Participation of surgical residents does not adversely affect the outcome of inguinal hernia repair in an integrated teaching program.
OBJECTIVE
The Lichtenstein inguinal hernia repair is commonly performed and suitable for teaching basic surgical skills. The objective of this study is to evaluate the feasibility of this procedure for surgical training, particularly in regard to patient outcomes.


METHODS
Retrospective case review after introduction of an integrated teaching program.


METHODS
University teaching hospital.


METHODS
The Lichtenstein inguinal hernia repair is the standard procedure for adult primary unilateral inguinal hernia since 2003 at Jichi Medical University. We introduced an integrated teaching system of lectures, skill training. and videos to teach the skills for Lichtenstein inguinal hernia repair to residents and junior faculty in 2003. Cases were retrospectively divided into 4 groups based on the experience of the operating surgeon; junior residents (PGY 1-2, group A), senior residents (PGY 3-5, group B), junior faculty (PGY 6-10, group C), and senior faculty (PGY 11 or more, group D). Background, perioperative factors, and outcomes were evaluated among the groups.


RESULTS
A total of 246 elective inguinal hernia repairs (group A: 136, group B: 49, group C: 42, group D: 19) were performed. There was a significant difference in the frequency of concomitant diseases (p = 0.012) and anticoagulant therapy (p = 0.031). Average operating time was 80.7 ± 24.9, 72.6 ± 20.8, 63.5 ± 22.0, and 54.7 ± 27.9 (min ± SD) in groups A, B, C, and D, respectively, with a significant difference between groups A and D (p < 0.001). No significant differences were observed in estimated blood loss (p = 0.216) or morbidity (p = 0.294).


CONCLUSIONS
The Lichtenstein inguinal hernia repair can be safely performed by residents and junior faculty with the appropriate supervision of senior faculty without any disadvantage to patients. This integrated teaching program for Lichtenstein inguinal hernia repair is effective and feasible for training residents and junior faculty.
Department of Surgery, Jichi Medical University School of Medicine, Shimotsuke, Tochigi, Japan.
Masaru
M
Koizumi
Naohiro
N
Sata
Masanobu
M
Taguchi
Naoya
N
Kasahara
Kazue
K
Morishima
Yuji
Y
Kaneda
Atsushi
A
Miki
Kunihiko
K
Shimura
Hideki
H
Sasanuma
Takehito
T
Fujiwara
Makoto
M
Ota
Atsushi
A
Shimizu
Masanobu
M
Hyodo
Alan T
AT
Lefor
Yoshikazu
Y
Yasuda
D000368:Aged; D003479:Curriculum; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome