SP9.12 The Global Practice of Inguinal Hernia Repair Study (GLACIER): A survey of 1014 hernia surgeons

Abstract

Abstract Introduction There are many variations in practices and preferences for inguinal hernia repair among surgeons globally. The purpose of the Global Practice of Inguinal Hernia Repair Study (GLACIER) was to capture these variations related to open, laparoscopic, and robotic inguinal hernia repair. Method A questionnaire-based survey on Survey Monkey® was created, and the link was shared freely on various social media platforms, personal email network of authors and email to members of the endorsed organisations, which include British Hernia Society (BHS), The Upper Gastrointestinal Surgical Society (TUGSS), and Abdominal Core Health Quality Collaborative (ACHQC). Results A total of 1014 surgeons from 81 countries completed the survey. Open and laparoscopic approaches were equally preferred (43% and 47% respectively). Transabdominal pre-peritoneal repair (TAPP) is the favoured minimally invasive approach. Bilateral and recurrent hernia following previous open repair were the most common indications for minimally invasive approach. Repair with a mesh was preferred by 98% of the surgeons and synthetic monofilament light weight mesh with large pores was the most common choice. Lichtenstein repair was the most favoured open mesh repair technique (90%), while Shouldice repair was the favoured non-mesh repair technique. The risk of chronic groin pain was quoted as 5% after open repair and, 1% after minimally invasive repair. Only 10% of surgeons preferred open repair with local anaesthesia. Conclusion This survey identified similarities and variations in practice globally along with some discrepancies in inguinal hernia repair compared to best practice guidelines. It also identifies several key areas where more focus future research is required.