Experience of Open Mesh Hernia Repair at a Teaching Hospital in Addis Ababa, Ethiopia- A Three Year Retrospective Study

Background- the treatment of hernias has been evolving very fast in the last few decades. The use of mesh for hernia repair has become increasingly popular & many centers considered it as a standard of care. Objective - To determine the rate and types of abdominal wall hernias treated with mesh repair techniques and outcomes of patients. Methods- A retrospective review medical records of all adult patients who underwent open mesh repair at St. Paul’s Hospital Millennium Medical College from September 2013 to August 2016.  Results- Hernia surgeries made 8% of adult elective surgeries. Of these, 130(40.9 %) had mesh repair. Incisional hernias (IH) 68(52.3%) and groin hernias 44(33.8%) being the most common forms repaired with mesh. Except inguinal hernias all hernias were more common in females. Laparotomy for bowel surgery and 29(42.6%) and cesarean section/gynecologic surgeries, 27(29.7%) were the most common surgeries resulting IH. Of IH 57.4 %( n=39) had emergency surgery & 33.8% (n=23) had a low midline incision. Recurrent hernias accounted for 28.5 %( n=37) of the cases repaired with mesh.  Postoperative complication was seen in 14 patients (10.8%) surgical site infection being the main form followed by seroma formation (n=3) & recurrence (n=3). There was an increased rate of complications in females (p=0.043) & in patients with co-morbidity (p=0.041). No death. Conclusion- Our study found that meshes are being used increasingly for incisional & recurrent inguinal hernias. Outcomes of our patients are comparable to published literatures. Key words- Inguinal hernia; incisional hernia; Mesh repair