Hernia Surgery in Nyeri Provincial General Hospital, Kenya: Our 6 Year Experience

Abstract

Introduction: Hernia is a common surgical condition world over. Much of hernia surgery in Africa is carried out as an emergency while elective procedures are few. Knowledge of the burden of hernia disease would facilitate optimal resource allocation.
Methods: A retrospective audit between 2007 and 2012 was carried out in Nyeri Provincial General Hospital.
Results: Hernia surgery accounted for 5.9% (N=239) of all surgeries excluding obstetric operations. The male to female ratio was 1.6:1 and 35.6% were aged below 5 years. Inguinal hernia was the most common type (51.4%) followed by umbilical (21.5%), epigastric (17.5%), incisional (6.2%) and hiatus hernia (3.4%). A painless abdominal or groin swelling was the most common presentation (81.6%). All cases underwent open surgical repair with 93.8% of the operations done electively. The average length of hospital stay was 3 days. Of the inguinal hernias, 81.3% were right while 18.7% were left sided. Methods of inguinal hernia repair included Modified Bassini (79%), Shouldice 4% and Mesh (19%). Surgery was done under general, spinal or local anaesthesia (86%, 12% and 2% respectively).
Conclusion: Hernia disease continues to be a significant source of morbidity in our set-up. While majority of the cases can be handled as elective cases, uptake of mesh repair remains low.

Key Words: Hernia surgery, Herniorapphy, Groin hernia, Mesh repair