Age and Regional Trends in Groin Hernia Surgery in Japan: An Analysis of Laparoscopic Repair, Outpatient Surgery, and...

Groin hernia repair is one of the most common surgical procedures worldwide. In Japan, nationwide studies have described overall surgical volumes and procedural characteristics; however, comprehensive analyses focusing on age- and sex-specific patterns across multiple aspects of groin hernia management remain limited.

We analyzed publicly available open data from the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB) for fiscal years 2014-2023. Age- and sex-specific surgery rates and lifetime surgical burden were estimated using population-based rates. Trends in laparoscopic and outpatient surgery were examined by age and sex. Manual reduction was evaluated using population-based rates per 100 000 population and a relative indicator in relation to surgical volume.

Total groin hernia surgery volumes declined during the COVID-19 pandemic and recovered thereafter. Age-specific surgery rates showed characteristic patterns, including a bimodal distribution for inguinal hernia and a progressive age-related increase for femoral hernia. Lifetime surgical burden in males was estimated at approximately 21 per 100 individuals, substantially higher than in females. Laparoscopic and outpatient surgery demonstrated distinct age- and sex-specific patterns. Population-based manual reduction rates were highest in early childhood, were minimal from adolescence through mid-adulthood, and increased again in advanced age.

Nationwide claims-based data reveal pronounced age- and sex-specific patterns in groin hernia management in Japan. These findings highlight substantial demographic differences in surgical burden, procedural selection, and manual reduction activity, underscoring the value of population-based data for understanding contemporary groin hernia care in an aging society.