Journal Article

Consensus on international guidelines for management of groin hernias

Bittner Reinhard, Van den Heuvel Baukje, Klinge Uwe, Smedberg Sam, van Veenendaal Nadine, Simons, Maarten, Morales-Conde, Salvador, Köckerling Ferdinand, Sani Rachid, telny Rene, Konate Ibrahima, Nordin Par, Niebuhr, Henning, Campanelli Giampiero, Fitzgibbons, Robert, Gillion, Jean Francois, Miserez Marc, Sathien, Tumtavitikul, Montgomery, Agneta, Sanders, David, Hope, William, Van Ramshorst Gabrielle, Eker Hasan, Chen, David, Misra Mahesh, Lopez-Cano, Manuel, Wijsmuller Arthur, Bury Kamil, Pawlak Maciej, Kukleta Jan, Loos Maarten, Reinpold Wolfgang, Bisgaard Thue, Lomanto Davide, Tran, Hanh, De Beaux Andrew, Bonjer Jaap, Bingener Julia, Liem Liong, Conze Joachim, Cuccurullo Diego, Muysoms Filip, Schouten Nelleke, Aufenacker Theo, Jorgensen, Lars, Berrevoet Fredrik, Chowbey Pradeep, Simmermacher Rogier, Smietanski Maciej

2020

Overview

BackgroundGroin hernia management has a significant worldwide diversity with multiple surgical techniques and variable outcomes. The International guidelines for groin hernia management serve to help in groin hernia management, but the acceptance among general surgeons remains unknown. The aim of our study was to gauge the degree of agreement with the guidelines among health care professionals worldwide.MethodsForty-six key statements and recommendations of the International guidelines for groin hernia management were selected and presented at plenary consensus conferences at four international congresses in Europe, the America’s and Asia. Participants could cast their votes through live voting. Additionally, a web survey was sent out to all society members allowing online voting after each congress. Consensus was defined as > 70% agreement among all participants.ResultsIn total 822 surgeons cast their vote on the key statements and recommendations during the four plenary consensus meetings or via the web survey. Consensus was reached on 34 out of 39 (87%) recommendations, and on six out of seven (86%) statements. No consensus was reached on the use of light versus heavy-weight meshes (69%), superior cost-effectiveness of day-case laparo-endoscopic repair (69%), omitting prophylactic antibiotics in hernia repair, general or local versus regional anesthesia in elderly patients (55%) and re-operation in case of immediate postoperative pain (59%).ConclusionGlobally, there is 87% consensus regarding the diagnosis and management of groin hernias. This provides a solid basis for standardizing the care path of patients with groin hernias.

• Publisher: Springer Nature B.V
• Subject: Antibiotics / Endoscopy / Evidence-based medicine / Experts / Hernias / Questionnaires / Surgeons / Surgery / Surgical techniques