ArticleHernia : the journal of hernias and abdominal wall surgery2026
Who will repair the next open inguinal hernia? Educational consequences of declining open surgery volumes.
Article in Hernia : the journal of hernias and abdominal wall surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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.
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.
Who cites it
1 citing paper in PubMed.
- Who will repair the next open inguinal hernia? Educational consequences of declining open surgery volumes.Hernia : the journal of hernias and abdominal wall surgery · 2026Article
Corrections and comments
- Commented on by
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeOver the past two decades, laparoscopic repair has increasingly replaced open techniques for elective groin hernia surgery in Denmark. This transition has profoundly altered the case mix and surgical exposure. The implications for surgical training, competence maintenance, and future service provision remain largely unexplored.
methodsUsing prospectively collected data from the Danish Inguinal Hernia Database, we conducted an updated nationwide cohort analysis of elective groin hernia repairs from 1998 to 2025. Surgical techniques were classified as open (primarily Lichtenstein repair) or minimally invasive (primarily laparoscopic TAPP repairs, including robot-assisted). Annual procedure volumes, departmental distribution in 2025, and cumulative reoperation rates after Lichtenstein and TAPP repairs were analyzed.
resultsA total of 296,864 unique elective repairs in 277,666 groins were analyzed. Open repair accounted for only 19% of unilateral repairs in 2025, while 80% were performed minimally invasive. Open procedures were unevenly distributed across departments: of 40 Danish departments performing Lichtenstein repair in 2025, only four performed more than 100 repairs annually, while 18 performed fewer than 20. Cumulative reoperation rates after Lichtenstein repair have increased significantly across consecutive five-year periods, whereas reoperation rates after TAPP repair did not show a comparable increase.
conclusionOpen inguinal hernia repair is now a low-volume operation, with declines in long-term outcomes. Maintaining broad competence in open repair through traditional surgical training pathways no longer seems realistic. Centralizing open hernia surgery at dedicated centers or with specialized surgeons, along with a stronger emphasis on laparoscopic training, may be necessary to preserve quality, safety, and training opportunities.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.