EuraHS: the development of an international online platform for registration and outcome measurement of ventral abdominal wall hernia repair

Abstract

Background: Although the repair of ventral abdominal wall hernias is one of the most commonly performed operations, many aspects of their treatment are still under debate or poorly studied. In addition, there is a lack of good definitions and classifications that make the evaluation of studies and meta-analyses in this field of surgery difficult.

Materials and methods: Under the auspices of the board of the European Hernia Society and following the previously published classifications on inguinal and on ventral hernias, a working group was formed to create an online platform for registration and outcome measurement of operations for ventral abdominal wall hernias. Development of such a registry involved reaching agreement about clear definitions and classifications on patient variables, surgical procedures and mesh materials used, as well as outcome parameters. The EuraHS working group (European registry for abdominal wall hernias) comprised of a multinational European expert panel with specific interest in abdominal wall hernias. Over five working group meetings, consensus was reached on definitions for the data to be recorded in the registry.

Results: A set of well-described definitions was made. The previously reported EHS classifications of hernias will be used. Risk factors for recurrences and co-morbidities of patients were listed. A new severity of comorbidity score was defined. Post-operative complications were classified according to existing classifications as described for other fields of surgery. A new 3-dimensional numerical quality-of-life score, EuraHS-QoL score, was defined. An online platform is created based on the definitions and classifications, which can be used by individual surgeons, surgical teams or for multicentre studies. A EuraHS website is constructed with easy access to all the definitions, classifications and results from the database.

Conclusion: An online platform for registration and outcome measurement of abdominal wall hernia repairs with clear definitions and classifications is offered to the surgical community. It is hoped that this registry could lead to better evidence-based guidelines for treatment of abdominal wall hernias based on hernia variables, patient variables, available hernia repair materials and techniques.

Fig. 1

Logo of EuraHS: European registry of abdominal wall hernias

Fig. 2

Screenshot of the dialogue for data input into the EuraHS database. A blue background of a question indicates that it has not been answered yet

Fig. 3

The triple-P triangle of abdominal wall hernia repair

Fig. 4

EuraHS ventral hernia model for registration and classification of abdominal wall hernias based on the localisation of the hernia

Fig. 5

EuraHS terminology of mesh positions during ventral hernia repair

Fig. 6

EuraHS quality-of-life score for pre- and post-operative assessment of patients with ventral abdominal wall hernias: EuraHS-QoL