V-014 TIPS AND TRICKS OF INGUINAL HERNIA SURGICAL MANAGEMENT IN SUB-SAHARAN AFRICA COOPERATION CAMPAIGNS

Abstract

Abstract Introduction and Aim Inguinal hernia is the most prevalent surgical pathology in every surgery department. However, in the African continent (especially the Sub-Saharan region), the shortage of surgeons and the population's difficulty in accessing medical care have made herniary pathology a very frequent cause of disability in the young population. That is why foundations such as “Hernia International” and “Cirujanos en acción” carry out numerous cooperation campaigns each year, in which surgical treatment of inguinal hernia is the key as it meets the four ideal requirements: high prevalence, high impact of surgical treatment, few serious postoperative complications and the possibility of operating on many patients with few resources.The standard surgery in this setting is the Lichtenstein type hernioplasty with sac ligation for L3EHS type hernias.But we believe that the preperitoneal approach through the anterior access (Berliner technique)also has an indication that the general surgeon should know. Material and Methods We present the two surgical approaches that we use in cooperation campaigns, analyzing the technical tricks for the management. 1.They are mostly L3 hernias with large chronic scrotal sacs due to persistent peritoneo-vaginal processes of long evolution; 2.High sac ligation is a resource that will reduce the risk of recurrence; 3.The Lichtenstein technique is the standard approach used when the posterior wall is acceptable and the deep inguinal orifice is less than 3cm; 4.In the rest of the cases,the Berliner technique is a technique with excellent long-term results and that the surgeon who operates hernias on the African continent should master.