There is insufficient epidemiologic evidence to draw meaningful conclusions about ( i ) the existence of causal associations between specific occupational mechanical exposures and the development of inguinal hernia , and ( ii ) the influence of these exposures on prognosis after inguinal hernia repair with respect to hernia recurrence and persistent pain
OBJECTIVES The aim of this review was to evaluate the epidemiologic evidence for ( i ) a causal effect of occupational mechanical exposures on incidence of inguinal hernia , and ( ii ) a prognostic effect of such exposures on hernia recurrence and persistent pain after inguinal hernia repair .
European Hernia Society guidelines on the treatment of inguinal hernia in adult patients
The European Hernia Society ( EHS ) is proud to present the EHS Guidelines for the Treatment of  Inguinal Hernia in Adult Patients . The Guidelines contain recommendations for the treatment of inguinal hernia from diagnosis till aftercare . They have been developed by a Working Group consisting of expert surgeons with representatives of 14 country members of the EHS . They are evidence -based and , when necessary , a consensus was reached among all members . The Guidelines have been review ed by a Steering Committee . Before finalisation , feedback from different national hernia societies was obtained . The  Appraisal of Guidelines for REsearch and Evaluation ( AGREE ) instrument was used by the Cochrane Association to vali date the Guidelines . The Guidelines can be used to adjust local protocol s , for training purpose s and quality control . They will be revised in 2012 in order to keep them up date d. In between revisions , it is the intention of the Working Group to provide every year , during the EHS annual congress , a short up date of new high-level evidence ( r and omised controlled trials [ RCTs ] and meta-analyses ) . Developing guidelines leads to questions that remain to be answered by specific research . Therefore , we provide recommendations for further research that can be performed to raise the level of evidence concerning certain aspects of inguinal hernia treatment . In addition , a short summary , specifically for the general practitioner , is given . In order to increase the practical use of the Guidelines by consultants and residents , more details on the most important surgical techniques , local infiltration anaesthesia and a patient information sheet is provided . The most important challenge now will be the implementation of the Guidelines in daily surgical practice . This remains an important task for the EHS . The establishment of an EHS school for teaching inguinal hernia repair surgical techniques , including tips and tricks from experts to overcome the learning curve ( especially in endoscopic repair ) , will be the next step . Working together on this project was a great learning experience , and it was worthwhile and fun . Cultural differences between members were easily overcome by educating each other , respecting different views and always coming back to the principles of evidence -based medicine . The members of the Working Group would like to thank the EHS board for their support and especially Ethicon for sponsoring the many meetings that were needed to finalise such an ambitious project
There is insufficient epidemiologic evidence to draw meaningful conclusions about ( i ) the existence of causal associations between specific occupational mechanical exposures and the development of inguinal hernia , and ( ii ) the influence of these exposures on prognosis after inguinal hernia repair with respect to hernia recurrence and persistent pain
OBJECTIVES The aim of this review was to evaluate the epidemiologic evidence for ( i ) a causal effect of occupational mechanical exposures on incidence of inguinal hernia , and ( ii ) a prognostic effect of such exposures on hernia recurrence and persistent pain after inguinal hernia repair .