Update of the international HerniaSurge guidelines for groin hernia management

Introduction

This guideline is an updated version of the guideline on groin/inguinal hernia, published in 2018: HerniaSurge Group. International guidelines for groin hernia management. Hernia. 2018

The aim of the present guideline is to provide updated statements and recommendations pertaining to specific key questions (KQs) from the previous version of HerniaSurge where new evidence is available. Secondary aims include improving patient outcomes, specifically to decrease recurrence rates and reduce chronic pain, the most frequent problems following groin hernia repair.

Each chapter in the present update is structured as in a traditional guideline: 

  • A summary is provided to help the reader in understanding the process and the challenges encountered in the preparation of the evidence and their appraisal.
  • A grid with the final recommendation, level of evidence and strength of recommendation (statements are included whenever needed as findings supporting the recommendation).
  • A general introduction.
  • Results of evidence search and detailed description of relevant data.
  • Discussion with evidence appraisal containing the criteria used to produce the updated recommendation. According to the GRADE method, scientific evidence is not the only guidance but other factors (patients’ values, desirable and undesirable effects, balance among them, cost effectiveness, acceptability, equity and feasibility) are incorporated in the process to inform decisions in a structured and transparent manner.
 
Reference: Stabilini C, van Veenendaal N, Aasvang E, Agresta F, Aufenacker T, Berrevoet F, Burgmans I, Chen D, de Beaux A, East B, Garcia-Alamino J, Henriksen N, Köckerling F, Kukleta J, Loos M, Lopez-Cano M, Lorenz R, Miserez M, Montgomery A, Morales-Conde S, Oppong C, Pawlak M, Podda M, Reinpold W, Sanders D, Sartori A, Tran HM, Verdaguer M, Wiessner R, Yeboah M, Zwaans W, Simons M. Update of the international HerniaSurge guidelines for groin hernia management. BJS Open. 2023 Sep 5;7(5):zrad080. doi: 10.1093/bjsopen/zrad080. 

Link to Guidelines

1st version

The many different approaches, treatment indications and a significant array of techniques for groin hernia repair warrant guidelines to standardize care, minimize complications, and improve results. Worldwide, more than 20 million patients undergo groin hernia repair annually. The main goal of these guidelines is to improve patient outcomes, specifically to decrease recurrence rates and reduce chronic pain.

The guidelines were developed by The HerniaSurge Group and have been endorsed by all five continental hernia societies, the International Endo Hernia Society and the European Association for Endoscopic Surgery. The guidelines were published in 2018 in the Journal Hernia. Ten chapters are in the process of being updated.

Reference: HerniaSurge Group. International guidelines for groin hernia management. Hernia. 2018 Feb;22(1):1-165. doi: 10.1007/s10029-017-1668-x. Epub 2018 Jan 12. PMID: 29330835; PMCID: PMC5809582.

Summary

A summary of the 1st version guideline is available in several languages.

The summary does not contain the references. They are to be viewed in the online article. The Guidelines consist of 165 pages with 136 statements, 88 recommendations and 1299 references. They are developed for general surgeons in all kinds of practice and meant to offer guidelines that apply to the majority of patients with groin hernia. We offer this summary for non-English speaking surgeons but advise to read the whole document for better insight in details of all aspects of management. Deviating from guidelines can be necessary or warranted especially realizing the differences in cultures, training, expertise, logistics and economical possibilities that continentally and even loco-regionally exist.

Please click the languages in the box to access the guideline summaries.

Download 1st version guideline

Download Summary of the 1st version guideline

Please click the languages below to access the guideline summaries.

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