Department of Surgery, Center for Minimally Invasive Surgery, Academic Teaching Hospital of Charité Medical School, Vivantes Hospital, Neue Bergstrasse 6, 13585, Berlin, Germany.
Associate Clinical Head of Division (Surgery), Manchester University NHS Foundation Trust, Manchester, UK.
Hernia. 2019 Apr;23(2):185-203. doi: 10.1007/s10029-018-1873-2. Epub 2019 Jan 23.
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.
由于新技术的出现、更复杂的病例以及公众对最佳治疗效果的需求不断提高，导致疝手术程序的日益复杂，因此需要疝中心和专业疝外科医生。因此，国际和国家疝学会应制定认证疝中心和专业疝外科医生的要求，同时考虑到各自的医疗保健系统。
欧洲疝学会 (EHS) 任命了一个由来自欧洲所有地区的 18 名疝专家组成的工作组（ACCESS 组 - 疝中心和外科医生认证和认证工作组），以制定基于科学的疝中心和专业疝外科医生的要求，同时考虑到不同的医疗保健系统。通过会议、电话会议和意见交流，就关键问题达成共识。以下列出的要求被认为是所有参与疝专家在各自国家都可以实施的。
ACCESS 组建议配备以下要求的疝中心：（a）由国家或国际疝学会认证/认可，（b）与本国普通外科部门相比，在所有类型的疝手术中执行更高的病例量，（c）由经验丰富的疝外科医生组成，这些外科医生已经超越了指南中推荐的所有类型疝手术的学习曲线，并负责部门的疝外科教育和培训，（d）根据当前指南和科学建议治疗疝患者，（e）在登记处或质量保证数据库中前瞻性记录每个病例，（f）进行随访，将自己的结果与基准数据进行比较，以持续改进治疗结果并确保为疝治疗研究做出贡献。要成为专业的疝外科医生，ACCESS 组建议普通外科医生掌握指南中推荐的所有开放和腹腔镜疝手术的学习曲线，完成高病例量，并另外实施和满足疝中心的其他要求。
基于欧洲疝学会制定的认证疝中心和疝专科医生的上述要求，国际和国家疝学会现在可以制定自己的计划，同时考虑到他们特定的医疗保健系统。
