Inguinal hernia repair at the Aga Khan Hospital, Nairobi: Practice and preference discordance

Objectives: To review the current hernia repair methods at the Aga Khan University Hospital (AKUH) and relate to the preferred method of choice for groin hernia repair among the practicing general surgeons. Design: An audit from retrospective practices. Setting: A tertiary referral hospital, Aga Khan University Hospital, Nairobi. Subjects: All elective adult hernia repairs performed at the Aga Khan University Hospital, Nairobi between 2004-5 by all surgeons with admitting privileges were reviewed. The methods of repair were noted. A questionnaire was also availed to the admitting surgeons to indicate their preferred method, and this was correlated with the audit results. Results: One hundred and seventy four hernia repairs were reviewed, 58 (33.72%) were left sided, 95 (54.07%) were right sided and 21 (12.21%) were bilateral. The most common method of repair was the Modified Bassini’s, performed in 99 (56.9%) repairs. The survey results however, indicated that three quarters of the practicing surgeons preferred non-tension repairs. The mean hospital stays were similar for the tissue and mesh repairs. Conclusion: Tissue repair is still practiced and favored at our institution by the surgical fraternity. This practice is at variance with the stated preference for mesh repairs. In the absence of outcome data for this local practice, it is difficult to justify its utility in an environment where meshes are easily available