We were delighted to read of Dhumale's enthusiasm and success in treating abdominal wall hernias.1 We have a similar experience with 400-plus groin hernia repairs. The model is different — surgery is performed by a retiring general surgeon with an interest in hernia surgery and an enthusiastic GP with a special interest in the subject. No sedation is used and the repair is of modified Shouldice type without mesh. Recurrent hernias and anti-coagulants don't worry us and no anaesthetist is required.
The patients are more satisfied than those from a hospital day care unit, whether in a district hospital, small community hospital or private hospital. There must be savings but no-one really seems to know their true costs. Even if we only save £100 per case and only 50% of the NHS load of 100 000 hernia repairs per year were cared for this way, the savings could be considerable.
- © British Journal of General Practice, 2004.
