P-058 In the path of a hernia center?

Abstract

Abstract Introduction and aim Hernia surgery is becoming more complex and demanding, increasing the need for specialization. Certification of units dedicated to hernia surgery must follow some requirements linked to surgical skills, resources, and outcomes. We aim to analyze the outcomes and benefits of a dedicated hernia unit. Methods We conducted a retrospective analysis of 333 abdominal wall hernia repairs performed from the start of a dedicated unit in 2020, until 2022. A total of 187 patients underwent groin hernia repair, 70 primary ventral and 75 incisional hernia. Demographic and clinical data, surgical techniques, and outcomes were assessed. The results were analyzed according to the accreditation and certification requirements for hernia centers and surgeons from European Hernia Society. Results The group performed 124 open and 63 laparoendoscopic groin hernias, 50 open and 20 laparoendoscopic primary ventral hernia, and 36 open and 39 laparoendoscopic incisional hernias. The total complication rate for groin hernia surgery, 30 days postoperatively, was 2,7% (< 5%) (1,6% wound dehiscence, 1,1% seroma, 0% pulmonary or cardiovascular), reoperation rate was 0% (<2%), recurrence 1,6%, and chronic pain 2,15%. In primary ventral repair, the morbidity within thirty days was 1,4%, infection was 1,4% and recurrence 0%. According to incisional hernias, the infection/revision rate after open surgery was 11/% (>10%), after laparoscopic surgery was 2,5% (<3%) and the reoperation rate was 0,5% (<10%). Conclusions Optimal results in hernia surgery can only be guaranteed in dedicated units that follow a “tailored-approach” concept, yet need expert hernia surgeons with increasing knowledge and experience.