Skip to main content
SpringerLink
Log in

Hernia Repair in Undeserved Areas

  • Chapter
  • First Online:
Textbook of Hernia

  • 2333 Accesses

Abstract

There is a substantial burden of disease in countries where the majority of the world’s groin hernia patients live. Although herniorrhaphy is one of the most commonly performed surgeries in undeserved areas, needs exceed capacity. This surgical “under-production” over time results in high hernia prevalence in populations. This in turn results in a high proportion of emergency surgery and significant morbidity and mortality. This, despite the fact that groin hernia repair is highly cost effective.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 99.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Beard JH, Oresanya LB, Akoko L, Mwanga A, Dicker RA, Harris HW. An estimation of inguinal hernia epidemiology adjusted for population age structure in Tanzania. Hernia. 2014;18(2):289–95. PubMed PMID: 24241326.

    Article  CAS  PubMed  Google Scholar 

  2. Beard JH, Oresanya LB, Ohene-Yeboah M, Dicker RA, Harris HW. Characterizing the global burden of surgical disease: a method to estimate inguinal hernia epidemiology in Ghana. World J Surg. 2013;37(3):498–503. PubMed PMID: 23224074.

    Article  PubMed  Google Scholar 

  3. Ohene-Yeboah M, Abantanga FA. Inguinal hernia disease in Africa: a common but neglected surgical condition. West Afr J Med. 2011;30(2):77–83. PubMed PMID: 21984452.

    CAS  PubMed  Google Scholar 

  4. Kingsnorth AN, Clarke MG, Shillcutt SD. Public health and policy issues of hernia surgery in Africa. World J Surg. 2009;33(6):1188–93. PubMed PMID: 19319593.

    Article  PubMed  Google Scholar 

  5. Higashi H, Barendregt JJ, Kassebaum NJ, Weiser TG, Bickler SW, Vos T. Surgically avertable burden of obstetric conditions in low- and middle-income regions: a modelled analysis. BJOG. 2015;122(2):228–36. PubMed PMID: 25546047.

    Article  CAS  PubMed  Google Scholar 

  6. Lofgren J, Makumbi F, Galiwango E, Nordin P, Ibingira C, Forsberg BC, et al. Prevalence of treated and untreated groin hernia in eastern Uganda. Br J Surg. 2014;101(6):728–34. PubMed PMID: 24652681.

    Article  CAS  PubMed  Google Scholar 

  7. Shillcutt SD, Clarke MG, Kingsnorth AN. Cost-effectiveness of groin hernia surgery in the Western Region of Ghana. Arch Surg. 2010;145(10):954–61. PubMed PMID: 20956763.

    Article  PubMed  Google Scholar 

  8. Primatesta P, Goldacre MJ. Inguinal hernia repair: incidence of elective and emergency surgery, readmission and mortality. Int J Epidemiol. 1996;25(4):835–9. PubMed PMID: 8921464.

    Article  CAS  PubMed  Google Scholar 

  9. Belcher DW, Nyame PK, Wurapa FK. The prevalence of inguinal hernia in adult Ghanaian males. Trop Geogr Med. 1978;30(1):39–43. PubMed PMID: 675826.

    CAS  PubMed  Google Scholar 

  10. Yordanov YS, Stoyanov SK. The incidence of hernia on the island of Pemba. East Afr Med J. 1969;46(12):687–91. PubMed PMID: 5378181.

    CAS  PubMed  Google Scholar 

  11. Sanders DL, Shahid MK, Ahlijah B, Raitt JE, Kingsnorth AN. Inguinal hernia repair in the anticoagulated patient: a retrospective analysis. Hernia. 2008;12(6):589–92; discussion 667–8. PubMed PMID: 18704620.

    Article  CAS  PubMed  Google Scholar 

  12. Ohene-Yeboah M, Abantanga F, Oppong J, Togbe B, Nimako B, Amoah M, et al. Some aspects of the epidemiology of external hernias in Kumasi, Ghana. Hernia. 2009;13(5):529–32. PubMed PMID: 19301084.

    Article  CAS  PubMed  Google Scholar 

  13. Ohene-Yeboah M. Strangulated external hernias in Kumasi. West Afr J Med. 2003;22(4):310–3. PubMed PMID: 15008294.

    CAS  PubMed  Google Scholar 

  14. Harouna Y, Yaya H, Abdou I, Bazira L. Pronostic de la hernie inguinale etranglee de l’adulte: influence de la necrose intestinale. A propos de 34 cas [Prognosis of strangulated inguinal hernia in the adult: influence of intestinal necrosis. Apropos of 34 cases]. Bull Soc Pathol Exot. 2000;93(5):317–20. PubMed PMID: 11775315.

