Surgical techniques and convalescence recommendations vary greatly in laparoscopic groin hernia repair: a nationwide survey among experienced hernia surgeons.

ABSTRACT

BACKGROUND: Laparoscopic groin hernia repair has become increasingly popular. In Denmark, all groin hernia repairs are registered in the Danish Hernia Database. However, many surgical technical parameters are not registered in neither the hernia database nor in other national registries or the patient files. Our aim was to characterize differences in surgical techniques and variations in convalescence recommendations in laparoscopic groin hernia repair that are not available elsewhere. METHODS: A questionnaire was sent to all surgeons in Denmark regularly performing unsupervised laparoscopic groin hernia repair. The questionnaire was developed in collaboration with an experienced chief surgeon and face-validated on the target group. It contained demographic details and items on surgical parameters such as the creation of pneumoperitoneum, size of the optic, choice of closure methods, preoperative information, and postoperative recommendation of convalescence. RESULTS: A total of 71 surgeons were eligible for inclusion, and 61 (86%) responded. We found large variations in almost all surgical parameters, i.e. there was no uniform way of performing laparoscopic groin hernia repair. The variation was not due to the level of experience. The median recommended convalescence period was 1.5 (range 0-28) days for activities of daily living, 4.5 (range 0-28) days for light physical activity, and 14 (range 0-35) days for hard physical activity. Three percent of surgeons routinely informed patients about the risk of sexual dysfunction prior to operation, and 98% informed about the risk of chronic pain. CONCLUSIONS: Surgical technical parameters and convalescence recommendations in laparoscopic groin hernia surgery vary widely in a national cohort of experienced hernia surgeons.