Elective Repair of Adult Abdominal Wall Hernia: A Nigerian Tertiary Hospital Experience

Abstract

Background: Hernia repair is one of the most common procedures performed by general surgeons, mostly in an elective setting. The true incidence/prevalence of hernias in Nigeria is unknown, however, suture (tissue) repair is predominantly reported. Aims: To study the distribution of adult abdominal wall hernia and the surgical and anaesthetic techniques for elective repair in a Nigerian tertiary hospital. Methods: A retrospective cross-sectional study of surgical patients undergoing elective abdominal wall hernia repair in University of Port Harcourt Teaching Hospital Nigeria from January 2009 to December 2014. Data extracted from the theatre records were patients’ demographic, type of hernia, repair technique, anaesthesia, operating time, and cadre of performing surgeon. Statistical analysis was performed using SPSS version 20. Results: A total of 400 adult patients had elective repair of abdominal wall hernias during study period. The age range was from 17- 85 years (mean 39.3 ± 6.0) and M: F ratio of 1.9:1. There were 287(70.9%) inguinal, 43(10.6%) incisional and 36(8.9%) epigastric hernias. Mesh repair was recorded in 11(2.7%) cases with laparoscopic technique in 2 cases. Subarachnoid block was the choice anaesthesia in 365(85.4%) cases. The least mean operating time (38.6 mins) recorded was in repair of femoral hernia and longest (105.3mins) with incisional hernia repair. Conclusions: Suture repair is the predominant repair technique. Routine hernioplasty and laparoscopic hernia repair need to be encouraged.