ArticleAnnals of the Royal College of Surgeons of England2026
Surgical training for simple and complex hernia repair in the UK: results of a nationwide training survey.
Article in Annals of the Royal College of Surgeons of England, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionAbdominal wall reconstruction (AWR) is increasingly recognised as a subspecialty in general surgery, owing to the growing complexity and advancement of hernia repair techniques. Concerns have been raised among UK hernia specialists about current surgical training adequately preparing trainees for both simple and complex hernia procedures.
methodsA CHERRIES-compliant survey was developed by a panel of hernia experts to evaluate UK training in hernia surgery. The 41-item questionnaire assessed perceived competence and confidence in performing eight types of hernia repair, categorised as simple (primary inguinal, umbilical, laparoscopic inguinal and Rives-Stoppa) or complex (recurrent inguinal, component separation and parastomal hernia repair), along with broader AWR-related topics (open abdomen management, participation in multidisciplinary meetings). The survey was disseminated via social media, targeted chat groups and surgical conferences.
resultsThe survey was conducted from 21 January to 27 September 2024. Of approximately 500 possible respondents, 116 completed the survey (47 surgical trainees (ST) 7-8s, 30 clinical fellows and 34 consultants), yielding an estimated 22.2% response rate. Curriculum requirements were met only for open inguinal and umbilical hernia repair. Although there are no formal curriculum requirements for complex repairs, trainee exposure remains limited; two-thirds had performed fewer than ten recurrent inguinal or component separation procedures. For parastomal hernias, confidence was highest with suture repair despite these being associated with poor outcomes. Overall, median confidence scores were highest for simple repairs and lowest for complex ones.
conclusionsCurrent UK surgical training provides inadequate exposure to complex AWR, highlighting the need for targeted curriculum improvement.
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