Long-term follow-up and operative performance metrics of inguinal hernioplasty training in the Dominican Republic

Purpose: The long-term outcomes of inguinal hernioplasty are crucial for evaluating patient benefits, though follow-up can be challenging, especially in low and middle-income countries (LMICs). Methods: Program coordinators in the Dominican Republic reached out to 288 patients operated on between 2014 and 2019 under a Hernia Repair for the Underserved (HRFU) training initiative. Each patient underwent an anterior Lichtenstein procedure performed by either an international HRFU expert surgeon (128 patients) or two local Dominican surgeons (160 patients) certified using the Operative Performance Rating Scale (OPRS). Results: Long-term outcomes were obtained from 30% (86/288) of patients. Follow-up data were obtained from 12% (35/288) of patients by a history and physical examination by independent Dominican surgeons. 18% (51/288) completed telephone follow-up using a four-question survey tailored for standard inguinal hernia outcomes. The phone questionnaire follow-up method (18%) was more effective than the H & P. One patient required reoperation for a mesh granuloma and one had a reoperation for a recurrent hernia. The average length of follow-up was 52 months. Conclusion: This study reports the longest durations of follow-up after inguinal hernia repair performed in a LMIC and the longest clinical outcomes follow-up of operations performed using the OPRS training method.