Abstract
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.
Highlights
In hernia surgery, too, the influence of the surgeon on the outcome can be demonstrated
Using multivariable analyses and propensity score-matched comparisons it is possible to identify the influence factors impacting the outcome in hernia surgery [1, 2]
That gives rise to a debate about appropriate training in hernia surgery [7]
Summary
Too, the influence of the surgeon on the outcome can be demonstrated. 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. Using multivariable analyses and propensity score-matched comparisons it is possible to identify the influence factors impacting the outcome in hernia surgery [1, 2]. Too, the influence of the individual surgeon on the outcome can be demonstrated [3]. Well-structured training opportunities and training concepts that take account of the learning curve, simulation-based training, supervision, surgeon, and hospital caseload are needed. The following analysis of the available literature investigates these aspects and their impact on outcomes in hernia surgery
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