Evidence map›Paper›PMID 37882629›Full record

ArticleBJS open2023

Learning curve in open groin hernia surgery: nationwide register-based study.

Olof Bladin, Nathalie Young, Jonas Nordquist, Joy Roy, Hans Järnbert-Pettersson, Gabriel Sandblom, Jenny Löfgren

Open access · goldAbstract read
In one paragraph

Article in BJS open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
3.5field-weighted citation impact, top 7% of its field
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

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

  1. Pooled it
  2. Article
  3. Observational
  4. Observational
  5. Observational
  6. Article
  7. Article
  8. Competency Assessment in Training in African Countries.Journal of abdominal wall surgery : JAWS · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Olof BladinDepartment of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden.ORCID 0000-0001-7447-7272
Nathalie YoungAcute and Trauma Surgery, Karolinska University Hospital, Stockholm, Sweden.ORCID 0000-0002-4675-7581
Jonas NordquistDepartment of Medicine (Huddinge), Karolinska Institute, Stockholm, Sweden.
Joy RoyDepartment of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden.
Hans Järnbert-PetterssonDepartment of Clinical Science and Education, Södersjukhuset Karolinska Institute, Stockholm, Sweden.
Gabriel SandblomDepartment of Clinical Science and Education, Södersjukhuset Karolinska Institute, Stockholm, Sweden.ORCID 0000-0002-7416-4951
Jenny LöfgrenDepartment of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden.
Karolinska Institutet · SEKarolinska University Hospital · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCurrent recommendations regarding the number of open groin hernia repairs that surgical trainees are required to perform during their residency are arbitrarily defined and vary between different curricula. This register-based study sought to investigate the learning curve of surgeons performing open anterior mesh repair for groin hernia by assessing hernia recurrence rates, surgical complications and operating times in relation to the number of procedures performed.

methodNationwide data on open anterior mesh repair for groin hernia performed by surgical residents were collected from the Swedish Hernia Register between 2005 and 2020. The data were analysed in a cohort undergoing procedures carried out by surgeons performing their first registered repair as resident general surgeons. Repairs by surgeons with fewer than 30 repairs were excluded.

resultsA total of 38 845 repairs carried out by 663 surgeons were included. Operation time decreased with increasing number of performed procedures, mean (s.d.) operation time was 79 (26) min for the first 15 procedures and 60 (23) min after 241 procedures (P <0.001). A turning point where complication rates began to decrease was seen after 60 procedures. Complication rates were 3.6 per cent (396 of 10 978) for procedures 31-60 and 2.7 per cent (157 of 5 798) for procedures 61-120 (P = 0.002). There was no significant relationship between the number of procedures performed and the rate of operation on for recurrence (P = 0.894).

conclusionSixty performed procedures during surgical residency is a reasonable target for achieving competency to perform open anterior mesh repair for groin hernia safely without supervision.

Indexed as

Hernia, InguinalSurgeonsCurriculumGroinHumansLearning Curve

Identifiers

PMID37882629
PMCPMC10601449
OpenAlexW4387950216

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.