Building a national hernia registry in South Africa: initial ventral hernia repair results from a diverse healthcare sector.

PURPOSE: The purpose of this paper was to introduce a new registry in a developing country by describing the demographics, management and 30-day outcomes of patients undergoing ventral hernia repair in the public and private healthcare sectors of South Africa. METHODS: This study was a retrospective review of a prospectively maintained hernia registry from the 1st of February 2019 to 29th of February 2020. RESULTS: 353 ventral hernia repair cases were recorded of which 47% were incisional hernias and the remainder were primary hernias. The median age was 54 years with even distribution of males and females. Half of the patients were obese with a median BMI of 31 kg/m2. The private sector performed 190 cases (54%) and the public sector 163 cases (46%). The public sector had more current smokers undergoing elective repairs, 28% vs 15%, p = 0.01 and performed more emergency repair cases, 21% vs 8%, p < 0.01. The majority (89%) of hernias were repaired with mesh and one-third were repaired laparoscopically. 30 day follow up was obtained in 30% of cases, the private sector had better follow up rates (42% vs 14%). CONCLUSION: Participation in the HIG (SA) registry was low with poor follow up over the first year. Ongoing prospective data capture on the HIG (SA) hernia registry will continue to provide further insights into hernia repair practices in South Africa.

The Guildford MATTU TEP hernia model.

BACKGROUND: The totally extraperitoneal technique (TEP) is a well-established method for repairing inguinal hernias laparoscopically. It has a low recurrence rate with minimal morbidity. Good training is necessary to decrease the length of the learning curve. Laparoscopic training courses at the Guildford Minimal Access Therapy Training Unit (MATTU) include lectures, live demonstrations, and practical training. In the absence of a commercially available TEP hernia model, the Guildford MATTU, along with Limbs and Things, has developed a realistic artificial model. OBJECTIVE: The aim was to develop a model that would familiarize course participants with the different anatomical perspective and the steps needed to complete the TEP repair, in an effort to shorten their learning curve. EVALUATION: The MATTU model has been evaluated in terms of anatomic accuracy, realism, versatility, cost effectiveness, and ease of use. CONCLUSIONS: The MATTU model accurately replicates TEP repair. It is robust, easy to use, cost effective, and easy to maintain. It will be widely available.