    CAS  PubMed  Google Scholar 

  15. McConkey SJ. Case series of acute abdominal surgery in rural Sierra Leone. World J Surg. 2002;26(4):509–13. PubMed PMID: 11910489.

    Article  PubMed  Google Scholar 

  16. Nilsson H, Nilsson E, Angeras U, Nordin P. Mortality after groin hernia surgery: delay of treatment and cause of death. Hernia. 2011;15(3):301–7. PubMed PMID: 21267615.

    Article  CAS  PubMed  Google Scholar 

  17. Mbah N. Morbidity and mortality associated with inguinal hernia in Northwest Nigeria. West Afr J Med. 2007;26:288–92.

    CAS  PubMed  Google Scholar 

  18. Grimes CE, Law RS, Borgstein ES, Mkandawire NC, Lavy CB. Systematic review of met and unmet need of surgical disease in rural sub-Saharan Africa. World J Surg. 2012;36(1):8–23. PubMed PMID: 22057752.

    Article  PubMed  Google Scholar 

  19. Odula PO, Kakande I. Groin hernia at Mulago Hospital—Kampala—Uganda. East Afr J Surg. 2009;9(1):48–52.

    Google Scholar 

  20. Mabula JB, Chalya PL. Surgical management of inguinal hernias at Bugando Medical Centre in northwestern Tanzania: our experiences in a resource-limited setting. BMC Res Notes. 2012;5:585. PubMed PMID: 23098556. Pubmed Central PMCID: 3526506.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Leive A, Xu K. Coping with out-of-pocket health payments: empirical evidence from 15 African countries. Bull World Health Organ. 2008;86(11):849–56. PubMed PMID: 19030690. Pubmed Central PMCID: 2649544.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Arowolo OA, Agbakwuru EA, Adisa AO, Lawal OO, Ibrahim MH, Afolabi AI. Evaluation of tension-free mesh inguinal hernia repair in Nigeria: a preliminary report. West Afr J Med. 2011;30(2):110–3. PubMed PMID: 21984458.

    CAS  PubMed  Google Scholar 

  23. Stephenson BM, Kingsnorth AN. Safety and sterilization of mosquito net mesh for humanitarian inguinal hernioplasty. World J Surg. 2011;35(9):1957–60. PubMed PMID: 21713575.

    Article  PubMed  Google Scholar 

  24. Lofgren J, Nordin P, Ibingira C, Matovu A, Galiwango E, Wladis A. A randomized trial of low-cost mesh in groin hernia repair. N Engl J Med. 2016;374(2):146–53. PubMed PMID: 26760085.

    Article  PubMed  Google Scholar 

  25. Tongaonkar RR, Sanders DL, Kingsnorth AN. Ten-year personal experience of using low density polyethylene (LDPE) mesh for inguinal hernia repair. Trop Med Surg. 2013;1:136.

    Google Scholar 

  26. Swadia ND. Laparoscopic totally extra-peritoneal inguinal hernia repair: 9 year’s experience. Hernia. 2011;15(3):273–9. PubMed PMID: 21290156.

    Article  CAS  PubMed  Google Scholar 

  27. Rutkow IM. Demographic and socioeconomic aspects of hernia repair in the United States in 2003. Surg Clin North Am. 2003;83(5):1045–51, v–vi. PubMed PMID: 14533902.

    Article  PubMed  Google Scholar 

  28. Sanders DL, Kingsnorth AN. Prosthetic mesh materials used in hernia surgery. Expert Rev Med Devices. 2012;9(2):159–79. PubMed PMID: 22404777.

    Article  PubMed  Google Scholar 

  29. Ashar BS, Dang JM, Krause D, Luke MC. Performing clinical studies involving hernia mesh devices: what every investigator should know about the FDA investigational device exemption (IDE) process. Hernia. 2011;15(6):603–5. PubMed PMID: 21909977.

    Article  CAS  PubMed  Google Scholar 

  30. Tongaonkar RR, Reddy BV, Mehta VK, Singh NS, Shivade S. Preliminary multicentric trial of cheap indigenous mosquito-net cloth for tension-free hernia repair. Indian J Surg. 2003;65:89–95.

