pp 1–11 | Cite as

Abdominal wall hernia surgery in The Netherlands: a national survey

  • J. A. WegdamEmail author
  • T. S. de Vries Reilingh
  • S. W. Nienhuijs
  • M. P. Simons
Original Article



In The Netherlands, the quality of abdominal wall hernia surgery is largely unknown due to the lack of a hernia registry. This study was designed to assess the current state of abdominal wall hernia surgery in The Netherlands, to create a starting point for future evaluation of new quality measures.


Dutch hernia management indicators and recently proposed European Hernia Society (EHS) requirements for accredited/certified hernia centers were used. The number of Dutch hospitals that meet the four main EHS requirements (on volume, experience, use of a registry and quality control) was assessed by analyzing governmental information and the results of a survey amongst all 1.554 Dutch general surgeons.


The survey was representative with 426 respondents (27%) from all 75 hospitals. Fifty-one percent of the hospitals had a median inguinal repair volume of more than 290 (14–1.238) per year. An open or laparo-endoscopic inguinal repair technique was not related to hospital volume. Experienced hernia surgeons, use of a registry and a structured quality control were reported to be present in, respectively, 97%, 39%, and 15% of the hospitals. Consensus in answers between the respondents per hospital was low (< 20%). Two hospitals (3%) met all four requirements for accreditation.


This descriptive analysis demonstrates that hernia surgery in the Netherlands is performed in every hospital, by all types of surgeons, using many different techniques. If the suggested EHS requirements are used as a measuring rod, only 3% of the Dutch hospitals could be accredited as a hernia center.


Ventral hernia Quality measures Certification requirements Accreditation 


Compliance with ethical standards

Conflict of interest

JW, TdVR, SN and MS declare no conflict of interest.

Ethical approval

This study was reviewed and approved by the Elkerliek Hospital Institutional Review Board.

Human and animal rights

This article does not contain studies directly involving human participants, as it is a descriptive study of the results of an electronic survey amongst Dutch surgeons, not patients.

Informed consent

For this type of study, formal consent was not necessary.


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Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of SurgeryElkerliek ZiekenhuisHelmondThe Netherlands
  2. 2.Department of SurgeryCatharina Ziekenhuis EindhovenEindhovenThe Netherlands
  3. 3.Department of SurgeryOnze Lieve Vrouwe Gasthuis, locatie OostAmsterdamThe Netherlands

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