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Perioperative outcome in groin hernia repair: what are the most important influencing factors?



Using registry analyses, a large number of influencing factors on the perioperative outcome of groin hernia repair has been identified. The interactions between several influencing factors and differences in the influencing value have to date been inadequately investigated.


This retrospective analysis of prospectively collected data from the Herniamed Registry included all fully documented cases with minimum age of 16 years and groin hernia repair. Patients were assigned to the risk groups unilateral, bilateral, recurrent and emergency groin hernia repair. Multivariable analysis was performed to investigate the influence of confirmatory defined patient- and procedure-related characteristics on the outcome parameters intraoperative, postoperative general and postoperative surgical complications, complication-related reoperation and total perioperative complications.


A highly significantly unfavorable association with the total perioperative complication rate was identified for emergency groin hernia repair, scrotal hernia, anticoagulant medication and coagulopathy. A significantly unfavorable relation with the total perioperative complication rate was found for recurrence procedure, bilateral repair, high age, ASA score III/IV, femoral hernia, antithrombotic medication, smoking, COPD and corticosteroid medication. A significantly favorable correlation with the total perioperative complication rate was observed for the laparo-endoscopic techniques, smaller defects, female gender, normal weight and medial hernia.


Both the number of potential influencing factors and their influencing value on the perioperative outcome should be considered when estimating the individual risk of a patient with groin hernia repair.

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Correspondence to F. Köckerling.

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Conflict of interest

Dr. Köckerling reports grants to fund Herniamed from Johnson & Johnson, Norderstedt, Karl Storz, Tuttlingen, pfm medical, Cologne, Dahlhausen, Cologne, B Braun, Tuttlingen, MenkeMed, Munich, Bard, Karlsruhe. Personal fees from Bard, Karlsruhe, outside the submitted work. All other authors have nothing to disclose.

Ethical approval

As only cases of routine hernia surgery are documented in the Herniamed Registry, an ethical approval was not neccessary.

Human and animal rights

This article does not contain any study with animals performed by any of the authors.

Informed consent

All patients with routine hernia surgery documented in the Herniamed Registry have signed an informed consent declaration agreeing to participate.

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Köckerling, F., Adolf, D., Lorenz, R. et al. Perioperative outcome in groin hernia repair: what are the most important influencing factors?. Hernia 26, 201–215 (2022).

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  • Groin hernia
  • Perioperative complications
  • Postoperative surgical complications
  • General complications
  • Complication-related reoperations