    Google Scholar 

  31. Oribabor FO, Amao OA, Akanni SO, Fatidinu SO. The use of nontreated mosquito-net mesh cloth for a tension free inguinal hernia repair: our experience. Niger J Surg. 2015;21(1):48–51. PubMed PMID: 25838767. Pubmed Central PMCID: 4382643.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Sanders DL, Kingsnorth AN, Moate R, Steer JA. An in vitro study assessing the infection risk of low-cost polyethylene mosquito net compared with commercial hernia prosthetics. J Surg Res. 2013;183(2):e31–7. PubMed PMID: 23485076.

    Article  PubMed  Google Scholar 

  33. Farmer DL. Surgeon, do you know where your DALYs are?: (Can you fix a hernia with a mosquito net?): comment on “Cost-effectiveness of groin hernia surgery in the Western Region of Ghana”. Arch Surg. 2010;145(10):961. PubMed PMID: 20968121.

    Article  PubMed  Google Scholar 

  34. Clarke MG, Oppong C, Simmermacher R, Park K, Kurzer M, Vanotoo L, et al. The use of sterilised polyester mosquito net mesh for inguinal hernia repair in Ghana. Hernia. 2009;13(2):155–9. PubMed PMID: 19089526.

    Article  CAS  PubMed  Google Scholar 

  35. Wilhelm TJ, Freudenberg S, Jonas E, Grobholz R, Post S, Kyamanywa P. Sterilized mosquito net versus commercial mesh for hernia repair: an experimental study in goats in Mbarara/Uganda. Eur Surg Res. 2007;39(5):312–7. PubMed PMID: 17595545.

    Article  CAS  PubMed  Google Scholar 

  36. Freudenberg S, Sano D, Ouangre E, Weiss C, Wilhelm TJ. Commercial mesh versus Nylon mosquito net for hernia repair. A randomized double-blind study in Burkina Faso. World J Surg. 2006;30(10):1784–9; discussion 90. PubMed PMID: 16983472.

    Article  PubMed  Google Scholar 

  37. Udwadia TE. Commercial mesh versus nylon mosquito net for hernia repair. A randomized double-blind study in Burkina Faso. World J Surg. 2007;31(4):858. PubMed PMID: 17347897.

    Article  PubMed  Google Scholar 

  38. Fox CA. Mosquito net: a story of the pioneers of tropical medicine. Manchester: i2i; 2008.

    Google Scholar 

  39. Sanders DL, Kingsnorth AN, Stephenson BM. Mosquito net mesh for abdominal wall hernioplasty: a comparison of material characteristics with commercial prosthetics. World J Surg. 2013;37(4):737–45. PubMed PMID: 23340707.

    Article  PubMed  Google Scholar 

  40. Shillcutt SD, Sanders DL, Teresa Butron-Vila M, Kingsnorth AN. Cost-effectiveness of inguinal hernia surgery in northwestern Ecuador. World J Surg. 2013;37(1):32–41. PubMed PMID: 23073503.

    Article  PubMed  Google Scholar 

  41. Stephenson BM, Kingsnorth AN. Inguinal hernioplasty using mosquito net mesh in low income countries: an alternative and cost effective prosthesis. BMJ. 2011;343:d7448. PubMed PMID: 22174320.

    Article  PubMed  Google Scholar 

  42. Yang J, Papandria D, Rhee D, Perry H, Abdullah F. Low-cost mesh for inguinal hernia repair in resource-limited settings. Hernia. 2011;15(5):485–9. PubMed PMID: 21607572.

    Article  CAS  PubMed  Google Scholar 

  43. Higashi H, Barendregt JJ, Kassebaum NJ, Weiser TG, Bickler SW, Vos T. Surgically avertable burden of digestive diseases at first-level hospitals in low and middle-income regions. Surgery. 2015;157(3):411–9; discussion 20–2. PubMed PMID: 25444219.

    Article  PubMed  Google Scholar 

  44. Ymo BJ, Schecter W. Hernia and hydrocele. In: Group WB, editor. Disease control priorities. 3rd ed. Essential surgery, vol. 1. Washington, DC: World Bank Group; 2015.

    Google Scholar 

  45. Galukande M, von Schreeb J, Wladis A, Mbembati N, de Miranda H, Kruk ME, et al. Essential surgery at the district hospital: a retrospective descriptive analysis in three African countries. PLoS Med. 2010;7(3):e1000243. PubMed PMID: 20231871. Pubmed Central PMCID: 2834708.

