Socioeconomic Aspects of Groin Hernias: What Is the Cost of Hernia Surgery?

Author(s):  
E. Eypasch ◽  
C. K. Kum ◽  
A. Paul ◽  
H. Troidl
2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Victoria Proctor ◽  
Olivia Spence ◽  
Flora Burns ◽  
Susanna Green ◽  
Adele Sayers ◽  
...  

Abstract Aim Acutely symptomatic abdominal wall and groin hernias (ASH) are a common reason for acute surgical admissions in the UK. There is limited data to guide the treatment of such presentations. This study aimed to assess outcomes of emergency hernia surgery, and identify common management strategies, to improve care for these high-risk patients. Material and Methods A 12 week, UK-based, multi-centre, collaborative, prospective cohort study (NCT04197271) recruited adults with ASH. Data on patient characteristics, inpatient management, quality of life, complications and wound healing was collected. 30 and 90-day follow-up phone calls assessed complications and quality of life. Descriptive analyses were performed to describe population and outcomes. Results Twenty-three acute Trusts recruited 268 patients. Inguinal (37.7%) and umbilical (37.7%) were the most common hernia locations. 13.4% were awaiting elective surgery and 13.1% had been previously declined intervention. CT was performed in 48%. 82% underwent surgical management with open repair (94%) under general anaesthesia (93%) being most common. 4/11 laparoscopic procedures were converted to open. 55% of repairs used mesh, typically synthetic non-absorbable (87%). Complications were infrequent with surgical site infection (9.4%), delirium (3.2%) and pneumonia (2.3%) being most common. Mortality was 1.5%. Immediate surgical management was associated with significant improvement in quality of life at 30 days. Conclusions There is variation in the investigation, management and surgical strategy to treat acutely symptomatic abdominal wall and groin hernias in the UK. Further large-scale work is needed to establish the optimal management strategy for specific acute presentations given the wide variation at present.


2021 ◽  
Vol 07 (01) ◽  
pp. e41-e46
Author(s):  
Bharati Pandya ◽  
Tanweerul Huda ◽  
Dilip Gupta ◽  
Bhupendra Mehra ◽  
Ravinder Narang

Abstract Background Abdominal wall hernia is a common surgical entity worldwide with groin hernias having the most common presentation among them. They are a cause of morbidity and mortality if not addressed in time. A variety of surgical methods are available for the repair of hernias. The tension-free repair using synthetic mesh has the least recurrence and is the most accepted. Aim To describe the surgical burden and clinical profile of abdominal wall hernias as well as experiences in their management in a rural setup. Methods This was a retrospective observational study of all the cases of abdominal wall hernias presenting to various surgical divisions of Mahatma Gandhi Institute of Medical Sciences, Sevagram, during a two-year period from December 2011 to November 2013. Relevant details were collected from the hospital information statistics and patient file records and analysis of obtained data was done. Result A total of 910 out of 90,056 surgical outpatients (10.10%) seen during this period had abdominal wall hernias; 816 (89.67%) got operated. A total of 163 (20%) of 816 were operated in an emergency. Groin hernias were the most common 653 (80%), followed by incisional 82 (10%), umbilical and paraumbilical 41 (5%), epigastric 33 (4%), and rarer hernias in 8 (1%). Of 816 operations, 24 (2.9%) had recurrent hernias and 83 (10.17%) were pediatric patients. Male to female ratio was 9:1 in adults and 4:1 in children. The median age among adults was 49 years (range: 14–95 years), and among the pediatric age group, it was 7 years (range: 3 months–14 years). The majority of the adult patients were from a low-income group and presented more than 2 years after symptoms appeared. Comorbid conditions encountered were hypertension in 212 (26%), diabetes in 155 (19%), chronic airway disorders in 449 (55%), cardiac problems in 163 (20%), obesity in 10 (1.2%), and chronic renal failure and liver disorder in 82 (1%). Predisposing factors in the majority of the patients were chronic cough 449 (55%), prostatic problems in 187 (23%), chronic constipation in 163 (20%), previous surgeries in 82 (10%), obesity in 10 (1.2%), and ascites in 9 (0.1%). Hernia surgery was performed laparoscopically in 51 (6.25%) patients. Simultaneous other surgeries were performed in 130 (16%) patients. Mortality occurred in 2 (0.24%) patients operated in emergency, and chief morbidity was due to wound infection in 25 (3%) and chronic pain in 30 (3.9%) patients. Conclusion Abdominal wall hernias are common clinical entities. Although the pattern of presentation and management is similar, the challenges faced in a rural setup are due to ignorance, social inhibitions, and financial restraints, leading to delayed presentations which increase their morbidity and mortality. Health programs and surveys to increase awareness in rural areas as well as cutting down on expenses could help these patients.


Author(s):  
James F. Mancuso

IBM PC compatible computers are widely used in microscopy for applications ranging from control to image acquisition and analysis. The choice of IBM-PC based systems over competing computer platforms can be based on technical merit alone or on a number of factors relating to economics, availability of peripherals, management dictum, or simple personal preference.IBM-PC got a strong “head start” by first dominating clerical, document processing and financial applications. The use of these computers spilled into the laboratory where the DOS based IBM-PC replaced mini-computers. Compared to minicomputer, the PC provided a more for cost-effective platform for applications in numerical analysis, engineering and design, instrument control, image acquisition and image processing. In addition, the sitewide use of a common PC platform could reduce the cost of training and support services relative to cases where many different computer platforms were used. This could be especially true for the microscopists who must use computers in both the laboratory and the office.


Author(s):  
H. Rose

The imaging performance of the light optical lens systems has reached such a degree of perfection that nowadays numerical apertures of about 1 can be utilized. Compared to this state of development the objective lenses of electron microscopes are rather poor allowing at most usable apertures somewhat smaller than 10-2 . This severe shortcoming is due to the unavoidable axial chromatic and spherical aberration of rotationally symmetric electron lenses employed so far in all electron microscopes.The resolution of such electron microscopes can only be improved by increasing the accelerating voltage which shortens the electron wave length. Unfortunately, this procedure is rather ineffective because the achievable gain in resolution is only proportional to λ1/4 for a fixed magnetic field strength determined by the magnetic saturation of the pole pieces. Moreover, increasing the acceleration voltage results in deleterious knock-on processes and in extreme difficulties to stabilize the high voltage. Last not least the cost increase exponentially with voltage.


1994 ◽  
Vol 58 (11) ◽  
pp. 832-835 ◽  
Author(s):  
ES Solomon ◽  
TK Hasegawa ◽  
JD Shulman ◽  
PO Walker
Keyword(s):  

1998 ◽  
Vol 138 (2) ◽  
pp. 205-205
Author(s):  
Snellman ◽  
Maljanen ◽  
Aromaa ◽  
Reunanen ◽  
Jyrkinen‐Pakkasvirta ◽  
...  
Keyword(s):  

2004 ◽  
Vol 171 (4S) ◽  
pp. 40-40
Author(s):  
Leslee L. Subak ◽  
Stephen K. Van Den Eeden ◽  
Jeanette S. Brown ◽  
Arona I. Ragins ◽  
Eric Vittinghoff ◽  
...  

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