Page 3 - International guidelines for groin hernia management

Hernia

Center’’. From a cost-effectiveness perspective, day-case 4. Groin hernia classification
laparoscopic IH repair with minimal use of disposables is 5. Indications: treatment options for symptomatic and
recommended. The development and implementation of asymptomatic patients
national groin hernia registries in every country (or region, 6. Surgical treatment of inguinal hernias
in the case of small country populations) is suggested. They 7. Individualization of treatment options
should include patient follow-up data and account for local 8. Occult hernias and bilateral repair
healthcare structures. A dissemination and implementation 9. Day surgery
plan of the guidelines will be developed by global (Her- 10. Meshes
niaSurge), regional (international societies) and local (na- 11. Mesh fixation
tional chapters) initiatives through internet websites, social 12. Antibiotic prophylaxis
media and smartphone apps. An overarching plan to 13. Anesthesia
improve access to safe IH surgery in low-resource settings 14. Postoperative pain: prevention and management
(LRSs) is needed. It is suggested that this plan contains 15. Convalescence
simple guidelines and a sustainability strategy, independent
PART 2
of international aid. It is suggested that in LRSs the focus
Specific aspects of groin hernia management
be on performing high-volume Lichtenstein repair under
local anesthesia using low-cost mesh. Three chapters dis- 16. Groin hernias in women
cuss future research, guidelines for general practitioners 17. Femoral hernia management
and guidelines for patients. 18. Complications: prevention and treatment
Conclusions The HerniaSurge Group has developed these 19. Pain: prevention and treatment
extensive and inclusive guidelines for the management of 20. Recurrent inguinal hernias
adult groin hernia patients. It is hoped that they will lead to 21. Emergency treatment of groin hernia
better outcomes for groin hernia patients wherever they
PART 3
live. More knowledge, better training, national audit and
Quality, research and global management
specialization in groin hernia management will standardize
Quality aspects
care for these patients, lead to more effective and efficient
healthcare and provide direction for future research. 22. Training and the learning curve
23. Specialized centers and hernia specialists
Keywords Hernia Inguinal hernia Groin hernia 24. Costs
Femoral hernia Inguinal hernia treatment Inguinal hernia 25. Registries
repair Open inguinal hernia Laparoscopic inguinal 26. Outcomes and quality assessment
hernia Shouldice Lichtenstein TEP TAPP Standard 27. Dissemination and implementation
of care Guideline Practice guideline
Global groin hernia management
Chapters 28. Inguinal hernia surgery in low-resource settings
PART 1
Research, general practitioner and patient perspectives
Management of inguinal hernias in adults
29. Questions for research
1. Introduction
30. Summary for general practitioners
2. Risk factors for the development of inguinal hernias
31. Management of groin hernias from patients’
in adults
perspectives
3. Diagnostic modalities

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