Inguinal hernia repair: Toward Asian guidelines

Abstract

Groin hernias are very common, and surgical treatment is usually recommended. In fact, hernia repair is the most common surgical procedure performed worldwide. In countries such as the USA, China, and India, there may easily be over 1 million repairs every year. The need for this surgery has become an important socioeconomic problem and may affect health-care providers, especially in aging societies. Surgical repair using mesh is recommended and widely employed in Western countries, but in many developing countries, tissue-to-tissue repair is still the preferred surgical procedure due to economic constraints. For these reason, the development and implementation of guidelines, consensus, or recommendations may aim to clarify issues related to best practices in inguinal hernia repair in Asia. A group of Asian experts in hernia repair gathered together to debate inguinal hernia treatments in Asia in an attempt to reach some consensus or develop recommendations on best practices in the region. The need for recommendations or guidelines was unanimously confirmed to help overcome the discrepancy in clinical practice between countries; the experts decided to focus mainly on the technical aspects of open repair, which is the most common surgery for hernia in our region. After the identification of 12 main topics for discussion (indication, age, and sex; symptomatic and asymptomatic hernia: type of hernia; type of treatment; hospital admission; preoperative care; anesthesia; surgical technique; perioperative care; postoperative care; early complications; and long-term complications), a search of the literature was carried out according to the five levels of the Oxford Classification of Evidence and the four grades of recommendation.

Day case hernia repair: weak evidence or practice gap?

“…Other evidence‐based CPGs concurred with the recommendations of the HerniaSurge Group . The only area of dissent identified was in the Asia Region guidelines which recommend all patients with ASA ≥III should be admitted for an overnight stay …”

Laparoscopic treatment for inguinal hernia combined with cryptorchidism: Totally extraperitoneal repair with orchiectomy under the same operative view

“…Laparoscopic repair has become a standard treatment for groin hernias. The rate of laparoscopic procedure for all patients with inguinal hernia in USA and Europe was 19.7% and 17%, respectively in 2010 [4] . The most popular techniques of laparoscopic repair include TEP and TAP repairs.…”

The Impact of Double Fixation with Titanium Tack and N-Butyl Cyanoacrylate Glue (NBCG) Mesh Fixation versus NBCG Fixation Only in Totally Extra-Peritoneal Hernioplasty with 3-Dimensional Configured Polyester Mesh: A Comparative Study

“…Inguinal hernioplasty is one of the most commonly performed procedures worldwide. 1,2 Laparoscopic hernioplasty offers benefits in terms of early recovery and lower postoperative complications, 3,4 minimize the trauma for bilateral inguinal hernia repair, and are excellent for recurrent hernia management following previous open repair. 5 Laparoscopic hernioplasty, therefore, is becoming the gold standard for hernia repair in these circumstances.…”