Hunterian Lecture. Hernia surgery: from guidelines to clinical practice

Area of Science:

• Surgical Practice
• Evidence-Based Medicine
• Clinical Guidelines

Background:

• Hernia repair has transformed over three decades, shifting from traditional methods to evidence-based practices.
• The development and dissemination of clinical guidelines have been pivotal in this evolution.
• Early UK practices involved nylon darn repairs, contrasting with modern mesh hernioplasty and laparoscopic approaches.

Discussion:

• The Royal College of Surgeons of England (RCSE) guidelines spurred debate and innovation in hernia repair techniques.
• The introduction of mesh hernioplasty and laparoscopic surgery marked significant advancements.
• Continued evolution led to the comprehensive European Hernia Society (EHS) guidelines in 2008.

Key Insights:

• The EHS guidelines offer a structured framework for abdominal wall surgery.
• They encompass crucial aspects from surgical indications and patient investigations to post-operative care and outcomes.
• These guidelines provide essential information for patient management and decision-making.

Outlook:

• The EHS guidelines empower surgeons with choices for personalized hernia repair.
• They serve as a foundation for informed decision-making in complex surgical cases.
• Future advancements will likely continue to refine hernia management strategies based on evolving evidence.