# Computational Analysis and Classification of Hernia Repairs
## 3 Results  
Analysis of hernia surgery is based on the database established by the European Hernia Society in 2011 and its use. The EHS registry collects demographic data, including BMI, age, gender, and comorbidities. Additionally, it records comprehensive information about the mesh utilized, type of repair, operative details, postoperative complications, patient satisfaction, and outcomes. Processing steps include:  
1. Record of facts about each surgery performed by the member of the society that includes information about the patient, surgery description, and its results,
2. Statistical evaluation of all records in the database,
3. Password-protected access of EHS members to the web page allowing the evaluation of selected facts in the given period of time. Table 2 provides the demographic composition of the total number of 3339 patients in the EHS database with 2048 Groin Hernia Repairs (GHR) and 1234 repairs of Primary Ventral Hernias (PVHR), Incisional Ventral Hernias (IVHR), and Parastomal Hernias (PHR). Figure 4 presents the percentage ratio of operation types (open, laparoscopic, and robotic) during selected years of the GHR and PVHR/IVHR/PHR surgery. It is the evident increase in open and laparoscopic operations and decrease in robotic operations recorded in the EHS database. Table 3 presents the number of open repairs, minimally invasive procedures, and robotic-assisted repairs. Among the variables recorded in the EHS registry for minimally invasive surgical approaches, the following techniques are listed: totally extra-peritoneal access (TEP), extended view TEP (e-TEP), endoscopic trans-abdominal accesses (TAPP, TAPP ventral, and TARUP), endoscopic subcutaneous access (SCOLA), and endoscopic hybrid access, which combines endoscopic and open repair. The registry also includes data on robotic-assisted operations, specifically robotic extra-peritoneal (robotic e-TEP), robotic trans-abdominal (rTAPP ventral and rTARUP), as well as combined techniques involving robotic endoscopic trans-abdominal access (rTAPP), robotic endoscopic extra-peritoneal access (rTEP), and robotic hybrid access (combined robotic and open repair). The graphical user interface (GUI) has been developed to extract specific information from the extensive and continuously expanding European hernia database. The required data can be processed using the proposed algorithm and presented to the user to analyze previous surgeries and propose the optimal solution for new patients. Figure 3 illustrates the body mass index of individuals in the EHS registry of GHR among hernia male and female patients with their mean values and their distribution. The total number of records acquired in the range of \(\langle 2012,2023\rangle\) years was reduced to 1088 GHR patients with complete database records. This characteristic, which serves as a measure of body fatness, is calculated by dividing a person's weight (in kg) by the square of their height (in m). BMI is a significant factor associated with worse outcomes and plays a crucial role in decision-making regarding the type of operation, operative approach, and choice of mesh. \begin{table}
\begin{tabular}{c c c c c c c c c} \hline \multirow{2}{*}{**Year**} & \multicolumn{3}{c}{**GHR**} & \multicolumn{3}{c}{**PVHR/IVHR/PHR**} \\ \cline{2-9}  & **Male** & **Female** & **Sum** & **Male** & **Female** & **Sum** & **UNSPECIFIED** & **Total** \\ \hline
2012–2017 & 35 & 2 & 37 & 28 & 41 & 69 & 0 & 106 \\
2018 & 34 & 3 & 37 & 15 & 15 & 30 & 0 & 67 \\
2019 & 54 & 12 & 66 & 22 & 33 & 55 & 1 & 122 \\
2020 & 279 & 37 & 316 & 117 & 99 & 216 & 4 & 536 \\
2021 & 396 & 41 & 437 & 190 & 166 & 356 & 8 & 801 \\
2022 & 572 & 43 & 615 & 144 & 137 & 281 & 14 & 910 \\
2023 & 495 & 45 & 540 & 135 & 92 & 227 & 30 & 797 \\ \hline Sum & 1865 & 183 & 2048 & 651 & 583 & 1234 & 57 & **3339** \\ \hline \end{tabular}
\end{table} 
Table 2: The demographic composition of the hernia database of GHR and PVHR/IVHR/PHR repairs during separate years.