Surgeon Experience Leads Risk Factors for Developing a Recurrent Hernia in Adults – International Guidelines

Patients often want to know what they did ‘wrong’ to have developed a hernia. The incidence of developing a primary inguinal hernia in a male is from about 27% – 42% and 3%-5.8% in women. The data shows that patients have no significant impact on their risk for developing a hernia. In other words, patients didn’t do anything ‘wrong’ to have developed a hernia. The risk factors with high likelihood for the development of a hernia include:

• first degree relative with a hernia
• male gender
• collagen metabolism disorders
• prostatectomy in the past

There is contradictory evidence that a patients social class, occupation, and their work load affects the risk of an inguinal hernia. This means that patients who are very physically active at work do not develop hernias more often.

Although patients often cannot affect their risk of developing a primary (first time) hernia, they actually can impact their development of a recurrent hernia. Recurrent hernias are ones that form after a surgeon has already attempted to repair the primary hernia. This can happen as early as days/weeks after the first surgery, or as long as decades. Regardless, there are important steps a patient can take to minimize their chances of having a recurrent hernia. The risk factors for developing a recurrent hernia after a primary repair include:

• low surgical volume of hernia repairs
• surgical inexperience
• open hernia surgery under local anesthesia
• insufficient surgical technique including:
  1. lack of mesh overlap
  2. improper mesh choice
  3. lack of proper mesh fixation
• presence of a sliding hernia
• collagen disorders
• obesity

The HerniaSurge group’s International Guidelines point to at least 4-5 different risk factors for hernia recurrence which are influenced by a patients surgeon. The best way a patient can help prevent a hernia recurrence is to find a surgeon who performs a high volume of hernia surgeries. This volume of surgeries clearly imparts a high level of surgical experience which can reduce a patients chance at developing a recurrent hernia.

Patients can read more from the International Guidelines for Inguinal Hernias here: