Fifteen‐year groin hernia trends in Australia: the era of minimally invasive surgeons

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Excerpt

Groin hernia repairs (GHRs) are among the most common surgical procedures performed in the Western world, accounting for more than 20 million repairs globally per annum.1 With the ageing Australian population, both elective and emergency GHRs are increasing. Further, this may be attributed to the increased diagnosis of asymptomatic GHs based on radiological scanning.2
In the present clinical practice, operative techniques include laparoscopic and open repairs, establishing a tension‐free mesh repair as the gold standard practice of care.1 The advancement in laparoscopy has had an impact on the incidence of associated complications over the last decade, with many studies indicating a reduction in post‐operative pain and length of hospital stay.3 Minimally invasive techniques include laparoscopic totally extraperitoneal (TEP) and trans‐abdominal preperitoneal (TAPP) approaches. Despite the predominant use of TEP repairs, comparative studies highlight similar post‐operative pain scores, hospital length of stay and rates of recurrence between the two laparoscopic hernia repairs (LHRs).4 Standard polypropylene mesh is still the preferred choice for most repairs.
Although studies have indicated considerable advantages of laparoscopic compared with open repairs, the steep learning curve associated with TEP and TAPP requires considerable surgical expertise to maintain acceptable outcomes.5 Operative times are longer compared with open repairs; however, this improves with experience. There are also higher operating costs associated with LHR, which may impact on service delivery of individual hospitals.6 In this study, we aim to determine the trends over the past 15 years in Australia for GHs.
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