Abstract
Specialization influences the way that we deliver surgical care and has a direct impact on surgeons, healthcare systems and patients. Abdominal wall hernia repairs are among the most commonly performed surgical procedures worldwide, and over 20 million prosthetic meshes are inserted annually. Worldwide outcomes from groin hernia repair, as reflected by 5-year recurrence rates, range from 1 to 4 %. However, the results for incisional hernia repair are at least ten times worse, with worldwide recurrence rates of about 25 % and upwards. This editorial aims to debate the argument for and against hernia subspecialists and provide a framework for implementing specialist hernia services.
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References
Sauerland S et al (2011) Laparoscopic versus open surgical techniques for ventral or incisional hernia repair. Cochrane Database of systematic Rev 3:CD007781. doi:10.1002/14651858.CD007781.pub2
Chowdhury MM, Dagash H, Pierro A (2007) A systematic review of the impact of volume of surgery and specialization on patient outcome. Br J Surg 94(2):145–161. doi:10.1002/bjs.5714
Swisher SG et al (2000) Effect of operative volume on morbidity, mortality, and hospital use after esophagectomy for cancer. J Thorac Cardiovasc Surg 119(6):1126–1132
Cassar K, Munro A (2002) Surgical treatment of incisional hernia. Br J Surg 89(5):534–545. doi:10.1046/j.1365-2168.2002.02083.x
Helgstrand F et al (2011) Nationwide analysis of prolonged hospital stay and readmission after elective ventral hernia repair. Dan Med Bull 58(10):A4322
Iannitti DA et al (2008) Technique and outcomes of abdominal incisional hernia repair using a synthetic composite mesh: a report of 455 cases. J Am Coll Surg 206(1):83–88. doi:10.1016/j.jamcollsurg.2007.07.030
Bittner R et al (2002) Laparoscopic transperitoneal procedure for routine repair of groin hernia. Br J Surg 89(8):1062–1066. doi:10.1046/j.1365-2168.2002.02178.x
Birkmeyer JD et al (2003) Surgeon volume and operative mortality in the United States. N Engl J Med 349(22):2117–2127. doi:10.1056/NEJMsa035205
Borenstein SH et al (2005) Effect of subspecialty training and volume on outcome after pediatric inguinal hernia repair. J Pediatr Surg 40(1):75–80. doi:10.1016/j.jpedsurg.2004.09.002
Cueto Rozon R et al (2006) Surgical training and inguinal hernia repair. Ann Chir 131(5):311–315. doi:10.1016/j.anchir.2006.02.003
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DS declares conflict of interest not directly related to the submitted work; AK declares conflict of interest not directly related to the submitted work; AW declares conflict of interest not directly related to the submitted work.
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Sanders, D.L., Kingsnorth, A.N. & Windsor, A.C.J. Is there a role for hernia subspecialists? Or is this a step too far?. Hernia 20, 637–640 (2016). https://doi.org/10.1007/s10029-016-1511-9
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DOI: https://doi.org/10.1007/s10029-016-1511-9