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F Kockerling - One of the best experts on this subject based on the ideXlab platform.

  • accreditation and certification requirements for Hernia centers and surgeons the access project
    Hernia, 2019
    Co-Authors: F Kockerling, R Fortelny, Aali J Sheen, Frederik Berrevoet, G Campanelli, Diego Cuccurullo, H Friisandersen, J F Gillion, J Gorjanc, Doron Kopelman
    Abstract:

    There is a need for Hernia centers and specialist Hernia surgeons because of the increasing complexity of Hernia Surgery procedures due to new techniques, more difficult cases and a tailored approach with an increasing public awareness demanding optimal treatment results. Therefore, the requirements for accredited/certified Hernia centers and specialist Hernia surgeons should be formulated by the international and national Hernia societies, while taking account of the respective health care systems. The European Hernia Society (EHS) has appointed a working group composed of 18 Hernia experts from all regions of Europe (ACCESS Group—Hernia Accreditation and Certification of Centers and Surgeons—Working Group) to formulate scientifically based requirements for Hernia centers and specialist Hernia surgeons while taking into consideration different health care systems. A consensus was reached on the key questions by means of a meeting, a telephone conference and the exchange of contributions. The requirements formulated below were deemed implementable by all participating Hernia experts in their respective countries. The ACCESS Group suggests for an adequately equipped Hernia center the following requirements: (a) to be accredited/certified by a national or international Hernia society, (b) to perform a higher case volume in all types of Hernia Surgery compared to an average general Surgery department in their country, (c) to be staffed by experienced Hernia surgeons who are beyond the learning curve for all types of Hernia Surgery recommended in the guidelines and are responsible for education and training of Hernia Surgery in their department, (d) to treat Hernia patients according to the current guidelines and scientific recommendations, (e) to document each case prospectively in a registry or quality assurance database (f) to perform follow-up for comparison of their own results with benchmark data for continuous improvement of their treatment results and ensuring contribution to research in Hernia treatment. To become a specialist Hernia surgeon, the ACCESS Group suggests a general surgeon to master the learning curve of all open and laparo-endoscopic Hernia procedures recommended in the guidelines, perform a high caseload and additionally to implement and fulfill the other requirements for a Hernia center. Based on the above requirements formulated by the European Hernia Society for accredited/certified Hernia centers and Hernia specialist surgeons, the national and international Hernia societies can now develop their own programs, while taking account of their specific health care systems.

  • development of a standardized curriculum concept for continuing training in Hernia Surgery german Hernia school
    Hernia, 2017
    Co-Authors: R Lorenz, Bernd Stechemesser, W Reinpold, R Fortelny, F Mayer, W Schroder, F Kockerling
    Abstract:

    The increasingly more complex nature of Hernia Surgery means that training programs for young surgeons must now meet ever more stringent requirements. There is a growing demand for improved structuring and standardization of education and training in Hernia Surgery. In 2011, the concept of a Hernia School was developed in Germany and has been gradually implemented ever since. That concept comprises the following series of interrelated, tiered course elements: Hernie kompakt (Hernia compact), Hernie konkret (Hernia concrete), and Hernie complex (Hernia complex). All three course elements make provision for structured clinical training based on guest visits to approved Hernia centers. The Hernia compact basic course imparts knowledge of anatomy working with fresh cadavers. Hernia Surgery procedures can also be conducted using unfixed specimens. Knowledge of abdominal wall ultrasound diagnostics is also imparted and Hernia Surgery procedures simulated on pelvic trainers. In all three course elements, lectures are delivered by experts across the entire field of Hernia Surgery using evidence-based practices from the literature. To date, eight Hernie kompakt (Hernia compact) courses have been conducted, in each case with up to 55 participants, and with a total of 390 participants. On evaluating the course, over 95% of participants expressed the view that the Hernia compact course content improved Hernia Surgery training. Following that positive feedback, the more advanced Hernie konkret (Hernia concrete) and Hernie complex (Hernia complex) course elements were introduced in 2016. The experiences gained to date since the introduction of a Hernia School—a standardized curriculum concept for continuing training in Hernia Surgery—has been evaluated by participants as an improvement on hitherto Hernia Surgery training.

