title: Fifteen-year groin hernia trends in Australia: the era of minimally invasive surgeons.
abstract: BACKGROUND
  Groin hernia repairs (GHRs) are among the commonest general surgical procedures in the Western population. The introduction of minimally invasive surgery has prompted the development of laparoscopic totally extraperitoneal and trans-abdominal preperitoneal hernia repairs. We aimed to determine the hernia treatment trends in Australia over the last 15 years.
  
  
  METHODS
  Using Medicare Benefit Schedule data, we categorized the number of laparoscopic and open hernia repairs between 2000 and 2015 in Australia. Population data were collected from the Australian Bureau of Statistics. Hernia repair rates were standardized by age, gender and location.
  
  
  RESULTS
  During the study period, a total of 324 618 GHRs were performed on adult patients in Australia, 43% by a laparoscopic method. While there was a slight yearly increase in overall total GHRs performed, laparoscopic surgeries increased by 3.1 per 100 000 population every year (95% CI: 2.9-3.3) while open surgeries declined yearly by 2.6 per 100 000 population (95% CI: 2.4-2.8). From the available data, there appears to be a crossover point in 2011/2012 where the laparoscopic hernia repair became more frequent. Considerable state and gender-based trends exist.
  
  
  CONCLUSIONS
  The use of laparoscopic GHRs has increased considerably over the last 15 years. Despite the increased use, significant state-based and gender discrepancies were observed. Our data offer insight to the public sector and the respective healthcare-related expenditures pertaining to laparoscopic hernia repair.
authors.affiliation: Department of Surgery, Monash Health, Monash University, Melbourne, Victoria, Australia.
authors.forename: Jasmina
authors.initials: J
authors.lastname: Kevric
authors.affiliation: Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Victoria, Australia.|Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.|Department of Surgery, Austin Health, The University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Nathan
authors.initials: N
authors.lastname: Papa
authors.affiliation: Department of Surgery, Eastern Health, Melbourne, Victoria, Australia.
authors.forename: Sumeet
authors.initials: S
authors.lastname: Toshniwal
authors.affiliation: Department of Surgery, Austin Health, The University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Marlon
authors.initials: M
authors.lastname: Perera
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001315:Australia; D005260:Female; D006119:Groin; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000706:statistics & numerical data*; D006801:Humans; D010535:Laparoscopy / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D000078337:Procedures and Techniques Utilization; D012189:Retrospective Studies; D013526:Surgical Mesh / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Australian trend hernia repair; inguinal hernia; laparoscopic hernia repair