C G Sørensen1, J Rosenberg. 1. University of Copenhagen, Copenhagen, Denmark. caspar_sorensen@hotmail.com
Abstract
INTRODUCTION: Hernia repair is among the most frequent surgeries performed. Surgeons prefer the tension-free mesh repair, but in large parts of the world, commercial meshes are unavailable or unaffordable. Consequently, surgeons have been experimenting with insertion of inexpensive non-commercial meshes, the most common being a non-impregnated, sterilized mosquito net. OBJECTIVE: To describe the results of inserting non-commercial meshes for hernioplastic surgery. METHODS: Systematic searches were performed in EMBASE, PubMed, and Cochrane databases, and articles were chosen based on predefined inclusion criteria. RESULTS: We found five original studies performed in humans, and one study was performed in goats using non-commercial meshes. A total of 577 non-commercial meshes have been inserted into humans, resulting in 35 patients (6.1 %) having short-term complications and one (0.17 %) recurrence. The majority of meshes inserted were mosquito nets. None of the short-term complications in any of the studies required reoperation. CONCLUSIONS: There seems to be good short-term and long-term outcomes when using non-commercial meshes for open inguinal hernia repair. Operating using a non-commercial mesh is highly cost-effective. Using non-commercial meshes for hernioplastic surgery is therefore interesting-especially in a resource-limited setting.
INTRODUCTION: Hernia repair is among the most frequent surgeries performed. Surgeons prefer the tension-free mesh repair, but in large parts of the world, commercial meshes are unavailable or unaffordable. Consequently, surgeons have been experimenting with insertion of inexpensive non-commercial meshes, the most common being a non-impregnated, sterilized mosquito net. OBJECTIVE: To describe the results of inserting non-commercial meshes for hernioplastic surgery. METHODS: Systematic searches were performed in EMBASE, PubMed, and Cochrane databases, and articles were chosen based on predefined inclusion criteria. RESULTS: We found five original studies performed in humans, and one study was performed in goats using non-commercial meshes. A total of 577 non-commercial meshes have been inserted into humans, resulting in 35 patients (6.1 %) having short-term complications and one (0.17 %) recurrence. The majority of meshes inserted were mosquito nets. None of the short-term complications in any of the studies required reoperation. CONCLUSIONS: There seems to be good short-term and long-term outcomes when using non-commercial meshes for open inguinal hernia repair. Operating using a non-commercial mesh is highly cost-effective. Using non-commercial meshes for hernioplastic surgery is therefore interesting-especially in a resource-limited setting.
Authors: Nakul P Raykar; Rachel R Yorlets; Charles Liu; Roberta Goldman; Sarah L M Greenberg; Meera Kotagal; Paul E Farmer; John G Meara; Nobhojit Roy; Rowan D Gillies Journal: BMJ Glob Health Date: 2016-12-16