Does resident post graduate year influence the outcomes of inguinal hernia repair?


Journal Article

INTRODUCTION: We evaluated the effect of the postgraduate medical education level (PGY) of surgery residents on recurrence of inguinal hernia, complications, and operative time. METHODS: Post hoc analysis was performed on prospectively collected data from a multicenter Veterans Affairs (VA) cooperative study. Men were randomly assigned to open or laparoscopic inguinal hernia repairs with mesh. Surgery residents performed repairs with designated attending surgeons present throughout all procedures. PGY level of the resident was recorded for each procedure. All patients were followed for 2 years for hernia recurrence and complications. PGY levels were grouped as follows: group I = PGY 1 and 2; group II = PGY 3; group III = PGY >/= 4; rates of recurrence, complications and mean operative time were compared. RESULTS: A total of 1983 patients underwent hernia repair. group III residents had significantly lower recurrence rates for open repairs when compared with group I (adjusted odds ratio = 0.24, 95% confidence interval [CI], 0.06, 0.997). The recurrence rate was similar among the groups for laparoscopic repair (P > 0.05) Complication rates were not different for either repair (P > 0.05). Mean operative time was significantly shorter for group III compared with group I for both open (-6.6 minutes; 95% CI, -11.7, -1.5) and laparoscopic repairs (-12.9 minutes; 95% CI, -19.8, -6.0) and between group II and group I for laparoscopic repair (-15.0; 95% CI, -24.3, -5.7). CONCLUSIONS: Despite the presence of an attending surgeon, open hernia repairs performed by junior residents were associated with higher recurrence rates than those repaired by senior residents. Lower resident level was associated with increased operative time for both open and laparoscopic repair.

Full Text

Duke Authors

Cited Authors

  • Wilkiemeyer, M; Pappas, TN; Giobbie-Hurder, A; Itani, KMF; Jonasson, O; Neumayer, LA

Published Date

  • June 2005

Published In

Volume / Issue

  • 241 / 6

Start / End Page

  • 879 - 882

PubMed ID

  • 15912037

Pubmed Central ID

  • 15912037

International Standard Serial Number (ISSN)

  • 0003-4932

Digital Object Identifier (DOI)

  • 10.1097/01.sla.0000164076.82559.72


  • eng

Conference Location

  • United States