Literature DB >> 18796191

Consenting practice for open inguinal hernia repairs - are we failing to warn patients of serious complications?

Moinuddin M Hoosein1, Hilary Towse, Gemma Conn, David L Stoker.   

Abstract

INTRODUCTION: Open inguinal hernia repairs are one of the most commonly performed procedures in the UK. The procedure can sometimes result in considerable morbidity. It is imperative that the consenting process for this procedure is meticulous. This allows the patient to make a fully informed decision as they are aware of potential complications. In turn, this reduces the risk of future litigation. The aim of this study was to examine the adequacy of consenting for open inguinal hernia repairs, in particular, focusing on serious risks associated with the procedure. PATIENTS AND METHODS: The notes of male patients who had undergone open inguinal hernia repair over a 6-month period were identified by the IT department. Inclusion and exclusion criteria were defined, giving a total of 97 male patients. Their consent forms were examined, focusing on: (i) the complications mentioned; and (ii) the grade of the consentor. A proforma was filled in for each of these patients and the data collated.
RESULTS: Of the 97 patients in the study, 25.7% of patients were consented by a consultant, 54.6% by a specialist registrar, and 19.6% by a senior house officer/FY2. The most commonly recorded risks included infection (100%) and bleeding (100%). Serious complications such as chronic pain (consented for at an average of 14%), testicular complications (45.3%) and visceral injury (52.1%) were poorly accounted for at all levels.
CONCLUSIONS: Consultants and juniors alike are not adequately consenting patients for inguinal hernia repairs, omitting serious complications such as chronic pain, recurrence and testicular complications. This leaves surgical teams vulnerable to claims for negligence. Good consenting practice may ultimately benefit both patient and surgeon.

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Mesh:

Year:  2008        PMID: 18796191      PMCID: PMC2727805          DOI: 10.1308/003588408X318165

Source DB:  PubMed          Journal:  Ann R Coll Surg Engl        ISSN: 0035-8843            Impact factor:   1.891


  3 in total

1.  Pain and functional impairment 1 year after inguinal herniorrhaphy: a nationwide questionnaire study.

Authors:  M Bay-Nielsen; F M Perkins; H Kehlet
Journal:  Ann Surg       Date:  2001-01       Impact factor: 12.969

2.  Variations in consenting practice for laparoscopic cholecystectomy.

Authors:  A M Chen; D R Leff; J Simpson; S J D Chadwick; P J McDonald
Journal:  Ann R Coll Surg Engl       Date:  2006-09       Impact factor: 1.891

3.  Risk factors for chronic pain after inguinal hernia repair.

Authors:  R Dennis; D O'Riordan
Journal:  Ann R Coll Surg Engl       Date:  2007-04       Impact factor: 1.891

  3 in total
  8 in total

1.  Consenting for pelvic nerve injury in colorectal surgery: need to address age and gender bias.

Authors:  Prabhu N Nesargikar; Vasha Kaur; Daniel M Cocker; John Lengyel
Journal:  Ann R Coll Surg Engl       Date:  2010-05-19       Impact factor: 1.891

2.  Pre-made consent for elective inguinal hernia repair: the need for standardisation-a survey of all UK NHS Trusts.

Authors:  M J Courtney; T J Royle
Journal:  Hernia       Date:  2017-12-12       Impact factor: 4.739

3.  Consent: an event or a memory in lumbar spinal surgery? A multi-centre, multi-specialty prospective study of documentation and patient recall of consent content.

Authors:  William B Lo; Ciaran P McAuley; Martin J Gillies; Patrick J Grover; Erlick A C Pereira
Journal:  Eur Spine J       Date:  2017-05-20       Impact factor: 3.134

4.  Chronic Pain as a Complication in Open Inguinal Hernia Repair: A Retrospective Study of Consenting Practice in a Single Centre.

Authors:  Spencer Probert; Wenyi Cai; Muhammad Rafaih Iqbal; Omotara Kafayat Lesi; Samer-Ul Haque; Bryony Lovett; Sarah-Jane Walton
Journal:  Cureus       Date:  2022-04-08

5.  Litigation following groin hernia repair in England.

Authors:  B Alkhaffaf; B Decadt
Journal:  Hernia       Date:  2009-12-11       Impact factor: 4.739

6.  Chronic groin pain following open inguinal hernia repair: has consenting practice improved?

Authors:  V Sivarajah; Bjm Farquharson; S Mahdi; P Cathcart; S Jeyarajah
Journal:  Ann R Coll Surg Engl       Date:  2020-09-28       Impact factor: 1.891

7.  Patient's views of the consent process for groin hernia repair: Use of consent template improves compliance with best practice (Original research).

Authors:  Saad U Khan; David J Bowrey; Robert N Williams; Jun Yi Soh; Aikaterini Peleki; Nazli Muhibullah; Peter W Waterland
Journal:  Ann Med Surg (Lond)       Date:  2018-09-25

8.  Litigation claims following laparoscopic and open inguinal hernia repairs.

Authors:  R Varley; C Lo; B Alkhaffaf
Journal:  Hernia       Date:  2020-03-30       Impact factor: 4.739

  8 in total

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