Hernia and Abdominal Wall Surgery Fellowships: results of a 1-year pilot program : Pilot of hernia surgery fellowship

Hernias are among the most common maladies treated by surgeons worldwide. Over the past decades, the spectrum of hernia disease has become increasingly more complex. There is thus a role for the creation of Hernia and Abdominal Wall Surgery Fellowships to better prepare surgeons to perform complex hernia repair.

The Fellowship Council (FC) engaged the American Hernia Society (AHS) and the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) to create a new designation for Hernia and Abdominal Wall Fellowships within the FC. Members of both organizations developed agreed upon case criteria for a program to receive this designation and received approval from the FC. During the 2023-2024 academic year, six fellowship programs volunteered to pilot the case criteria to assess whether they were achievable within their training program. All programs had a strong historic track record of hernia and abdominal wall surgery. From January 2024 onwards, their case logs were entered into a modified version of the existing case log system to account for the new criteria.

Over a 12-month period, eight fellows from six fellowship programs logged their cases in the modified case log system. 935 core procedures were logged with an average of 117 cases per fellow (range 68-173). The proportion of fellows meeting the minimum number of cases was variable depending on type of procedure. All fellows met requirements for inguinal hernia case numbers (n = 30). Due to the mid-year change in the case log definitions, no fellow met the minimum requirement of cases for 3-10 cm ventral hernia repairs (n = 30).

In this 1-year pilot program, there was varied success with respect to fellows meeting the pre-defined procedures minimum. This is likely multifactorial owing to differences in hospital volume, practice patterns, mid-year change of the case log, and self-reporting of case numbers.