In a study conducted in Uganda and published in JAMA Surgery, researchers from Karolinska Institutet evaluated a new surgical method for treating groin hernias in women. The method could become an alternative in resource-limited settings where laparoscopic techniques are not generally available.
Groin hernia repair is the most common general surgical procedure in the world. Groin hernias are more common in men, but women are more likely to experience complications due to this condition.
Many women in low- and middle-income countries who need surgery for groin hernias lack access to laparoscopy (keyhole surgery). To evaluate a new method using open surgery, the researchers conducted a randomised clinical trial at two publicly funded hospitals in Uganda. The study included 200 women who underwent groin hernia surgery and were followed up after two weeks and after one year.
Femoral hernias were common
There are two main types of groin hernias, called inguinal and femoral hernias. The evaluation showed that the new surgical method was effective for both femoral and inguinal groin hernias.
Its effectiveness for both types is particularly important as the study also showed that nearly 45 percent of the women had femoral hernias, which carry a higher risk of complications.
"The fact that so many of the women had femoral hernias was unexpected and highlights the need to develop effective, safe and accessible methods," says Alphonsus Matovu, PhD at the Department of Molecular Medicine and Surgery, Karolinska Institutet and first author of the article.
Millions of women affected
The results are promising as the new method could be developed into a viable alternative where access to advanced laparoscopic surgery is limited.
"Women with groin hernias can suffer serious and even fatal complications and therefore need access to effective surgical methods," says Jenny Löfgren, docent at the same department and last author of the article. "The new method could become a valuable tool to improve care for millions of women".
The method needs further evaluation, and the researchers will also follow up with the study participants five years after surgery to ensure long-term results. To improve treatment, the new method will also be compared with other surgical methods, both open and laparoscopic.
The Swedish Research Council funded the study. See the scientific article for information about potential conflicts of interest.