Abdominal wall hernia surgery in The Netherlands: a national survey

• Published in: Hernia : the journal of hernias and abdominal wall surgery Vol. 24; no. 3; pp. 601 - 611
• Main Authors: Wegdam, J. A., de Vries Reilingh, T. S., Nienhuijs, S. W., Simons, M. P.
• Format: Journal Article
• Language: English
• Published: Paris Springer Paris 01.06.2020; Springer Nature B.V
• Subjects: Abdomen; Abdominal Surgery; Abdominal wall; Abdominal Wall - surgery; Accreditation - standards; Endoscopy; Health Care Surveys - statistics & numerical data; Hernia; Hernia, Abdominal - classification; Hernia, Abdominal - epidemiology; Hernia, Abdominal - surgery; Herniorrhaphy - methods; Herniorrhaphy - standards; Herniorrhaphy - statistics & numerical data; Hospitals; Hospitals, Special - standards; Hospitals, Special - statistics & numerical data; Humans; Incisional Hernia - epidemiology; Incisional Hernia - surgery; Medicine; Medicine & Public Health; Netherlands - epidemiology; Original Article; Polls & surveys; Quality Assurance, Health Care; Quality control; Quality of Health Care - statistics & numerical data; Registries; Surgeons; Surgery; Netherlands; Accreditation; Certification requirements; Quality measures; Ventral hernia
• ISSN: 1265-4906; 1248-9204
• DOI: 10.1007/s10029-019-02048-x

Purpose In The Netherlands, the quality of abdominal wall hernia surgery is largely unknown due to the lack of a hernia registry. This study was designed to assess the current state of abdominal wall hernia surgery in The Netherlands, to create a starting point for future evaluation of new quality measures. Methods Dutch hernia management indicators and recently proposed European Hernia Society (EHS) requirements for accredited/certified hernia centers were used. The number of Dutch hospitals that meet the four main EHS requirements (on volume, experience, use of a registry and quality control) was assessed by analyzing governmental information and the results of a survey amongst all 1.554 Dutch general surgeons. Results The survey was representative with 426 respondents (27%) from all 75 hospitals. Fifty-one percent of the hospitals had a median inguinal repair volume of more than 290 (14–1.238) per year. An open or laparo-endoscopic inguinal repair technique was not related to hospital volume. Experienced hernia surgeons, use of a registry and a structured quality control were reported to be present in, respectively, 97%, 39%, and 15% of the hospitals. Consensus in answers between the respondents per hospital was low (< 20%). Two hospitals (3%) met all four requirements for accreditation. Conclusion This descriptive analysis demonstrates that hernia surgery in the Netherlands is performed in every hospital, by all types of surgeons, using many different techniques. If the suggested EHS requirements are used as a measuring rod, only 3% of the Dutch hospitals could be accredited as a hernia center.