Page 7 - International guidelines for groin hernia management

Hernia

HerniaSurge would like to stress the importance of Chapter 2
shared decision-making with patients. Type of hernia,
patient profile, surgeons’ expertise, patient’s wishes and
expectations, logistical possibilities and local resources are Risk factors for the development of inguinal
all key factors that finally lead to a treatment advice. hernias in adults
All search strategies, tables with articles and back-
ground information will be published on HerniaSurge’s L. N. Jorgensen, W. W. Hope, and T. Bisgaard
website (https://www.herniasurge.com). All articles are
R
filed per chapter in Mendeley reference manager. Introduction
We would like to emphasize the fact that the ‘‘Interna-
tional Guidelines for Groin Hernia Management’’ is NOT a Numerous risk factors exist for the development of primary
legal document, merely guidelines. If surgeons choose not inguinal hernias (IH) and recurrent inguinal hernias (RIH)
to follow strong recommendations, they should do so in in adults, some better studied than others. These risk fac-
consultation with their patients and document this in the tors span a range, from acquired to genetic and modifiable
medical record. to immutable. Some are under the surgeon’s control, but
HerniaSurge encourages the establishment of local and many are not.
national registries because they are valuable for audit and For the purposes of this chapter (unless stated other-
research. HerniaSurge predicts an increase in training of wise), IH repair is considered synonymous with IH diag-
hernia specialist surgeons and the formation of hernia nosis. The studies referenced below do not distinguish
centers, but acknowledges that training and educating between open and laparo-endoscopic repairs or between
general surgeons who work in general practice in the short- direct and indirect hernias. Femoral hernias are not con-
term will have a greater impact on the results of groin sidered in this review nor are IHs in children except for a
hernia surgery. Furthermore, HerniaSurge is committed to brief mention.
develop E-learning modules and a ‘‘HerniaSurge App’’ to
aid surgeons and patients around the world. Key questions
The HerniaSurge Group has formulated a large number KQ02.a What are the risk factors for the development of
of new research questions. The guidelines will be updated primary inguinal hernias in adults?
every 2 years as new evidence is published. The expiration KQ02.b What are the acquired, demographic and periop-
date for this document is June 1, 2018. erative risk factors for recurrence after treatment of IH in
The guidelines were externally reviewed by professors adults?
Jeekel (Europe), Ramshaw (USA) and Sharma (Asia). The
Agree scores are published in the website of HerniaSurge
(https://www.herniasurge.com).

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