2013年腹腔镜下腹股沟疝修补EAES共识.docx

1. Occasional lifting, constipation, and prostatism do not predispose to the development of groin hernia. (LoE:3; LoC: majority, 68 of 110 = 62 %)2. In patients with aneurysmal disease, the incidence of groin hernia is increased. (LoE: 3; LoC: majority, 60of 115 = 52 %)3. In case of clear clinical diagnosis of inguinal hernia, no additional imaging studies are necessary. (LoE: 2c;LoC: consensus, 137 of 147 = 93 %)4. When a groin hernia is suspected but clinical findings are equivocal, the first step in imaging is dynamic ultrasonography, followed by dynamic MRI. (LoE: 2c;LoC: consensus, 138 of 149 = 93 %)5. Ultrasonography and MRI have a high sensitivity and specificity considering the detection of an occult inguinal hernia and have replaced herniography as a diagnostic instrument. (LoE: 2c; LoC: consensus, 136of 149 = 91 %)6. CT can be a useful adjunct for the detection of an occult groin hernia. (LoE: 3; LoC: majority, 112 of152 = 74 %)7. Physical examination does not allow distinguishing direct (i.e., medial) from indirect (i.e., lateral) inguinal hernias. (LoE: 2; LoC: majority, 103 of 154 = 67 %)8. Endoscopic surgery is preferred in patients with a recurrent groin hernia after open repair. (LoE: 1b;LoC: strong consensus, 151 of 158 = 96 %)9. Repeat endoscopic repair is only feasible when the surgeon has a high level of experience in repeatendoscopic groin hernia repair (TAPP). (LoE: 5; LoC: consensus, 109 of 134 = 81 %)10. Especially in bilateral groin hernia, endoscopic surgery is an excellent approach. (LoE: 5 for TEP/2b for TAPP; LoC: strong consensus, 154 of161 = 96 %)11. Concerning the repair of (a bilateral) groin hernia, there is no clear advantage of TEP over TAPP or vice versa. (LoE: 2a; LoC: majority, 105 of 142 = 73 %)12. When an occult contralateral hernia is discovered during endoscopic repair of a symptomatic unilateral hernia, the occult and the symptomatic hernia can be repaired in the same surgical procedure. (LoE: 5; LoC: strong consensus, 148