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Trends in Inguinal Hernia Repair Approach: An Augmented Evidence Review
William T Head1, Sidhant Kalsotra1, Divyaam Satija1
1Center for Abdominal Core Health, Department of Surgery, The Ohio State University Wexner Medical Center.
Summary
Minimally invasive surgery (MIS) is increasingly used for inguinal hernia repair (IHR), including recurrent cases, with robot-assisted procedures driving this shift. This trend was confirmed across empiric, social media, and AI data streams.
Area of Science:
- Surgical innovation and practice patterns
- Hernia surgery outcomes and trends
- Minimally invasive surgical techniques
Background:
- Minimally invasive surgery (MIS) has advanced inguinal hernia repair (IHR).
- Quantifying the shift from open to MIS for IHR, especially in recurrent cases, is crucial.
- Current utilization trends require updated assessment.
Purpose of the Study:
- To evaluate the utilization trends of open versus minimally invasive surgery (MIS) for inguinal hernia repair (IHR).
- To specifically analyze these trends in the context of recurrent inguinal hernias.
- To employ an innovative Augmented Evidence Review (AER) methodology.
Main Methods:
- Utilized the novel Augmented Evidence Review (AER) framework.
- Integrated empiric data (Abdominal Core Health Quality Collaborative registry, 2016-2023), social media insights (International Hernia Collaboration), and AI-synthesized literature (OpenEvidence).
- Analyzed three distinct evidence streams independently before synthesizing findings.
Main Results:
- MIS utilization increased by 20.2% (initial) and 18.0% (recurrent) for IHR, primarily driven by robot-assisted repairs.
- Temporal analysis showed a significant positive correlation between MIS adoption and year for both initial and recurrent IHR.
- Social media data indicated a strong respondent shift towards MIS, with significant adoption of robotic platforms.
Conclusions:
- A significant shift towards MIS, particularly robot-assisted techniques, is evident for both initial and recurrent IHR.
- The AER framework successfully captured real-world practice patterns and outcomes.
- Approach selection should be individualized, considering patient factors, surgeon experience, and available resources.