  • development of a standardized curriculum concept for continuing training in Hernia Surgery german Hernia school
    Hernia, 2017
    Co-Authors: R Lorenz, Bernd Stechemesser, W Reinpold, R Fortelny, F Mayer, W Schroder, F Kockerling
    Abstract:

    Introduction The increasingly more complex nature of Hernia Surgery means that training programs for young surgeons must now meet ever more stringent requirements. There is a growing demand for improved structuring and standardization of education and training in Hernia Surgery.

  • what is a certified Hernia center the example of the german Hernia society and german society of general and visceral Surgery
    Frontiers in Surgery, 2014
    Co-Authors: F Kockerling, Dieter Berger, Johannes O Jost
    Abstract:

    To date the scientific definition "Hernia Center" does not exist and this term is beeing used by hospitals and private institutions as a marketing instrument. Hernia Surgery has become increasingly more complex over the pass 25 years. Differenciated use of the various techniques in Hernia Surgery has been adopted as a " taillord approach" program and requires intensive engagement with, and extensive experience of, the entire field of Hernia Surgery. Therefore there is a need for Hernia centers. A basic requirement for a credible certification process for Hernia centers involves definition of requirements and there verification by Hernia societies and/or non-profit organizations that are interested in assuring the best possible quality of Hernia Surgery. At present there are two processes for certification of Hernia centers by Hernia societies or non-profit organizations.

  • Herniamed an internet based registry for outcome research in Hernia Surgery
    Hernia, 2012
    Co-Authors: Bernd Stechemesser, Dietmar Jacob, C Schugpas, F Kockerling
    Abstract:

    Purpose Despite the high frequency of Hernia Surgery procedures and continuous improvements, thanks to new Hernia meshes and fixation techniques, in Germany, for example, the recurrence rate and rate of chronic inguinal pain after inguinal Surgery are more than 10% far too high. Introduction of a Hernia register in Denmark led to a significant reduction in the recurrence rate.

Pär Nordin - One of the best experts on this subject based on the ideXlab platform.

  • Groin Hernia Surgery in Uganda: Caseloads and Practices at Hospitals Operating Within the Publicly Funded Healthcare Sector
    World Journal of Surgery, 2020
    Co-Authors: Alphonsus Matovu, Andreas Wladis, Pär Nordin, Mary Margaret Ajiko, Jenny Löfgren
    Abstract:

    Background Groin Hernia is a major public health problem with over 200 million people affected. The unmet need for Surgery is greatest in Sub-Saharan Africa where specialist surgeons are few. This study was carried out in Uganda to investigate caseloads and practices of groin Hernia Surgery at publicly funded hospitals. Methods The study employed mixed methods covering 29 hospitals: the National Referral Hospital (NRH), 14 Regional Referral Hospitals (RRH) and 14 General Hospitals (GH). In part one of the study, surgeons and medical doctors performing Hernia repair were interviewed about their practices and experiences of groin Hernia Surgery. In part two, operating theater records from 2013 to 2014 from the participating hospitals were reviewed and information about groin Hernia operations collected. Results All respondents reported that sutured repair was the first-choice method. A total of 5518 groin Hernia repairs were performed at the participating hospitals, i.e., an annual Hernia repair rate of 7/100 000 population. Of the patients operated, almost 16% were women and 24% were children. Local anesthesia (LA) was used in 40% of the cases, and non-surgeon physicians performed 70.3% of the groin Hernia repairs. Conclusion Groin Hernia repair outputs need to increase along with the training of surgical providers in modern Hernia repair methods. Methods and outcomes for Hernia repair in women and children should be investigated to improve the quality of care.

  • Recurrent groin Hernia Surgery
    British Journal of Surgery, 2011
    Co-Authors: Dan Sevonius, Ulf Gunnarsson, Pär Nordin, Erik Nilsson, Gabriel Sandblom
    Abstract:

    Background: The reoperation rate after recurrent groin Hernia Surgery is more than twice that recorded for primary groin Hernia procedures. The aim was to define the outcome from routine redo herni ...

