Hernia Repair Surgery in International Cooperation Programmes in Africa

Introduction Hernia pathology is particularly prevalent in underdeveloped countries. The population is often forced to perform physically demanding work in order to survive. In many cases, hernia repair can be a vital part of survival. Materials and Methods Retrospective study of a consecutive series of patients who underwent inguinal hernia repair between 2005 and 2023 in Cameroon, Mali, Algeria, Kenya and Senegal as part of an international cooperation programme of the Spanish NGO "Cirugía Solidaria". Results 1634 patients were operated on, with a total of 1823 surgical procedures. The mean age was 52.21 years. A total of 83.2% were male. More than 90% of the patients had comorbidities. 23% of patients had had the hernia for more than 10 years and 25.2% of patients were unable to work. Of the hernias repaired, 9.8% were recurrent and 13.2% were bilateral. The rate of use of local anaesthesia with sedation was 16.36%. Antibiotic prophylaxis was 100%, but DVT prophylaxis was never used. The use of mesh was 82.8% and the number of procedures performed by residents was 20.42%. There was no mortality. The haematoma rate was 4.66% and the wound infection rate was 1.16%. The hernia recurrence rate was 3.3%, although only 20.97% were followed up. The mean length of stay was 18.8 hours. Conclusions Hernia surgery in underdeveloped countries with scarce instrumentation and suboptimal operating conditions can be performed with quality standards similar to those in developed countries.