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Current trends in hernia surgery in NHS England
M Pawlak1, B Tulloh1, A de Beaux1
1General Surgery, Royal Infirmary of Edinburgh, Edinburgh, UK.
Annals of the Royal College of Surgeons of England
|August 17, 2019
Summary
Mesh is frequently used for hernia repair in NHS England, with over 75% of procedures employing mesh. However, suture repair remains common for certain hernia types, particularly umbilical hernias.
Area of Science:
- General Surgery
- Hernia Repair Techniques
- Medical Device Utilization
Background:
- Mesh is a standard for hernia repair, aiming to prevent recurrence.
- Potential for increased patient complications exists with mesh use.
- Quantifying mesh utilization in abdominal wall hernia surgery is crucial.
Purpose of the Study:
- To quantify the recent use of mesh in abdominal wall hernia surgery within NHS England.
- To analyze mesh vs. suture repair trends for different hernia types.
Main Methods:
- Analysis of NHS Digital Secondary Uses Service database (2016/17-2017/18).
- Inclusion of elective primary hernia repairs (inguinal, umbilical, incisional, other abdominal wall).
- Exclusion of recurrent and emergency hernia surgeries.
Main Results:
- Approximately 100,000 hernia repairs are performed annually in NHS England.
- Mesh is used in roughly 75% of all hernia repairs.
- Mesh repair rates vary by hernia type: 95% (inguinal), 50% (umbilical), 82% (incisional).
Conclusions:
- Mesh repair is more prevalent than suture repair across all hernia types.
- A significant proportion of umbilical and other abdominal wall hernias are repaired without mesh.
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