Page 110 - International guidelines for groin hernia management

Hernia

through every Hernia or National General Surgery key recommendations will be used for those test countries
Society after an inventory of these societies worldwide. based on the up-to-date status of hernia surgery. The dis-
Presentation of the key recommendations worldwide at semination will be conducted and monitored by dedicated
hernia congresses (EHS/AHS/EAES/Annual congresses Ph.D. students. An evaluation after 5 years will be per-
of Hernia Societies). formed and analyzed so that improvements can be made.
Mass media: several mass channels (for example, The proposed dissemination plan is ambitious, however,
Euronews, BBC, CNBC) should be approached through lookingthroughthe prism oftoday’ssociety thatisorientedon
media and communication departments to communicate fast collection and processing of information we need a clear,
the existence of the first worldwide surgical guidelines. yet modern method for dissemination. It will be an innovative
Spokesmen will be chosen for this task. project that will determine the trend for the possibility and
potential success of introducing future guidelines.
The use of Modern Multimedia and Network tools.
The aim is not only to offer written guidelines, but also to
Global Groin Hernia Management
offer assistance in their implementation.
• Video—tutorial videos for procedures. Videos of the Chapter 28
most common hernia operations for the instruction of
new learners (Lichtenstein, TEP, TAPP).
• Podcasts—recorded discussions on the guidelines con- Inguinal Hernia Surgery in Low Resource Settings
ducted by recognized hernia experts and authorities. P. Nordin, D.L. Sanders, I. Konate ´, R. Sani and M.
There will be a few selected essential topics like P. Simons
algorithms for groin hernia treatment pointing out the
advantages and disadvantages of proposed procedures Introduction
as well as defining the indications. Most importantly, HerniaSurge (http://www.herniasurge.com) develops
this information will be submitted in an understandable guidelines intended for use globally. This chapter contains
and accessible fashion so that they are clear even for guidelines on the performance of safe, cost-effective IH
novice surgeons. The information should focus on the repair in low resource settings (LRSs). HerniaSurge
complexity of the treatment selection accordingly to believes that every patient with a groin hernia, wherever
defined factors such as gender, age, etc. These factors they may live, has the right to the best possible care.
will be determined by the HerniaSurge Group and Nevertheless, it will take time to achieve a consistent high
presented in the Podcast. level of care throughout many areas in the world that lack
• Teaching—PowerPoint presentations will be developed the resources that are necessary and this is reflected in the
and available on the website. Surgeons worldwide will recommendations made in this chapter.
be able to use these for teaching/learning in their own There is a substantial burden of disease in countries
institutions. where the majority of the world’s groin hernia patients live.
• App—HerniaSurge will create an application for PC, Although herniorrhaphy is one of the most commonly
smartphones and other devices which will help to analyze performed surgeries in LRSs, 185, 186 needs exceed capacity.
and select the best treatment option for individual This surgical ‘‘under-production’’ over time results in high
patients according to the guidelines. Further it will hernia prevalence in populations. This in turn results in a
contain critical information on the topic, an anatomical high proportion of emergency surgery and significant
atlas of the groin region, answers on all frequently asked morbidity and mortality. 187–194 This, despite the fact that
questions and a knowledge quiz to entertain and stim- groin hernia repair is highly cost effective. 195–197
ulate the curiosity of residents and experts.
Key Questions:
Evaluation and Revision
KQ28.a What is the epidemiology of inguinal hernia in
The dissemination process will be monitored and audited
LRSs?
by each of the national chapters. The level of implemen-
KQ28.b Which types of inguinal hernia repairs are cur-
tation will be determined by a predefined set of criteria
rently performed in LRSs?
(guidelines awareness, target groups’ attitudes, application
KQ28.c What is the recommended operation for inguinal
of recommendations, and the effect on medical care).
hernias in low resource environments?
During the dissemination, a study will be performed
KQ28.d What are the logistical challenges for safe groin
examining the quality and effectiveness of the process of
hernia repair in low resource environments?
implementation in two to three test countries that will be
KQ28.e Should any special precautions be taken?
selected by the HerniaSurge Group. The most important
KQ28.f What is the most suitable mesh?
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