Training Center of IEHS. Hernia Center.

Requirements for acknowledgement as training center of IEHS:

  1.  Documentation of all hernia cases.
  2. Operative techniques according to guidelines.
  3. Perioperative management according to guidelines.
  4. Organization of at least two standardized training courses per year (anatomy, indication, performance, aftercare, pitfalls, difficult cases, management of complications, pain management, management of recurrent hernias, materials, hands on: model training, operation theater).
  5. External evaluation.

Requirements for acknowledgement as certified Hernia Center of IEHS

(Parameter for quality):

A. Structure.

    1. Providing of all possibilities for open and laparo-endoscopic hernia repair.
    2. Providing all possibilities for ambulatory and in hospital operations.
    3. Providing all diagnostic facilities for difficult cases esp. ultrasound, CT-scan and MRI.
    4. Providing cooperation with plastic surgery.
    5. Providing outpatient care at regular time intervals.
    6. Providing at least two experienced hernia surgeons (Proof of at least 500 hernia repairs incl. teaching operations). One of both should always been present.
    7. B. Process.

    8. Documentation of all hernia cases.
    9. Follow-up of at least 60% of the cases at one year, three years and five years.
    10. Evaluation of operative techniques by an external audit.
    11. Monthly organization of a morbidity/mortality conference.
    12. Providing a pathway for pain management.
    13. C. Results.

    14. Minimum number of hernia operations per year: 250 repairs (out of them at least 40 operations because of incisional hernias).
    15. Percentage of laparo-endoscopic operations in primary hernias: At least 75%.
    16. All bilateral inguinal hernias should be operated on by laparo-endoscopic techniques.
    17. Recurrent hernias should be operated on according to guidelines.
    18. The following quality parameters should be respected:
      • Total complication rate in inguinal hernia repair < 5%.
      • Reoperation rate (within 30 days) after inguinal hernia repair <2%.
      • Reoperation rate (within 30 days) after incisional hernia repair <10%.
      • Infection rate after open incisional hernia repair <10%.
      • Infection rate after laparo-endoscopic incisional hernia repair <3%.

    D. Education.

    The leader of the hernia center should participate in at least two national or international hernia meetings per year outside their hospital.

    E. External Evaluation.

    A certification process for proof of the requirements and accordingly for the acknowledgement as Hernia Center (excellence) of IEHS is necessary. Main part of the certification process should be an external audit by one (two) experts nominated by IEHS. The recognition as Hernia Center of IEHS should be valid for three years.