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Inguinal hernia repair: a survey of Canadian practice patterns
1Department of Surgery, University of Calgary, Alta.
Objective:
To describe the preferences of general surgeons across Canada with respect to hernia repair technique.
Design:
A survey by mailed questionnaire.
Participants:
All 1452 fellows of the Royal College of Physicians and Surgeons of Canada currently holding a certificate in general surgery.
Intervention:
Two mailings of the survey: the first in December 1996, the second to nonrespondents in February 1997.
Main Outcome Measures:
Surgeons' preference of hernia repair technique for specified indications. This was analysed according to practice setting and geographic location.
Main Results:
Based on 706 completed questionnaires, the preferred techniques for repair of primary inguinal hernias were as follows: 23% Bassini, 20% mesh plug, 16% Lichtenstein, 15% laparoscopic, 11% Shouldice and 11% McVay. Preference for laparoscopic repair increased to 34% for recurrent hernias and 35% for bilateral hernias. The Atlantic provinces had the lowest preference rates for laparoscopic repair and the highest rates for the mesh plug technique.
Conclusions:
Most surgeons select the type of repair on the basis of the clinical scenario. Large variations in practice exist between provinces.