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Experience with the PINQ-PHONE telephone questionnaire for detection of recurrences after endoscopic inguinal hernia repair

  • W. J. BakkerEmail author
  • M. M. Roos
  • T. Kerkman
  • J. P. J. Burgmans
Original Article



The PINQ-PHONE is a 4-question telephone questionnaire designed and validated as a recurrence detection method after laparo-endoscopic inguinal hernia repair. The study aim was to evaluate the PINQ-PHONE by describing our experience with the questionnaire in a high-volume randomized-controlled trial.


The PINQ-PHONE was performed 5 years postoperatively after endoscopic totally extraperitoneal (TEP) repair. Positive PINQ-PHONE responses were compared with clinical assessments for a recurrence. An “experience with the PINQ-PHONE”-survey was conducted among the executing researchers. Furthermore, positive predictive values (PPV) for the separate questions and overall PINQ-PHONE were determined.


Fifty-two of 769 responding patients (6.8%) had positive PINQ-PHONE responses and were invited to visit the outpatient clinic, thus preventing follow-up visits in 93.2% of included patients. Two recurrences were detected (0.3%). The overall PPV of the PINQ-PHONE was low (0.057). The PPV of question 1 (0.040) and 2 (0.100) was lower than that of question 3 (0.222) and 4 (0.286). The PPV of only question 3 and 4 combined was 0.183, and no recurrence would have been missed. The researcher survey unanimously produced that the PINQ-PHONE was user-friendly and executed in < 5 min, and questions 3 and 4 were considered adequate for recurrence detection. The majority found questions 1 and 2 to be inadequate questions.


The PINQ-PHONE proved to be a valuable tool in TEP repair follow-up for recurrences. Enhancement of the PINQ-PHONE using only question 3 and 4 is recommended, since more patients refrain from outpatient clinic visits, and nevertheless, recurrences are safely detected.


PINQ-PHONE Experience Follow-up Recurrences Inguinal hernia TEP 



The authors would like to thank Demi Post and Maud Reijntjes for telephonically contacting the participants and filling out the researcher survey.

Author contributions

WJB: study conception and design, data collection, analysis and interpretation of data, and drafting of manuscript. MMR: study conception and design, data collection, interpretation of data, and critical revision. TK: data collection and critical revision. JPJB: study conception and design, interpretation of data, and critical revision.



Compliance with ethical standards

Conflict of interest

The authors WJB, MMR, TK, and JPJB declare that they have no conflict of interests.

Ethical approval

Ethical approval was obtained by the Regional Medical Ethics Committee and the hospitals Ethics Board.

Human and animal rights statement

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


  1. 1.
    HerniaSurge Group (2018) International guidelines for groin hernia management. Hernia 22:1–165CrossRefGoogle Scholar
  2. 2.
    Roos M, Bakker WJ, Schouten N, Voorbrood C, Clevers GJ, Verleisdonk EJ, Davids P, Burgmans J (2018) Higher recurrence rate after endoscopic totally extraperitoneal (TEP) inguinal hernia repair with ultrapro lightweight mesh: 5-year results of a randomized controlled trial (TULP-trial). Ann SurgGoogle Scholar
  3. 3.
    Lopez-Cano M, Vilallonga R, Sanchez JL, Hermosilla E, Armengol M (2007) Short postal questionnaire and selective clinical examination combined with repeat mailing and telephone reminders as a method of follow-up in hernia surgery. Hernia 11:397–402CrossRefGoogle Scholar
  4. 4.
    Vos PM, Simons MP, Luitse JS, van Geldere D, Koelemaij MJ, Obertop H (1998) Follow-up after inguinal hernia repair. Questionnaire compared with physical examination: a prospective study in 299 patients. Eur J Surg 164:533–536CrossRefGoogle Scholar
  5. 5.
    van den Heuvel B, van Jarwaarde JA, Wichers P, de Lange de Klerk ES, Bonjer HJ, Dwars BJ (2015) Follow-up after laparoscopic inguinal hernia repair, can it be done by phone? A prospective study in 300 patients, the PINQ-PHONE. Surg Endosc 29:3292–3297CrossRefGoogle Scholar
  6. 6.
    Burgmans JP, Voorbrood CE, Schouten N, Smakman N, Elias S, Clevers GJ, Davids PH, Verleisdonk EJ, Hamaker ME, Simmermacher RK, van Dalen T (2015) Three-month results of the effect of ultrapro or prolene mesh on post-operative pain and well-being following endoscopic totally extraperitoneal hernia repair (TULP trial). Surg Endosc 29:3171–3178CrossRefGoogle Scholar
  7. 7.
    Burgmans JP, Voorbrood CE, Simmermacher RK, Schouten N, Smakman N, Clevers G, Davids PH, Verleisdonk EM, Hamaker ME, Lange JF, van Dalen T (2016) Long-term results of a randomized double-blinded prospective trial of a lightweight (ultrapro) versus a heavyweight mesh (prolene) in laparoscopic total extraperitoneal inguinal hernia repair (TULP-trial). Ann Surg 263:862–866CrossRefGoogle Scholar

Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Hernia Clinic, Department of SurgeryDiakonessenhuis Utrecht/ZeistZeistThe Netherlands

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