R Dhumale1, J Tisdale, N Barwell. 1. Probus Health and Surgical Centre, Probus, Cornwall, UK. rajdhumale@doctors.org.uk
Abstract
INTRODUCTION: This paper outlines the development and feasibility of a dedicated ambulatory primary care hernia service and examines the outcomes achieved during the period 1 March 2005 to 31 December 2008. PATIENTS AND METHODS: A prospective analysis of 1164 patients who underwent abdominal wall hernia repair at Probus Surgical Centre during the study period. The operations were carried out by two GPs with a special interest (GPwSI) and one retired surgeon. The techniques used were a Lichtenstein mesh repair or modified Shouldice repair for inguinal hernias and a primary sutured repair for ventral hernias. All procedures were performed as day-cases under local anaesthesia without sedation. All patients were reviewed routinely at 6 weeks. The primary outcomes of the study were recurrence and patient satisfaction levels, and complications such as infection, haematoma and chronic pain. RESULTS: No patient required conversion to general anaesthesia. There were three (0.3%) recurrences. Complication rates were low and similar to those obtained in other specialist hernia units. More than 90% of patients were satisfied with the service and would recommend it to a friend. CONCLUSIONS: Routine elective abdominal wall hernia repairs can be performed in a primary care setting, safely and with excellent outcomes.
INTRODUCTION: This paper outlines the development and feasibility of a dedicated ambulatory primary care hernia service and examines the outcomes achieved during the period 1 March 2005 to 31 December 2008. PATIENTS AND METHODS: A prospective analysis of 1164 patients who underwent abdominal wall hernia repair at Probus Surgical Centre during the study period. The operations were carried out by two GPs with a special interest (GPwSI) and one retired surgeon. The techniques used were a Lichtenstein mesh repair or modified Shouldice repair for inguinal hernias and a primary sutured repair for ventral hernias. All procedures were performed as day-cases under local anaesthesia without sedation. All patients were reviewed routinely at 6 weeks. The primary outcomes of the study were recurrence and patient satisfaction levels, and complications such as infection, haematoma and chronic pain. RESULTS: No patient required conversion to general anaesthesia. There were three (0.3%) recurrences. Complication rates were low and similar to those obtained in other specialist hernia units. More than 90% of patients were satisfied with the service and would recommend it to a friend. CONCLUSIONS: Routine elective abdominal wall hernia repairs can be performed in a primary care setting, safely and with excellent outcomes.
Authors: E Gianetta; F de Cian; S Cuneo; D Friedman; B Vitale; G Marinari; G Baschieri; G Camerini Journal: Br J Surg Date: 1997-07 Impact factor: 6.939
Authors: Christopher J Pannucci; Amy Shanks; Marc J Moote; Vinita Bahl; Paul S Cederna; Norah N Naughton; Thomas W Wakefield; Peter K Henke; Darrell A Campbell; Sachin Kheterpal Journal: Ann Surg Date: 2012-06 Impact factor: 12.969