Department of Surgical Sciences, University of Genoa, Italy.
Department of Surgery "P. Valdoni", Sapienza University, Rome, Italy.
Int J Surg. 2018 Jun;54(Pt A):222-235. doi: 10.1016/j.ijsu.2018.04.052. Epub 2018 May 4.
The terms "Hernia Center" (HC) and Hernia Surgeon" (HS) have gained more and more popularity in recent years. Nevertheless, there is lack of protocols and methods for certification of their activities and results. The Italian Society of Hernia and Abdominal Wall Surgery proposes a method for different levels of certification.
The national board created a commission, with the task to define principles and structure of an accreditation program. The discussion of each topic was preceded by a Systematic Review, according to PRISMA Guidelines and Methodology. In case of lack or inadequate data from literature, the parameter was fixed trough a Commission discussion.
The Commission defined a certification process including: "FLC - First level Certification": restricted to single surgeon, it is given under request and proof of a formal completion of the learning curve process for the basic procedures and an adequate year volume of operations. "Second level certification": Referral Center for Abdominal Wall Surgery. It is a public or private structure run by at least two already certified and confirmed FLC surgeons. "Third level certification": High Specialization Center for Abdominal Wall Surgery. It is a public or private structure, already confirmed as Referral Centers, run by at least three surgeons (two certified and confirmed with FLC and one research fellow in abdominal wall surgery). Both levels of certification have to meet the Surgical Requirements and facilities criteria fixed by the Commission.
The creation of different types of Hernia Centers is directed to create two different entities offering the same surgical quality with separate mission: the Referral Center being more dedicated to clinical and surgical activity and High Specialization Centers being more directed to scientific tasks.
近年来，“疝中心”（HC）和“疝外科医生”（HS）这两个术语越来越受欢迎。然而，它们的活动和结果的认证缺乏协议和方法。意大利疝和腹壁外科学会提出了一种用于不同认证级别的方法。
国家委员会成立了一个委员会，负责定义认证计划的原则和结构。根据 PRISMA 指南和方法，对每个主题的讨论都进行了系统回顾。在文献中缺乏或数据不足的情况下，通过委员会讨论确定了参数。
委员会定义了一个认证流程，包括：“FLC-第一级认证”：仅限于单个外科医生，应在请求下提供，并证明已完成基本程序的学习曲线过程和足够的年手术量。“第二级认证”：腹壁外科转诊中心。它是由至少两名已经认证和确认的 FLC 外科医生运营的公共或私人结构。“第三级认证”：腹壁外科高级专科中心。它是一个公共或私人结构，已经被确认为转诊中心，由至少三名外科医生（两名认证和确认的 FLC 外科医生和一名腹壁外科研究研究员）运营。这两个级别的认证都必须满足委员会规定的手术要求和设施标准。
创建不同类型的疝中心旨在创建两个提供相同手术质量的不同实体，具有不同的使命：转诊中心更专注于临床和手术活动，而高级专科中心更专注于科学任务。
