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Primary inguinal hernia repair in The Netherlands
M P Simons1, H F Hoitsma, F J Mullan
1Department of Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
Summary
Dutch surgeons lack a standard inguinal hernia repair technique. Most use multiple methods, with few employing prosthetic meshes or laparoscopic approaches, indicating significant practice variation.
Area of Science:
- Surgery
- Hernia Repair Techniques
Background:
- Inguinal hernia repair is a common surgical procedure.
- Standardization of operative methods is crucial for consistent patient outcomes.
Purpose of the Study:
- To assess the operative methods used in Dutch surgical practice for primary inguinal hernia repair.
- To identify variations in surgical techniques and materials employed.
Main Methods:
- A nationwide survey by questionnaire was distributed to all Dutch surgeons.
- Data collected included repair methods, specific surgical options, materials used, and comparisons between training and district hospitals.
Main Results:
- A high departmental response rate (94%) but a lower surgeon response rate (58%) was achieved.
- Most surgeons (57%) used combinations of 11 different methods, with only 9 using prosthetic mesh and 7 laparoscopic repair.
- The Shouldice method was more popular in training hospitals (36%) than non-training hospitals (20%). Significant technique modifications were reported, with 64% of surgeons adapting methods to individual patients.
Conclusions:
- There is a notable lack of a standardized technique for inguinal hernia repair in the Netherlands.
- The wide variation in methods and frequent modifications suggest a need for further research into best practices.