Page 7 - Read Online

Oyola et al. Mini-invasive Surg 2023;7:26 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2023.26

Original Article Open Access

Are we following guidelines in inguinal hernia

repair? An evaluation of practice patterns in the
abdominal core health quality collaborative

Anna Malysz Oyola, Seth Beeson, Colston Edgerton, William Hope

Department of General Surgery, Novant New Hanover Regional Medical Center, Wilmington, NC 28401, United States.
Correspondence to: Anna Malysz Oyola, Department of General Surgery, Novant New Hanover Regional Medical Center, 2131 S.
17th St, Wilmington, NC 28401, United States. E-mail: Anna.oyola@nhrmc.org
How to cite this article: Oyola AM, Beeson S, Edgerton C, Hope W. Are we following guidelines in inguinal hernia repair? An
evaluation of practice patterns in the abdominal core health quality collaborative. Mini-invasive Surg 2023;7:26.
https://dx.doi.org/10.20517/2574-1225.2023.26

Received: 21 Mar 2023 First Decision: 12 May 2023 Revised: 2 Jun 2023 Accepted: 3 Jul 2023 Published: 17 Jul 2023
Academic Editors: Giulio Belli, R. Fortelny Copy Editor: Pei-Yun Wang Production Editor: Pei-Yun Wang

Abstract
Aim: The HerniaSurge Group established inguinal hernia repair guidelines to reduce recurrence and chronic pain.
We evaluated whether the surgeons of the Abdominal Core Health Quality Collaborative (ACHQC) follow these
guidelines and identify areas for improvement.

Methods: A retrospective evaluation of data from the ACHQC database between 2013-2021 using 18,641 eligible
subjects undergoing elective and emergent hernia repair with 30-day follow-up. Compliance with a given guideline
was defined as following the recommendation in 70% of cases.

Results: Twelve of 19 questions with available data met recommendations based on our above criteria. Eight
recommendations with strong evidence and four recommendations with weak evidence were met. The
recommendations not met were using the Shouldice technique for any non-mesh open inguinal herniorrhaphy,
using local anesthesia for open repair of reducible inguinal hernias, using lightweight mesh, and avoiding the use of
prophylactic antibiotics in laparoscopic herniorrhaphy.

Conclusion: Despite varied techniques for inguinal hernia repair, surgeons of the ACHQC follow the majority of the
recently published guidelines on the subject. While further research is needed to strengthen the existing guidelines,
a standardized approach will facilitate this effort while aiming to reduce negative patient outcomes.

Keywords: Inguinal, hernia, guidelines, hernia repair, ACHQC

© The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and
indicate if changes were made.

www.misjournal.net