Inguinal hernia repair by surgical trainees at a Malaysian teaching hospital

OBJECTIVE: To assess the outcome of inguinal hernia repaired by surgical trainees at Universiti Kebangsaan Malaysia Hospital. METHODS: Retrospective review of 103 patients who underwent surgery between November 2001 and October 2002. RESULTS: The mean age of patients was 50 years and the male-to-female ratio was 20:1. Most hernias (60%) were right-sided inguinal hernias. Admissions consisted of 60% elective, 31% day-case and 9% emergency. General anaesthesia was administered in 66% of cases, spinal anaesthesia in 33% and local anaesthesia in 1%. Ten inguinal hernia repairs were performed by first-year trainees, 61 by third-year trainees and 19 by fourth-year trainees. First-year trainees did more darning (60%) and fewer mesh (40%) repairs. Third-year trainees still used darning (57%) but also performed more mesh repairs (43%). Fourth-year trainees performed 68% darning (mainly to teach the first-year trainees) and 32% mesh repairs. Senior surgeons assisted in 13 difficult cases where mesh repair was preferred (92%) to darning repairs (8%). Prophylactic antibiotic was more frequently used in patients undergoing mesh repair (p < 0.001). The mean operative time was the same for both types of repair. There were no significant differences in complications between the two types of repair. One hernia recurred after darning repair but none after mesh repair. CONCLUSIONS: Mesh repair of inguinal hernia is effective. Trainees easily acquire this skill and it becomes their preferred method of repair.