2019Annals of The Royal College of Surgeons of EnglandOpen access

Management of the uncomplicated primary inguinal hernia in 2019: the practice amongst members of the British Hernia Society

Duncan Light, BM Stephenson, DL Sanders, On behalf of the British Hernia Society

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Abstract

INTRODUCTION: The aim of this study was to survey the current practice of UK-based hernia surgeons in elective inguinal hernia repair. MATERIALS AND METHODS: A questionnaire was created using SurveyMonkey™ and sent electronically to registered members of the British Hernia Society. RESULTS: A total of 368 responses were obtained (a response rate of 55%); 83% were consultant surgeons, 91% were male and 91% stated that they had an interest in laparoscopic surgery. For an uncomplicated inguinal hernia in a male patient, 60% would perform an open Lichtenstein repair, 20% trans-abdominal pre-peritoneal repair and 20% totally extra-peritoneal repair. In a female patient, 54% would perform an open Lichtenstein repair, 25% trans-abdominal pre-peritoneal repair and 21% totally extra-peritoneal repair. 90% always use mesh in inguinal hernia repair. 93% of surgeons rarely or never perform a tissue repair. CONCLUSIONS: Despite recent controversy, UK surgeons support the use of mesh in the repair of inguinal hernias with an open Lichtenstein repair being the most common choice. There has only been a modest increase in the use of laparoscopic surgery over the past 20 years.

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INTRODUCTION: The aim of this study was to survey the current practice of UK-based hernia surgeons in elective inguinal hernia repair. MATERIALS AND METHODS: A questionnaire was created using SurveyMonkey™ and sent electronically to registered members of the British Hernia Society. RESULTS: A total of 368 responses were obtained (a response rate of 55%); 83% were consultant surgeons, 91% were male and 91% stated that they had an interest in laparoscopic surgery. For an uncomplicated inguinal hernia in a male patient, 60% would perform an open Lichtenstein repair, 20% trans-abdominal pre-peritoneal repair and 20% totally extra-peritoneal repair. In a female patient, 54% would perform an open Lichtenstein repair, 25% trans-abdominal pre-peritoneal repair and 21% totally extra-peritoneal repair. 90% always use mesh in inguinal hernia repair. 93% of surgeons rarely or never perform a tissue repair. CONCLUSIONS: Despite recent controversy, UK surgeons support the use of mesh in the repair of inguinal hernias with an open Lichtenstein repair being the most common choice. There has only been a modest increase in the use of laparoscopic surgery over the past 20 years.

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Available abstract

INTRODUCTION: The aim of this study was to survey the current practice of UK-based hernia surgeons in elective inguinal hernia repair. MATERIALS AND METHODS: A questionnaire was created using SurveyMonkey™ and sent electronically to registered members of the British Hernia Society. RESULTS: A total of 368 responses were obtained (a response rate of 55%); 83% were consultant surgeons, 91% were male and 91% stated that they had an interest in laparoscopic surgery. For an uncomplicated inguinal hernia in a male patient, 60% would perform an open Lichtenstein repair, 20% trans-abdominal pre-peritoneal repair and 20% totally extra-peritoneal repair. In a female patient, 54% would perform an open Lichtenstein repair, 25% trans-abdominal pre-peritoneal repair and 21% totally extra-peritoneal repair. 90% always use mesh in inguinal hernia repair. 93% of surgeons rarely or never perform a tissue repair. CONCLUSIONS: Despite recent controversy, UK surgeons support the use of mesh in the repair of inguinal hernias with an open Lichtenstein repair being the most common choice. There has only been a modest increase in the use of laparoscopic surgery over the past 20 years.

Key concepts: Medicine, Inguinal hernia, General surgery, Hernia, Hernia repair, Surgery, Abdominal surgery, Laparoscopy

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