Inguinal Hernia Repair is Safe in Africa

Background: Inguinal hernias are a major problem in the developing world. Many patients do not have access to safe elective surgery. They therefore present with the complications of hernia. Those who do have access to elective surgery mostly have non-mesh repairs because of lack of knowledge of Lichtenstein repair, cost of mesh and fear of placing a foreign body in an African setting. This exposes the patient to a high recurrence rate due to the fact that mesh has not been used.
Methods: .Operation hernia is a charitable organization that has been working in Africa since 2005. We have analyzed patients operated on between 2005 until December 2010 in Ghana, Nigeria and the Ivory Coast. Hernias have been operated on electively in a variety of setting, ranging from well-equipped hernia centre to more rural clinics with a makeshift operating room.
Results: A total of 1748 patients with inguinal hernias have been repaired in Africa using mesh as part of the work done by Operation Hernia. In all, 52.3% were performed using local anaesthetic only. The complication rate was less than 1%.
Recommendations: We recommend that it is safe to use mesh in Africa provided the level of sterility during the procedure is high and the surgeon has adequate experience of the procedure.