Learning Curve of Resident Surgeons for Open Mesh Repair of Inguinal Hernia

Abstract

We evaluated the effect of postgraduate surgical education on inguinal hernia repair for resident surgeons. A total of 93 adult patients underwent open mesh repairs for inguinal hernias. These patients were randomly assigned to junior or senior resident surgeon groups for inguinal hernia repairs. The surgical training program for inguinal hernia repair was subdivided into 3 consecutive steps: sections A, B, and C. The sections were defined as follows: (A) the starting point of the surgery to hanging the spermatic cord, (B) dissection of the hernia sac, and (C) placement of the hernia mesh. The time to complete each procedure was recorded. We then evaluated the learning curve of the junior resident surgeons for open mesh repair of inguinal hernia. The mean operative time of the junior resident group was significantly longer than that of the senior resident group. Particularly, the mean times of the junior residents for sections B and C were significantly longer than those of the senior resident group. However, the volume of intraoperative blood loss and the short-term outcomes were not significantly different between the groups. For section C of the procedure, the learning curve seemed shorter for junior resident surgeons who had completed the training program for inguinal hernia repair than that for junior resident surgeons who were just beginning this program. This study demonstrates that a junior resident surgeon's initial experience with hernia repair is associated with an identifiable learning curve when participating in a suitable training program.