Evidence map›Paper›PMID 33502639›Full record

ReviewHernia : the journal of hernias and abdominal wall surgery2021

Shouldice standard 2020: review of the current literature and results of an international consensus meeting.

R Lorenz, G Arlt, J Conze, R Fortelny, J Gorjanc, A Koch, J Morrison, V Oprea, G Campanelli

Abstract readReviewConsensus Statement
PubMed Publisher
In one paragraph

Review in Hernia : the journal of hernias and abdominal wall surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Review
  4. Article
  5. Temporal patterns for inguinal hernia recurrence operations after Shouldice Repair.Hernia : the journal of hernias and abdominal wall surgery · 2024
    Article
  6. Article
  7. Article
  8. Article
  9. Improving surgical education in East Africa with a standardized hernia training program.Hernia : the journal of hernias and abdominal wall surgery · 2021
    Article
  10. Results of Shouldice hernia repair after 18 years of follow-up in all the patients.Hernia : the journal of hernias and abdominal wall surgery · 2021
    Article
  11. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

R Lorenz3+CHIRURGEN Hernia Center, Klosterstrasse 34/35, 13581, Berlin, Germany. lorenz@3chirurgen.de.ORCID 0000-0001-9749-3005
G ArltDepartment for General- Visceral and Minimal-Invasive Surgery, Park-Klinik Weissensee, Schönstraße 80, 13086, Berlin, Germany.
J ConzeUM Hernienzentrum Dr. Conze, Arabellastraße 17, 81925, München, Germany.
R FortelnyDepartment of General Surgery, Wilhelminenhospital, Montleartstraße 37, 1160, Vienna, Austria.
J GorjancDepartment of Surgery, Krankenhaus der Barmherzigen Brüder, St. Veit an Der Glan, Spitalgasse 26, 9300, St. Veit an der Glan, Austria.
A KochHernia Center Cottbus, Gerhard-Hauptmann-Strasse 15, 03044, Cottbus, Germany.
J MorrisonChatham Kent Health Alliance, 78 Victoria Avenue, Chatham, ON, N7L 3A1, Canada.
V OpreaDepartment of Surgery, Military Hospital Cluj-Napoca, Strada General Traian Moșoiu 22, Cluj-Napoca, Romania.
G CampanelliDepartment of Surgical Science, University of Insubria, Istituto Clinico Santambrogio, Milano, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionFor many years the Shouldice technique was the gold standard for inguinal hernia repair. Nowadays mesh repair has been proven to entail better results in randomized trials. Since the first publication 1953 the Repair has been described in detail in many textbooks, articles and You Tube videos. It appears that the original technique is used almost exclusively in the Shouldice Hospital in Thornhill/ Canada and despite the success of the Shouldice Hospital many surgeons inexplicably modify this original technique in their daily practice. In the last couple of years there appears to be an increasing interest in pure tissue repairs for various reasons, often fear of mesh-related pain. The aim of the study was to review the current evidence and to define an updated standard with key principles of the Shouldice repair.

methodsBecause of unpublished evidence regarding many operative details the organizing group decided to create a technical update via a consensus meeting with 13 international designated hernia surgeons from six countries. In preparation of the meeting a review of the current literature regarding Shouldice repair was done by the organizing group. A questionnaire was prepared and sent to all participants before the meeting to get an independent answer on all critical aspects.

resultsAll questions regarding a detailed standard of the operation technique could be outlined. As result of the consensus meeting the participants have formulated all key-points of preparation/dissection and repair of the Shouldice technique. For 5 of 6 critical technical surgical steps a strong consensus could be defined in the group. There was no consensus among the group regarding the cremaster resection and the ideal indication for Shouldice repair.

conclusionAfter a 75-year history of the Shouldice repair the technique should continue to merit consideration by all hernia surgeons. After this consensus meeting a clear binding standard of the Shouldice technique for all interested surgeons is proposed.

Indexed as

Hernia, InguinalHerniorrhaphyDissectionHumansRecurrenceSurgical MeshGroin herniaPure tissue repairShouldice repair

Identifiers

PMID33502639

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.