    Article  PubMed  PubMed Central  Google Scholar 

  46. McCord C, Kruk ME, Mock CN. Organization of essential services and the role of first-level hospitals. In: Disease control priorities. 3rd ed. Essential surgery, vol. 1. Washington, DC: World Bank; 2015.

    Google Scholar 

  47. Ozgediz D, Jamison D, Cherian M, McQueen K. The burden of surgical conditions and access to surgical care in low- and middle-income countries. Bull World Health Organ. 2008;86(8):646–7. PubMed PMID: 18797625. Pubmed Central PMCID: 2649455.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Dudley L, Garner P. Strategies for integrating primary health services in low- and middle-income countries at the point of delivery. Cochrane Database Syst Rev. 2011;7:CD003318. PubMed PMID: 21735392.

    Google Scholar 

  49. Lê G, Morgan R, Bestall J, Featherstone I, Veale T, Ensor T. Can service integration work for universal health coverage? Evidence from around the globe. Health Policy. 2016;120:406–19.

    Article  PubMed  Google Scholar 

  50. Bainbridge D, Martin J, Arango M, Cheng D, Evidence-based Peri-operative Clinical Outcomes Research G. Perioperative and anaesthetic-related mortality in developed and developing countries: a systematic review and meta-analysis. Lancet. 2012;380(9847):1075–81. PubMed PMID: 22998717.

    Article  PubMed  Google Scholar 

  51. Walker IA, Wilson IH. Anaesthesia in developing countries—a risk for patients. Lancet. 2008;371(9617):968–9. PubMed PMID: 18358913.

    Article  PubMed  Google Scholar 

  52. Reece-Smith AM, Maggio AQ, Tang TY, Walsh SR. Local anaesthetic vs. general anaesthetic for inguinal hernia repair: systematic review and meta-analysis. Int J Clin Pract. 2009;63(12):1739–42. PubMed PMID: 19817912.

    Article  CAS  PubMed  Google Scholar 

  53. Cavallo JA, Ousley J, Barrett CD, Baalman S, Ward K, Borchardt M, et al. A material cost-minimization analysis for hernia repairs and minor procedures during a surgical mission in the Dominican Republic. Surg Endosc. 2014;28(3):747–66. PubMed PMID: 24162140. Pubmed Central PMCID: 3943836.

    Article  PubMed  Google Scholar 

  54. Shrime MG, Sleemi A, Ravilla TD. Charitable platforms in global surgery: a systematic review of their effectiveness, cost-effectiveness, sustainability, and role training. World J Surg. 2015;39(1):10–20. PubMed PMID: 24682278. Pubmed Central PMCID: 4179995.

    Article  PubMed  Google Scholar 

  55. World Alliance for Patient Safety. Second global patient safety challenge: safe surgery saves lives. Geneva: WHO Press; 2008.

    Google Scholar 

  56. Wang YT, Mehes MM, Naseem HR, Ibrahim M, Butt MA, Ahmed N, et al. Assessing the impact of short-term surgical education on practice: a retrospective study of the introduction of mesh for inguinal hernia repair in sub-Saharan Africa. Hernia. 2014;18(4):549–56. PubMed PMID: 24777428.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Upper GI Surgery, North Devon District Hospital, Raleigh Park, Barnstaple, UK

    David L. Sanders BSc, MBCHB, FRCS, MD, PGDipMedEd

  2. Department of Surgery, OLVG Hospital, Amsterdam, The Netherlands

    Maarten Simons M.D., Ph.D.

  3. Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden

    Pär Norden

Authors
  1. David L. Sanders BSc, MBCHB, FRCS, MD, PGDipMedEd
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Maarten Simons M.D., Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Pär Norden
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to David L. Sanders BSc, MBCHB, FRCS, MD, PGDipMedEd .

Editor information

Editors and Affiliations

  1. Department of Surgery, New Hanover Regional Medical Center, Wilmington, North Carolina, USA

    William W. Hope

  2. USC School of Medicine-Greenville, Greenville Health System, Greenville, North Carolina, USA

    William S. Cobb

  3. Johns Hopkins Hospital, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

    Gina L. Adrales

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Sanders, D.L., Simons, M., Norden, P. (2017). Hernia Repair in Undeserved Areas. In: Hope, W., Cobb, W., Adrales, G. (eds) Textbook of Hernia. Springer, Cham. https://doi.org/10.1007/978-3-319-43045-4_47

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-43045-4_47

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-43043-0

  • Online ISBN: 978-3-319-43045-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation