The learning curve for laparoscopic inguinal hernia repair: a newly qualified surgeon perspective

• Published in: The Journal of surgical research 2016-09, Vol.205 (1), p.246-251
• Main Authors: Mathur, Sachin, Lin, Ssu-Yu Suei
• Format: Article
• Language: English
• Subjects: Adult; Aged; CUSUM; Female; Herniorrhaphy - methods; Herniorrhaphy - statistics & numerical data; Humans; Laparoscopic extra-peritoneal inguinal hernia repair; Laparoscopy; Leaning curve; Learning Curve; Male; Middle Aged; Retrospective Studies; Treatment Outcome
• ISSN: 0022-4804; 1095-8673
• DOI: 10.1016/j.jss.2016.06.041

The number of cases required to overcome the learning curve (LC) for laparoscopic extra-peritoneal inguinal hernia repair (TEP) varies widely in the literature. Less is known about the LC for inexperienced surgeons performing this procedure early in their career. The present study describes the technical challenges of TEP repair and the LC from the perspective of a recently qualified general surgeon. Retrospective analysis of a single-surgeon experience of TEP repairs performed during the first 2 y of practice from 2011–2013. Patient demographics, hernia details, operative details, and postoperative outcome were all assessed. The CUSUM method was used to analyze the LC for operative time. There were 149 consecutive patients (mean age, 56 ± 17, 146 males, 24 bilateral, BMI 26 ± 4) followed for a median of 15 (4–26) mo. Direct herniae accounted for 61% of the cohort, and 16% were recurrent open presentations. The major complication and recurrence rate were