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Current practices of laparoscopic inguinal hernia repair: a population-based analysis
M Trevisonno1, P Kaneva1, Y Watanabe1,2
1Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, McGill University, 1650 Cedar Avenue, Montreal, QC, H3G 1A4, Canada.
Hernia : the Journal of Hernias and Abdominal Wall Surgery
|March 11, 2015
Summary
Most surgeons prefer open surgery for inguinal hernia repair, despite guidelines. A small group of surgeons perform most laparoscopic inguinal hernia repairs (LIHR), indicating a practice gap.
Area of Science:
- General Surgery
- Surgical Innovation
- Hernia Repair Techniques
Background:
- Laparoscopic inguinal hernia repair (LIHR) adoption varies among surgeons.
- Current practice patterns for LIHR in Quebec are not well-documented.
- Understanding surgeon preferences is crucial for improving hernia repair outcomes.
Purpose of the Study:
- To describe the practice patterns of inguinal hernia repair among Quebec surgeons.
- To identify factors associated with the choice of a laparoscopic approach for inguinal hernias.
- To investigate the gap between recommended and actual LIHR utilization.
Main Methods:
- Population-based cohort study of inguinal hernia repairs in Quebec (2007-2011).
- Analysis of 49,657 repairs performed by 478 surgeons.
- Generalized linear model used to identify predictors of laparoscopic approach selection.
Main Results:
- Laparoscopic inguinal hernia repair (LIHR) was used in only 8% of all cases.
- Surgeons who performed many LIHRs accounted for a large proportion of all laparoscopic cases.
- Younger patient age, fewer comorbidities, and hernia type (bilateral, recurrent) were associated with LIHR.
Conclusions:
- Open repair remains the predominant approach for inguinal hernias, even in cases favoring LIHR.
- A significant divide exists among surgeons regarding LIHR adoption.
- A discrepancy between clinical guidelines and actual surgical practice necessitates further investigation into barriers for wider LIHR uptake.
