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Methods: Different approaches to assessing the relative cost-effectiveness of the surgical techniques were considered: Systematic review of economic evaluation; A cost-consequence analysis; A cost-utility analysis; Incorporation of a discrete choice experiments (DCEs). Results: The data provided by the systematic review of economic evaluations were unreliable and unlikely to fully address the needs of decision-makers. However, using these data and data from a review of effectiveness, the National Institute for Clinical Excellence (NICE) concluded that laparoscopic repair of primary inguinal hernias was not worth the additional cost. A cost-consequence analysis was developed to make better use of the available data. It found that open non-mesh was not cost-effective and that a judgement is required about whether the benefits of laparoscopic repair (reduced pain and earlier return to usual activities) are worth the extra cost and the risk of rare, potentially serious intra-operative complications. The cost-utility analysis combined the effects of care into estimates of incremental cost per quality adjusted life year (QALY). The analysis suggested that laparoscopic repair was highly likely to be cost-effective. In 2004, NICE revised its guidance on inguinal hernia repair by recommending that laparoscopic repair was an acceptable method for use in the NHS. Conclusions: the progressive evaluation informed decision-makers about the role of laparoscopic repair. The systematic review of economic evaluations was of limited value but the three different forms of the economic evaluation drew attention to the choices and trade-offs that could be made.

As laparoscopic surgery continues to gain widespread popularity in the world of surgery, the lack of one fundamental sensation at times put surgeons in a state of apprehension. Tactile feedback, the missing sensation, is claimed by surgeons to be an essential process to secure accurate knowledge of the region that is being operated on. In cases where visual cues alone fail to allow distinction of tissues of an area, tactile information may be the only remaining alternative the surgeon can rely upon to make a correct judgement. It is therefore imperative that this form of perceptual feedback may also be portrayed to surgeons using laparoscopic surgery, thereby recreating their more familiar environment, and assist them increase the chances of successfully completing a surgical procedure. In an attempt to remedy the present situation where tactile information in laparoscopic surgery is lacking, conditions that are thought to influence the surgeons' tactual perception during surgery were chosen to be investigated. Namely, these conditions are composed of bare hand, gloved, and the use of an intermediate tool. Unfortunately, the exact tactual dimensions that are relevant during surgery in general remain ambiguous and unclear. Therefore, as a preliminary investigation, it was proposed to take the dimension "softness", a dimension that is in general accepted as one of the fundamental tactual perception dimensions, and examine how the aforementioned examination conditions affect tactual perception for a material that differs in "softness" alone. Modified two alternative forced choice tasks were performed as a first experiment through which fruitful and promising outcomes were seen. To build on the finding of this experiment, a second experiment, which involved the softness magnitude estimations of the stimuli set, again under the same examination conditions, was carried out. The standalone results from the two experiments showed some interesting outcomes, primarily that softness was perceived differently under different examination conditions. Upon comparison, however, behaviours and activities which were to some extent, remarkable and perplexing, were encountered, leading to conclusions which in part were contradictory.

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A quantitative descriptive study was conducted to establish professional nurses’ and patients’ knowledge and understanding of laparoscopic surgery and to determine whether nurses are sufficiently knowledgeable to disseminate adequate information about laparoscopic surgery to patients. Two state hospitals based in KwaZulu-Natal where laparoscopic surgery is done were selected and the respondents were selected through convenience sampling. Data were collected by administering questionnaires to theatre nurses (n=39), ward nurses (n=87) and patients (n=42) scheduled for laparoscopic surgery. The SPSS version 15 for Windows was used to compute the results. The findings revealed that the professional nurses were not sufficiently knowledgeable about laparoscopic surgery to give adequate information to patients and the patients themselves were not fully informed about all aspects of laparoscopic surgery including the possibility of conversion to open surgery, complications and advantages and after care. There is therefore a dire need for improvement of patient education to assist patients gaining optimal recovery / Health Studies / M.A. (Health Studies)

A quantitative descriptive study was conducted to establish professional nurses’ and patients’ knowledge and understanding of laparoscopic surgery and to determine whether nurses are sufficiently knowledgeable to disseminate adequate information about laparoscopic surgery to patients. Two state hospitals based in KwaZulu-Natal where laparoscopic surgery is done were selected and the respondents were selected through convenience sampling. Data were collected by administering questionnaires to theatre nurses (n=39), ward nurses (n=87) and patients (n=42) scheduled for laparoscopic surgery. The SPSS version 15 for Windows was used to compute the results. The findings revealed that the professional nurses were not sufficiently knowledgeable about laparoscopic surgery to give adequate information to patients and the patients themselves were not fully informed about all aspects of laparoscopic surgery including the possibility of conversion to open surgery, complications and advantages and after care. There is therefore a dire need for improvement of patient education to assist patients gaining optimal recovery / Health Studies / M.A. (Health Studies)