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Aim To describe and assess how minimal invasive surgery in inguinal hernia repair is in spanish general surgery residency. Material & Methonds An anonymus survey with 26 questions was sent to all Surgery Residents in Spain by email by Spanish Surgeons Association. Responses were analysed using both qualitative and quantitative methods. Results 161 answers were recieved. Residents of each year and each hospital answered that survey. 83.2% performed minimal invasive abdominal wall surgery. But in 78.2% of hospital this surgery was conducted by 1 or 2 senior surgeon. 55.1% performed less than 30 surgeries per year. TEP was preferred than TAPP in most cases. 51.2% of residents did not rotate in an abdominal wall surgery unit. At least 48% of residents did not performed any minimal invasive surgery during their residency training, but 71.4% performed their first open inguinal hernia repair at their first year of residency. Those who performed minimal invasive surgery, just 6% performed more than 20 surgeries. 91.9% of residents percieved gaps in their minimal invasive inguinal hernia repair surgery training. Conclusion Abdominal wall surgery is infraestimated. This survey findings highlighted the gaps and the callenges encouterd by Spanish General Surgery residents in acquiring satisfactory minimal invasive inguinal hernia surgery skills during their residency. An improvement in our formation is needed.

Las hernias intercostales son muy poco frecuentes y las que han sido reportadas en la literatura muestran un origen traumático. Por ello, presentamos un caso insólito al ocurrir en un paciente sin antecedente traumático conocido además de otros datos peculiares como la presencia de hernia intercostal con preservación diafragmática, asociación muy poco frecuente. El diagnóstico radiológico es fundamental y permite orientar la estrategia terapeútica adecuada. En la mayoría de los casos el tratamiento quirúrgico se basa en la reparación herniaria asociada a la utilización de material protésico que , como en el caso presentado, permiten una buena evolución clínica de los pacientes.

<p>Las hernias intercostales son muy poco frecuentes y las que han sido reportadas en la literatura muestran un origen traumático.  Por ello, presentamos un caso insólito al ocurrir en un paciente sin antecedente traumático conocido además de otros datos peculiares como la presencia de  hernia intercostal con preservación diafragmática, asociación muy poco frecuente. El diagnóstico radiológico es fundamental y permite orientar la estrategia terapeútica adecuada. En la mayoría de los casos el tratamiento quirúrgico se basa en la reparación herniaria asociada a la utilización de material protésico que , como en el caso presentado, permiten una buena evolución clínica de los pacientes.</p><p> </p><p>ABSTRACT</p><p>Intercostal hernias are very rare and those reported in the literature show a traumatic origin.  Therefore, we present an unusual case when occurring in a patient without a traumatic history known in addition to other peculiar data such as the presence of intercostal hernia with diaphragmatic preservation, very rare association. Radiological diagnosis is essential and allows to guide the appropriate therapeutic strategy. In most cases surgical treatment is based on herniary repair associated with the use of prosthetic material which, as in the case presented, allow a good clinical evolution of patients.</p>

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