title: Inguinal hernia repair in Switzerland.
abstract: OBJECTIVE
  Inguinal hernia repair is one of the most common procedures in visceral surgery, and an important teaching operation for residents during their first years. A variety of surgical approaches is currently available, including open surgery with or without mesh and laparoscopic surgery. Here we assessed the current clinical practice for inguinal hernia surgery in Switzerland and the impact on training of surgical residents.
  
  
  METHODS
  An anonymous online survey was performed among surgical clinics of the Swiss Society of Visceral Surgery (SSVS).
  
  
  RESULTS
  The overall response rate was 51 %. Nearly all hernia repairs are performed with prosthetic material, and only 3.2 % of the procedures use no mesh. Overall, open surgery is used for 58.5 % of hernias and 41.5 % are operated laparoscopically. In laparoscopic surgery, TEP is the first choice. Overall, the Lichtenstein repair is the classical teaching operation performed by residents in 77.3 % of cases. In contrast to open surgery, laparoscopic hernia repair is not a training operation and residents perform only 9.7 % of laparoscopic hernia repairs.
  
  
  CONCLUSIONS
  The survey confirms the use of prosthetic material as the standard, and the Lichtenstein repair as the first choice for primary inguinal hernia repair. The popularity of laparoscopic hernia surgery is increasing at the price of less teaching operations available for young residents.
authors.affiliation: Department of Surgery, University Hospital Zurich, Ramistrasse 100, 8091, Zurich, Switzerland. christoph.tschuor@usz.ch.
authors.forename: C
authors.initials: C
authors.lastname: Tschuor
authors.affiliation: Department of Surgery, Cantonal Hospital Lucerne, Spitalstrasse, 6000, Lucerne, Switzerland.
authors.forename: J
authors.initials: J
authors.lastname: Metzger
authors.affiliation: Department of Surgery, University Hospital Zurich, Ramistrasse 100, 8091, Zurich, Switzerland.
authors.forename: P-A
authors.initials: PA
authors.lastname: Clavien
authors.affiliation: Department of Surgery, University Hospital Zurich, Ramistrasse 100, 8091, Zurich, Switzerland.
authors.forename: R
authors.initials: R
authors.lastname: Vonlanthen
authors.affiliation: Department of Surgery, University Hospital Zurich, Ramistrasse 100, 8091, Zurich, Switzerland. kuno.lehmann@usz.ch.
authors.forename: K
authors.initials: K
authors.lastname: Lehmann
mesh_terms: D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy; D006801:Humans; D007396:Internship and Residency; D010535:Laparoscopy; D018579:Patient Selection; D010818:Practice Patterns, Physicians'; D013526:Surgical Mesh; D011795:Surveys and Questionnaires; D013557:Switzerland
keywords: Inguinal hernia repair; Survey; Switzerland