  • mortality after groin Hernia Surgery delay of treatment and cause of death
    Hernia, 2011
    Co-Authors: Hanna Nilsson, Erik Nilsson, Ulf Angeras, Pär Nordin
    Abstract:

    Emergency Hernia Surgery, in contrast to elective Hernia Surgery, is associated with appreciable mortality. Incarcerated Hernia is the second most common cause of small bowel obstruction after adhesions, and the leading cause of bowel strangulation. Information on patients who died within 30 days of groin Hernia Surgery was retrieved from the Swedish Hernia Register, from the Cause-of-Death Register, and from hospital notes. Of 103,710 groin Hernia operations between 1992 and 2004, 292 patients died within 30 days of Surgery. Hospital notes and cause of death were retrieved for 242 cases (82%). In 5 of these patients, the Hernia operation was done in addition to more urgent Surgery and therefore excluded from further analyses; 152 patients were admitted as emergency cases and 55 of these patients underwent bowel resection. A total of 107 patients had signs of bowel obstruction when admitted. For 37% of these patients, physical examination of the groin was not documented. Patients with bowel obstruction without a note on a palpable groin lump were more likely to undergo imaging investigation preoperatively (P < 0.001) and they had an increased time to Surgery compared to patients with a palpable lump. Women and patients with femoral Hernia were significantly less likely to undergo a groin examination compared to other patients. Local anaesthesia was used in 7% of all patients who died postoperatively, and in 3% of emergency cases. Pulmonary disease, sepsis and malignant disease were more common as causes of death after emergency Surgery than after elective Surgery. Groin examination of patients presenting with bowel obstruction is of utmost importance in order to minimise delay to Hernia Surgery.

  • effect of body mass index on groin Hernia Surgery
    Annals of Surgery, 2010
    Co-Authors: Anders Rosemar, Ulf Angeras, Annika Rosengren, Pär Nordin
    Abstract:

    OBJECTIVE: To analyze the effect of underweight, overweight, and obesity in relation to clinical characteristics, the risk of postoperative complications, 30-day mortality, and reoperations for recurrence after groin Hernia Surgery. SUMMARY OF BACKGROUND DATA: Groin Hernia Surgery is one of the most frequent operations performed in general Surgery. Several studies have demonstrated a protective effect of overweight and obesity on the risk of developing primary groin Hernia. However, obesity has also been suggested to increase the risk for recurrence of groin Hernia. METHODS: Through the Swedish Hernia Register, 49,094 primary groin Hernia operations were identified between January 1, 2003 and December 31, 2007. Patients were divided into 4 body mass index (BMI) groups: BMI 1, 30 kg/m2. RESULTS: Of the 49,094 patients, 3.5% had a BMI 25 had a significant increased risk when compared with patients with BMI from 20 to 25. Reoperation for recurrence of groin Hernia has an increased hazard ratio of 1.20 (95% confidence interval, 1.00-1.40) in overweight, which was particularly evident after open suture and preperitoneal mesh techniques. CONCLUSIONS: In this large and unselected population of patients with a first surgical procedure for groin Hernia a relative dominance of female and femoral Hernias presented as an emergency condition was observed in the low BMI group. The prevalence of obesity was markedly low. Both lean and obese patients had an increased risk for postoperative complications.

  • mortality after groin Hernia Surgery
    Annals of Surgery, 2008
    Co-Authors: Hanna Nilsson, Erik Nilsson, Georgios Stylianidis, Markku M Haapamaki, Pär Nordin
    Abstract:

    Objective: To analyze mortality following groin Hernia operations.Summary Background Data: It is well known that the incidence of groin Hernia in men exceeds the incidence in women by a factor of 1 ...

Jacob Rosenberg - One of the best experts on this subject based on the ideXlab platform.

Gabriel Sandblom - One of the best experts on this subject based on the ideXlab platform.

Shanjun Tan - One of the best experts on this subject based on the ideXlab platform.