We searched MEDLINE (1980–2002) and EMBASE using the search terms hernia, inguinal, femoral, and incisional alone and in combination. We selected publications mostly from the past 5 years but did not exclude commonly referenced and highly regarded older publications. We also searched the reference list of articles identified by the search strategy and selected those that were relevant. Selected review articles and meta-analyses or book chapters were included because they provide comprehensive
SeminarHernias: inguinal and incisional
Section snippets
Incidence
Inguinal hernia repair consumes a lot of healthcare resources because it has a high lifetime risk; 27% for men and 3% for women.1 More than 20 million hernias are estimated to be repaired every year around the world; specific rates vary between countries from around 100 to 300 per 100 000 population per year.2 In the UK, about 100 000 inguinal hernias are repaired every year; and in the USA this number reaches 500 000. Most inguinal hernias develop for the first time in patients aged younger
Day-case outpatient surgery
High quality day-case inguinal hernia surgery has been promoted by enthusiasts. These disciplines have been developed mainly in private Hernia Clinics but also include one within the National Health Service (NHS) in Plymouth, UK.125, 126 The Plymouth Hernia Service is based within the outpatient unit of Derriford Hospital and was started in 1996. Its introduction involved careful construction of care pathways by surgeons, anaesthetists, director of nursing and quality, day-case manager, local
Search strategy and selection criteria
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