The economic burden of incisional ventral hernia r
Incisional hernias are a frequent complication of abdominal surgery and some patient variables including obesity, postoperative surgical site infections and the presence of abdominal aortic aneurysm have been identified as risk factors [1–3]. The surgical technique and material to close abdominal wall incisions are also of utmost importance to avoid a high frequency of incisional hernias [4, 5]. The European Hernia Society has recently developed and published guidelines on the closure of abdominal wall incisions . As part of this initiative, the Guidelines Development Group ‘‘The Bonham Group’’ has tried to determine the economic burden related to the treatment of an incisional hernia according to previously published recommendations . Apart from the known negative impact of an incisional hernia on the patients’ quality of life and body image, patients with an incisional hernia are at risk of potential serious complications . The repair of incisional hernia has direct costs and indirect costs. Esti- mation of the costs related to the treatment of incisional hernias can reflect the socio-economic gain to be made by optimizing abdominal wall closure technique and reduction of the incidence of incisional ventral hernia.
The magnitude on a national level of the costs related to incisional hernias has been reported for Sweden, where about 2000 incisional hernias are repaired annually with a direct cost approximately 170 million Swedish Krona (SEK) (±18 million Euro). The direct and indirect costs for an incisional hernia have been calculated to be 86,257 SEK (±9112€) . In a nationwide study for the United State (US) an estimated 348,000 ventral hernia repairs were performed in 2006 with a direct cost for inpatient proce- dures of 15,899 US dollar (±13,000€) and for outpatient procedures 3873 US dollar (±3168€) . This amounts to a total cost of ventral hernia repair for the US in 2006 of 3.2 billion US dollar (±2.6 billion Euro).
The objective of this study was to perform a review of the literature on the costs related to incisional hernia repair and to make an estimate of the direct and indirect costs for incisional hernia repair in France using nationwide data.