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The Shouldice Method: an expert's consensus.

Marguerite Mainprize¹, Fernando A C Spencer Netto², Cassim Degani²

¹Department of Surgery, Shouldice Hospital, 7750 Bayview Avenue, Thornhill, ON, L3T 7N2, Canada. mmainprize@shouldice.com.

Hernia : the Journal of Hernias and Abdominal Wall Surgery

|August 8, 2022

Summary

This summary is machine-generated.

This study outlines the essential steps of the Shouldice Method for inguinal hernia repair, based on expert consensus. It provides a detailed framework for surgeons performing non-mesh hernia repairs.

Keywords:

Consensus Delphi technique Shouldice repair Tissue repair

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Area of Science:

Surgical Procedures
Hernia Repair Techniques
Surgical Consensus

Background:

Inguinal hernia repair is a common surgical procedure.
The Shouldice Repair is a well-documented technique with established outcomes.
Previous literature has not fully detailed the essential steps from Shouldice Hospital experts.

Purpose of the Study:

To identify and define the critical steps of the Shouldice Method for inguinal hernia repair.
To establish a consensus among Shouldice Hospital experts on the core components of their technique.

Main Methods:

Delphi methodology was employed with content experts from Shouldice Hospital.
Surgeons responded to items on a five-point Likert scale.
Consensus was defined as Cronbach's Alpha ≥ 0.8 and ≥ 80% agreement on key items.

Main Results:

A consensus framework comprising 39 items and 7 overarching steps was established.
The 7 steps include: preoperative preparation, anesthesia, incision/nerve identification, cremasteric muscle treatment, hernia management, posterior wall reconstruction, and postoperative care.
This provides a structured approach to the Shouldice Method.

Conclusions:

The consensus provides a step-by-step guide to the Shouldice Method.
This information is valuable for surgeons implementing non-mesh hernia repairs.
The study refines understanding of this specific surgical technique.