Logistics and Specialised Hernia Units
A Specialised Hernia Unit is a multidisciplinary programme providing state-of-the-art care for all types of hernias, from the most common to the most complex and technically challenging, from the simple primary hernia to multi-recurrent hernia or mesh-related complication (such as infection or post-operative chronic pain), from the small ventral hernia to the swiss cheese with real loss of substance incisional hernia, from the pubic inguinal pain syndrome (the so-called sportsman hernia) to the floppy abdomen postpartum.
General surgeon, plastic and reconstructive surgeon, osteopath and physiotherapist, nutritionist, radiologist, anaesthesiologists and pain therapist: these are essential part of the unit and collaborate to gain better result in each single patient.
Surgeon should be confident in all kinds of approach (open and laparoscopic, both for inguinal and ventral hernia, in anterior and posterior approach), in the use of further surgical step in abdominal wall reconstruction, like, for example, in the different possibilities of component separation or TAR (transversus abdominis release) when necessary and in the use of all surgical implants (synthetic, composite or biological) and their fixation.
Several procedures in abdominal wall hernia repair can be performed as outpatient.
In ambulatory surgery (called also as day surgery or outpatient service), as the name implies, the patient is sent home the same day of the surgical treatment, with no overnight stay.
EHS guidelines for inguinal hernia repair report day surgery as safe, effective and in addition cheaper for every patient.
Modern day surgery is not simply a shortened hospital stay or an architectural model. Rather, it is a complex, multifaceted concept involving institutional, organisational, medical, economic and qualitative consideration.
KeywordsHernia centre Outpatient Day surgery Ambulatory surgery Day service
This is an updated version of the chapter authored by Giampiero Campanelli, Marta Cavalli, Valentina Bertocchi and Cristina Sfeclan. Valentina Bertocchi and Cristina Sfeclan have not participated in the revision of this chapter for the 5th edition.
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