Impact of Training on Outcomes Following Incisional Hernia Repair

Oa, Khan; Balaji, Sam; Lahiri, O; Monsell, M; Agunloye,; Na, Davies; Bennett, D H

doi:10.1080/00015458.2012.11680868

Cited by 3 publications

(1 citation statement)

References 14 publications

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“…Only in the operative time was a difference found in a further study of the Lichtenstein operation to the disadvantage of trainees ( 63 ). But not even a longer operative time was found for trainees compared with consultants in all studies ( 64 , 65 ).…”

Section: Learning Curve Under Supervisionmentioning

confidence: 80%

What Is the Influence of Simulation-Based Training Courses, the Learning Curve, Supervision, and Surgeon Volume on the Outcome in Hernia Repair?—A Systematic Review

Köckerling

2018

Front. Surg.

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Introduction: In hernia surgery, too, the influence of the surgeon on the outcome can be demonstrated. Therefore the role of the learning curve, supervised procedures by surgeons in training, simulation-based training courses and surgeon volume on patient outcome must be identified.Materials and Methods: A systematic search of the available literature was carried out in June 2018 using Medline, PubMed, and the Cochrane Library. For the present analysis 81 publications were identified as relevant.Results: Well-structured simulation-based training courses was found to be associated with a reduced perioperative complication rate for patients operated on by trainees. Open as well as, in particular, laparo-endoscopic hernia surgery procedures have a long learning curve. Its negative impact on the patient can be virtually eliminated through consistent supervision by experienced hernia surgeons. However, this presupposes availability of an adequate trainee caseload and of well-trained hernia surgeons and calls for a certain degree of centralization in hernia surgery.Conclusion: Training courses, learning curve, supervision, and surgeon volume are important aspects in training and outcomes in hernia surgery.

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Section: Learning Curve Under Supervisionmentioning

confidence: 80%

What Is the Influence of Simulation-Based Training Courses, the Learning Curve, Supervision, and Surgeon Volume on the Outcome in Hernia Repair?—A Systematic Review

Köckerling

2018

Front. Surg.

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Physical activity recommendations pre and post abdominal wall reconstruction: a scoping review of the evidence

Adams

Bedwani

Massey

et al. 2022

Hernia

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There are no universally agreed guidelines regarding which types of physical activity are safe and/or recommended in the perioperative period for patients undergoing ventral hernia repair or abdominal wall reconstruction (AWR). This study is intended to identify and summarise the literature on this topic. Methods:Database searches of PubMed, CINAHL, Allied & Complementary medicine database, PEDro and Web of Science were performed followed by a snowballing search using two papers identified by the database search and four hand-selected papers of the authors' choosing. Inclusion -cohort studies, randomized controlled trials, prospective or retrospective. Studies concerning complex incisional hernia repairs and AWRs including a "prehabilitation" and/or "rehabilitation" program targeting the abdominal wall muscles in which the interventions were of a physical exercise nature. RoB2 and Robins-I were used to assess risk of bias. Prospero CRD42021236745. No external funding. Data from the included studies were extracted using a table based on the Cochrane Consumers and Communication Review Group's data extraction template. Results:The database search yielded 5,423 records. After screening two titles were selected for inclusion in our study. The snowballing search identified 49 records. After screening one title was selected for inclusion in our study. Three total papers were included -two randomised studies and one cohort study (combined 423 patients). All three studies subjected their patients to varying types of physical activity preoperatively, one study also prescribed these activities postoperatively. The outcomes differed between the studies therefore meta-analysis was impossible -two studies measured hernia recurrence, one measured peak torque. All 4 three studies showed improved outcomes in their study groups compared to controls however significant methodological flaws and confounding factors existed in all three studies. No adverse events were reported. Conclusions:The literature supporting the advice given to patients regarding recommended physical activity levels in the perioperative period for AWR patients is sparse. Further research is urgently required on this subject.

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Randomised controlled trial: standard lightweight mesh vs self-gripping mesh in Lichtenstein procedure

Zamkowski¹,

Ropel²,

Makarewicz

2022

Pol Przegl Chir

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Introduction Lichtenstein hernioplasty is gold standard of hernioplasty for 30 years now. Although, the proceudre may be followed by an unacceptably high rate of chronic pain, numbness and discomfort. Aim To compare outcomes of repair procedures using a Parietene ProGrip self-fixing mesh versus the traditional Lichtenstein procedure. Material and methods 141 patients with unilateral primary inguinal hernia participated in this single-centre, randomised, prospective, single-blind (patient-blinded) study. Randomisation yielded two treatment groups: control group of 88 patients treated with Lichtenstein procedure (LS) and study group of 53 patients receiving treatment with self-fixing mesh (PG). Patients were followed up for 6 months. Primary outcome was the presence and severity of postoperative pain at discharge, at 30 days and 6 months post-procedure. Other study parameters were: duration of the procedure, duration of hospitalisation, presence of early and late complications, time needed to return to full activity and patient satisfaction. Results No statistically significant differences in pain severity were demonstrated at discharge or at long-term follow-up. In the first 30 days post-procedure the patients in the PG group complained of pain of greater severity on the NRS (2.0 vs 1.4) (p=0.0466). The duration of the procedure in PG group was 9.4 minutes shorter than in LS group (p=0.0027). No statistically significant differences between the groups were found in other studied parameters. Conclusions Self-fixing mesh can be safely used in inguinal canal repair procedures. It significantly shortened the duration of the procedure but at the same time did not reduce the severity of pain, including the rate of chronic postoperative inguinal pain.

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Impact of Training on Outcomes Following Incisional Hernia Repair

Abstract: Supervised trainees can successfully undertake both open and laparoscopic incisional hernia repairs with no detrimental effects on overall hospital costs, post-operative morbidity and long-term recurrence rates.

Cited by 3 publications

References 14 publications

What Is the Influence of Simulation-Based Training Courses, the Learning Curve, Supervision, and Surgeon Volume on the Outcome in Hernia Repair?—A Systematic Review

What Is the Influence of Simulation-Based Training Courses, the Learning Curve, Supervision, and Surgeon Volume on the Outcome in Hernia Repair?—A Systematic Review

Physical activity recommendations pre and post abdominal wall reconstruction: a scoping review of the evidence

Randomised controlled trial: standard lightweight mesh vs self-gripping mesh in Lichtenstein procedure

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