Surgeon annual volume impacts recurrence rates of pediatric inguinal hernia repairs: A multi-institutional study
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- Low-volume surgeons have 1.5× higher recurrence rates for pediatric inguinal hernia repairs overall
- Laparoscopic repairs by low-volume surgeons show 3.3× increased recurrence risk; open repairs show no volume effect
- Surgeon annual case volume significantly impacts laparoscopic hernia outcomes but not open technique outcomes
- Maintaining high laparoscopic repair volume or consulting high-volume colleagues may reduce recurrence rates
- Multi-institutional data confirms surgeon experience is a modifiable risk factor for pediatric hernia recurrence
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You have a patient in clinic with a recurrent inguinal hernia. What do you think contributed to their recurrence? I'm Jill Kneroth with Stay Current MD, and this is an article you should know about. In 2025, Heller et al. published a multi-institutional study in the Journal of Pediatric Surgery. They wanted to explore the impact of surgeon volume on patients with inguinal hernias. So what did they find? The authors found that inguinal hernias repaired by lower volume surgeons had a 1.5 fold increase in the odds of recurrence. When they broke it down by surgical approach, there was no difference for open repairs. However, laparoscopic repairs done by lower volume surgeons had a 3.3 fold increase in the odds of recurrence. How can we fix this? The authors recommend maintaining a high volume of laparoscopic repairs, and if that's not possible, to seek help from a higher volume surgeon. How would you improve outcomes for these patients?