Education and Learning Curve in Ventral Hernia Repair

  • Davide LomantoEmail author
  • Sujith Wijerathne


Minimally invasive surgery has evolved with the intent of minimizing surgical trauma and to achieve better postoperative pain control and better cosmetic outcome. To achieve these goals with minimal perioperative complications and acceptable clinical outcome, a surgeon needs to have an adequate training and experience in any surgical procedure, which demands specialized skills. In some cases, the curve to reach the proficiency may be a stepwise process. Surgery for ventral hernia has advanced over the years incorporating the minimally invasive techniques and demands a technically challenging learning curve in the current surgical practice.


  1. 1.
    LeBlanc KA, Booth WV. Laparoscopic repair of incisional abdominal hernias using expanded polytetra-fuoroethylene: preliminary findings. Surg Laparosc Endosc. 1993;3:39–41.PubMedGoogle Scholar
  2. 2.
    Lomanto S, Iyer G, Shabbir A, et al. Laparoscopic versus open ventral hernia mesh repair: a prospective study. Surg Endosc. 2006;20:1030–5.CrossRefPubMedGoogle Scholar
  3. 3.
    Chowbey PK, Sharma A, Khullar R, et al. Laparoscopic ventral hernia repair. J Laparoendosc Adv Surg Tech A. 2000;10:79–84.CrossRefPubMedGoogle Scholar
  4. 4.
    Misra MC, Bansal VK, Kulkarni MP, et al. Comparison of laparoscopic and open repair of incisional and primary ventral hernia: results of a prospective randomized study. Surg Endosc. 2006;20:1839–45.CrossRefPubMedGoogle Scholar
  5. 5.
    Al-Harazi A, Goel R, Tan CTK, et al. Laparoscopic ventral hernia repair: defining the learning curve. Surg Laparosc Endosc Percutan Tech. 2014;24:475–7.PubMedGoogle Scholar
  6. 6.
    Sajid MS, Bokhari SA, Mallick AS, et al. Laparoscopic versus open repair of incisional/ventral hernia: a meta- analysis. Am J Surg. 2009;197:64–72.CrossRefPubMedGoogle Scholar
  7. 7.
    Bencini L, Sánchez LJ. Learning curve for laparoscopic ventral hernia repair: 1. Am J Surg. 2004;187:378.CrossRefPubMedGoogle Scholar
  8. 8.
    Lomanto D, Chua H, Chou P, Aung MM, Salonga MC, So JBY, Cheah WK. Use of virtual reality simulators in pre- and post-training assessment of laparoscopic surgical workshops. Oral presentation during the 8th Asia Pacific meeting of the Endoscopic and Laparoscopic Surgeons of Asia (ELSA), Hyderabad, 17–19 Aug 2007.Google Scholar
  9. 9.
    Hawkins WJ, Moorthy KM, Tighe D, Yoong K, Patel RT. With adequate supervision, the grade of the operating surgeon is not a determinant of outcome for patients undergoing urgent colorectal surgery. Ann R Coll Surg Engl. 2007;89:760–5.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Paisley AM, Madhavan KK, Paterson-Brown S, Praseedom RK, Garden OJ. Role of the surgical trainee in upper gastrointestinal resectional surgery. Ann R Coll Surg Engl. 1999;81:40–5.PubMedPubMedCentralGoogle Scholar
  11. 11.
    Praseedom RK, Paisley A, Madhavan KK, Garden OJ, Carter DC, Paterson-Brown S. Supervised surgical trainees can perform pancreatic resections safely. J R Coll Surg Edinb. 1999;44:16–8.PubMedGoogle Scholar
  12. 12.
    Sanjay P, Woodward A. Local anaesthetic inguinal hernia repair performed under supervision: early and long-term outcomes. Ann R Coll Surg Engl. 2009;91(8):677–80.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Haidenberg J, Kendrick ML, Meile T, Farley DR. Totally extraperitoneal (TEP) approach for inguinal hernia: the favorable learning curve for trainees. Curr Surg. 2003;60(1):65–8.CrossRefPubMedGoogle Scholar
  14. 14.
    Robson AJ, Wallace CG, Sharma AK, Nixon SJ, Paterson-Brown S. Effects of training and supervision or recurrence rate after inguinal hernia repair. Br J Surg. 2004;91:774–7.CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Senior Consultant, Department of General SurgeryNational University Health SystemSingaporeSingapore
  2. 2.Senior Registrar, Department of General SurgeryNational Univeristy Health SystemSingaporeSingapore

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