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Tailored approach in inguinal hernia repair - decision tree based on the guidelines
Ferdinand Köckerling1, Christine Schug-Pass1
1Department of Surgery, Centre for Minimally Invasive Surgery, Vivantes Hospital Berlin, Academic Teaching Hospital of Charité Medical School , Berlin , Germany.
Frontiers in Surgery
|January 17, 2015
Summary
This review summarizes current guidelines for inguinal hernia repair, detailing endoscopic and open techniques. It emphasizes a tailored approach, selecting the best method based on patient specifics to minimize risks.
Area of Science:
- Surgery
- Gastroenterology
Background:
- Endoscopic (TEP, TAPP) and open (Lichtenstein, Plug and Patch, PHS) techniques are gold standards for inguinal hernia repair.
- Guidelines from major surgical societies recommend these evidence-based approaches.
Purpose of the Study:
- To review and synthesize recommendations from various guidelines on inguinal hernia repair.
- To develop a practical decision tree for surgeons based on evidence-based guidelines.
Main Methods:
- Review of existing evidence-based guidelines and expert consensus conferences.
- Analysis of differential therapeutic situations in inguinal hernia repair.
Main Results:
- The "tailored approach" is used by 82% of experienced surgeons, differentiating techniques based on patient findings.
- Key differential situations include unilateral, bilateral, scrotal, recurrent, and emergency hernias, as well as cases with contraindications to general anesthesia.
Conclusions:
- A differentiated, tailored approach to inguinal hernia repair is crucial for minimizing risks.
- A practical decision tree integrating guideline recommendations can aid surgeons in daily practice.
