1 / 15

Simon Marsh FRCS (Traditional)

Hernia Repair. Simon Marsh FRCS (Traditional). Things to consider. Technique Early complications Late complications Serious complications Economy What does NICE say. Evolution of Open Hernia Repair. Bassini Shouldice Lichtenstein Tension free Mesh Plug. What do studies tell us?.

emile
Download Presentation

Simon Marsh FRCS (Traditional)

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Hernia Repair Simon Marsh FRCS (Traditional)

  2. Things to consider • Technique • Early complications • Late complications • Serious complications • Economy • What does NICE say

  3. Evolution of Open Hernia Repair • Bassini • Shouldice • Lichtenstein • Tension free • Mesh Plug

  4. What do studies tell us? • Maddern et al 1994: Both can be performed successfully as a day case. • Added cost of laparoscopic does not warrant its use in unilateral hernias • Lawrence et al 1995: longer theatre time and greater complication rate • Wellwood et al 1998: Laparoscopic costs greater • Wright et al 2002: Similar outcome; no difference in chronic pain or recurrence • Menon et al 2003: longer operating time and higher recurrence • McKormak 2007: More serious complication rate

  5. Meta-analysis of laparoscopic inguinal hernia trials favors open hernia repair with preperitoneal mesh prosthesis C.Randle Voyles, M.D. Brian J Hamilton, B.S. William D Johnson, Ph.D. Nobuyasu Kano, M.D. 2002 Conclusions: Although LHR was associated with an earlier return to work compared with conventional sutured OHR, more recent mesh OHRs provide equivalent outcomes but at lower costs and potentially less severe complications, supporting an open technique using preperitoneal mesh prostheses as the optimal hernia repair.

  6. NICE on Laparoscopic Hernia Repair: • Laparoscopic surgery can be used as an option for repairing inguinal hernia. • As with all surgery, there are some risks involved, which may include serious problems.

  7. NICE on Mesh Plug Repair: • Procedures do not fall within the programme's remit if they are considered standard clinical practice with an efficacy and safety profile that is sufficiently well known.

More Related