Surgical training for simple and complex hernia repair in the UK: results of a nationwide training survey

R Willmott ¹, S G Parker ², D Slade ³

⁰University College London Hospitals NHS Foundation Trust, UK.

Annals of the Royal College of Surgeons of England +

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October 1, 2025

View abstract on PubMed

Summary

UK surgical training inadequately prepares surgeons for complex abdominal wall reconstruction (AWR) and hernia repair. Curriculum improvements are needed to enhance trainee competence in advanced hernia procedures.

Area Of Science

General Surgery
Surgical Training
Hernia Repair

Background

Abdominal wall reconstruction (AWR) is an evolving surgical subspecialty.
Concerns exist regarding the adequacy of current UK surgical training for complex hernia procedures.

Purpose Of The Study

To evaluate the effectiveness of UK surgical training in hernia repair.
To assess trainee competence and confidence in simple versus complex hernia repairs.

Main Methods

A CHERRIES-compliant survey was developed by hernia experts.
The survey assessed perceived competence in eight hernia repair types and AWR topics.
Data were collected from surgical trainees, fellows, and consultants.

Main Results

Only open inguinal and umbilical hernia repairs met curriculum requirements.
Two-thirds of trainees performed fewer than ten recurrent inguinal or component separation procedures.
Confidence was highest for simple repairs and lowest for complex ones.

Conclusions

Current UK surgical training is insufficient for complex AWR.
Targeted curriculum enhancements are necessary for complex hernia repair training.

Keywords:

Abdominal wall Curriculum General surgery Hernia Specialties Surgical