Inguinal hernia repair: A survey of Canadian practice patterns

OBJECTIVE: To describe the preferences of general surgeons across Canada wi th respect to hernia repair technique. DESIGN: A survey by mailed questionnaire.. PARTICIPANTS: All 1452 fellows of the Royal College of Physicians and Surge ons of Canada currently holding a certificate in general surgery. INTERVENTION: Two mailings of the survey: the first in December 1996, the s econd to nonrespondents in February 1997. MAIN OUTCOME MEASURES: Surgeons' preference of hernia repair technique for specified indications. This was analysed according to practice setting and geographic location. MAIN RESULTS: Based on 706 completed questionnaires, the preferred techniqu es for repair of primary inguinal hernias were as follows: 23% Bassini, 20% mesh plug; 16% Lichtenstein, 15% laparoscopic, 11% Shouldice and 11% McVay . Preference for laparoscopic repair increased to 34% for recurrent hernias and 35% for bilateral hernias. The Atlantic provinces had the lowest prefe rence rates for laparoscopic repair and the highest rates for the mesh plug technique. CONCLUSIONS: Most surgeons select the type of repair on the basis of the cl inical scenario. Large variations in practice exist between provinces.