) respondents, the most difficult part of open hernia surgery was sac dissection.

Conclusions

Surgical trainees in Nigeria perform more tissue-based inguinal hernia repair than mesh but majority would recommend both mesh repair and laparoscopic surgery. Majority found sac dissection as the most difficult part of open hernia surgery.

Keywords

Inguinal hernia repair Surgical trainees Nigeria 

Notes

Compliance with ethical standards

Conflict of interest

BI declares no conflict of interest. BA declares no conflict of interest. EO declares no conflict of interest. AS declares no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This experiment complies with the laws in Nigeria where this study was carried out.

Informed consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Collaboration EUHT (2002) Repair of groin hernia with synthetic mesh. Meta-analysis of randomized control trials. Ann Surg 235(3):322–332CrossRefGoogle Scholar
  2. 2.
    Bolkan HA, Von Schreeb J, Samai MM et al (2015) Met and unmet needs for surgery in Sierra Leone: a comprehensive, retrospective, countrywide survey from all health care facilities performing operations in 2012. Surgery 157(6):992–1001CrossRefGoogle Scholar
  3. 3.
    Beard JH (2014) Characterizing the global burden of surgical disease: a method to estimate inguinal hernia epidemiology in Ghana: reply. World J Surg 18(2):289–295Google Scholar
  4. 4.
    Ohene-Yeboah MA Abantanga FA (2011) Inguinal hernia disease in Africa: a common but neglected surgical condition West. Afr J Med 30(2):77–83Google Scholar
  5. 5.
    Ismaila BO, Misauno MA, Ojo EO (2010) Inguinal hernia: the quest for the best repair. Niger J Med 19(4):369–373CrossRefGoogle Scholar
  6. 6.
    Simons MP, Aufenacker T, Bay-Nielsen M et al (2009) European hernia society guidelines on the treatment of inguinal hernia in adult patients. Hernia 13(4):343–403CrossRefGoogle Scholar
  7. 7.
    Ismaila BO, Sule AZ, Lindquist L et al. (2012) Plug and patch inguinal hernia repair technique in Jos, Nigeria—a preliminary report. J Med Res Pract 1(2):66–69Google Scholar
  8. 8.
    Shamim SM, Shamim MS, Jaffary SA et al (2006) Trends in the management of inguinal hernia in Karachi, Pakistan: a survey of practice patterns. Singap Med J 47(6):512–517Google Scholar
  9. 9.
    Mbah N (2007) Morbidity and mortality associated with inguinal hernia in Northwestern Nigeria. West Afr J Med 26(4):288–292Google Scholar
  10. 10.
    Grimes CE, Henry JA, Maraka J et al (2014) Cost-effectiveness of surgery in low- and middle-income countries: a systematic review. World J Surg 38(1):252–263CrossRefGoogle Scholar
  11. 11.
    Shillcutt SD, Clarke MG, Kingsnorth AN (2010) Cost-effectiveness of groin hernia surgery in the western region of Ghana. Arch Surg 145(10):954–961CrossRefGoogle Scholar
  12. 12.
    Collaboration EUHT (2000) Mesh compared with non-mesh methods of open groin hernia repair: systematic review of randomized controlled trials. Br J Surg 87(7):854–859CrossRefGoogle Scholar
  13. 13.
    Arowolo OA, Agbakwuru EA, Adisa AO et al (2011) Evaluation of tension-free mesh inguinal hernia repair in Nigeria: a preliminary report. West Afr J Med 30(2):110–113Google Scholar
  14. 14.
    Etonyeaku A, Olasehinde O, Talabi A et al (2015) Groin Hernias at the Wesley Guild Hospital Ilesa, Nigeria: characteristics and emerging patterns of repair. Niger J Surg Sci 25(1):9–14CrossRefGoogle Scholar
  15. 15.
    Olasehinde O, Lawal OO, Agbakwuru EA et al (2016) Comparing Lichtenstein with darning for inguinal hernia repair in an African population. Hernia 20(5):667–674CrossRefGoogle Scholar
  16. 16.
    Olasehinde OO, Adisa AO, Agbakwuru EA et al (2015) A 5-year review of darning technique of inguinal hernia repair. Niger J Surg 21(1):52–55CrossRefGoogle Scholar
  17. 17.
    Sanchez-Manuel FJ, Lozano-Garcia J, Seco-Gil JL. Antibiotic prophylaxis for hernia repair. Cochrane Database Syst Rev. 2012(2):Cd003769Google Scholar
  18. 18.
    Li JF, Lai DD, Zhang XD et al (2012) Meta-analysis of the effectiveness of prophylactic antibiotics in the prevention of postoperative complications after tension-free hernioplasty. Can J Surg 55(1):27–32CrossRefGoogle Scholar
  19. 19.
    Enyinnah M, Dienye PO, Njoku P (2013) Inguinal mesh hernioplasties: a rural private clinic experience in South Eastern Nigeria. Glob J Health Sci 5(4):176–181CrossRefGoogle Scholar
  20. 20.
    Ravindran R, Bruce J, Debnath D et al (2006) A United Kingdom survey of surgical technique and handling practice of inguinal canal structures during hernia surgery. Surgery 139(4):523–526CrossRefGoogle Scholar
  21. 21.
    Morgan MS, Reynolds A, Swan AV, Beech R, Devlin HB (1991) Are current techniques of inguinal hernia repair optimal? A survey in the United Kingdom. Ann R Coll Surg Engl 73:341–345Google Scholar
  22. 22.
    Trevisonno M, Kaneva P, Watanabe Y et al (2015) A survey of general surgeons regarding laparoscopic inguinal hernia repair: practice patterns, barriers, and educational needs. Hernia 19(5):719–724CrossRefGoogle Scholar
  23. 23.
    Aiken AM, Haddow JB, Symons NR et al (2013) Use of antibiotic prophylaxis in elective inguinal hernia repair in adults in London and south-east England: a cross-sectional survey. Hernia 17(5):657–664CrossRefGoogle Scholar
  24. 24.
    Shaikh I, Olabi B, Wong VM et al (2011) NICE guidance and current practise of recurrent and bilateral groin hernia repair by Scottish surgeons. Hernia 15(4):387–391CrossRefGoogle Scholar

Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2019

Authors and Affiliations

  • B. O. Ismaila
    • 1
    Email author
  • B. T. Alayande
    • 1
  • E. O. Ojo
    • 1
  • A. Z. Sule
    • 1
  1. 1.Department of SurgeryJos University Teaching HospitalJosNigeria

Personalised recommendations