Open posterior mesh versus Lap posterior mesh – and local vs general anesthesia

Hernia Discussion Forums Hernia Discussion Open posterior mesh versus Lap posterior mesh – and local vs general anesthesia

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    • #32612
      Good intentions
      Participant

      A new paper looking at ways to place mesh similar to how it’s placed during a lap procedure but without the need for general anesthesia.

      It’s still fascinating how powerful the “Guidelines” are despite the question of the validity of their foundation, by professionals in statistics, plus the fact they were sponsored by mesh companies. The people that put them together really made a strong and lasting document. Seems like a quagmire that holds on to anyone that enters.

      The authors explore some uncommon open repair methods, with illustrations. Worth reading just for that if you are a student of the various methods.

      I don’t know what the EuraHS quality of life scores mean or how they asses them. I did find a paper though which I will link in the following post.

      https://link.springer.com/article/10.1007/s10029-022-02680-0

      Excerpt –

      “Purpose
      International guidelines suggest the use of lapro-endoscopic technique for primary unilateral inguinal hernia (IHR) because of lower postoperative pain and reduction in chronic pain. It is unclear if the primary benefit is due to the minimally invasive approach, the posterior mesh position or both. Further research evaluating posterior mesh placement using open preperitoneal techniques is recommended. A potential benefit of open preperitoneal repair is the avoidance of general anesthesia, as these repairs can be performed under local anesthesia. This study compares clinical and patient-reported outcomes after unilateral laparo-endoscopic, robotic, and open posterior mesh IHRs.”

    • #32613
      Good intentions
      Participant

      EuraHS stands for European Hernia Society, apparently. The data is apparently collected and input to a database by individual doctors or their staff, then made available to anyone that wants to use it. A sample of a questionnaire would be interesting. I think that it is similar to efforts by the AHSQC.

      This is from 2012 for ventral hernias. I assume that its use has been extended to inguinal hernias.

      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3360853/

    • #32614
      Good intentions
      Participant

      I found questionnaires on the ACHQC (formerly AHSQC) web site.

      https://achqc.org/resources

      Reproduced from the EuraHS form, apparently.

      “Used with permission from the European Registry of Abdominal Wall Hernias (EuraHS)”

      https://achqc.org/uploads/general_images/ACHQC_COMBINED_POSTOPERATIVE_ASSESSMENT_-_ENGLISH_-_6-22-20.pdf

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