Inguinal hernia repair: a survey of Canadian practice patterns.

OBJECTIVE To describe the preferences of general surgeons across Canada with respect to hernia repair technique. DESIGN A survey by mailed questionnaire. PARTICIPANTS All 1452 fellows of the Royal College of Physicians and Surgeons of Canada currently holding a certificate in general surgery. INTERVENTION Two mailings of the survey: the first in December 1996, the second to nonrespondents in February 1997. MAIN OUTCOME MEASURES Surgeons' preference of hernia repair technique for specified indications. This was analysed according to practice setting and geographic location. MAIN RESULTS Based on 706 completed questionnaires, the preferred techniques for repair of primary inguinal hernias were as follows: 23% Bassini, 20% mesh plug, 16% Lichtenstein, 15% laparoscopic, 11% Shouldice and 11% McVay. Preference for laparoscopic repair increased to 34% for recurrent hernias and 35% for bilateral hernias. The Atlantic provinces had the lowest preference rates for laparoscopic repair and the highest rates for the mesh plug technique. CONCLUSIONS Most surgeons select the type of repair on the basis of the clinical scenario. Large variations in practice exist between provinces.