State of groin hernia repair in Japan: Annual Report of 2022 from the National Clinical Database

The National Clinical Database (NCD) in Japan captures over 95% of the surgeries performed by general surgeons. In May 2021, the Japan Hernia Society (JHS) introduced additional categories for groin hernia repair at JHS-registered institutions. This study presents the 2022 data on groin hernia repair from the NCD.

This study included all cases of groin hernia repair registered in the NCD for 2022. The basic data collected included age, sex, type of surgery, day surgery status, emergency status, and anesthesia involvement. For JHS-registered institutions, data on hernia laterality, whether the case was primary or recurrent, surgical details, and groin hernia classifications were also collected.

Of the 908 institutions reporting to the NCD, 459 (50.6%) were JHS registered. A total of 118,365 groin hernia repairs were recorded, of which 43,952 (37.1%) were from JHS-registered institutions. Endoscopic repair accounted for 53.3% (n = 63,208) of the patients. Day surgery was performed in 5.1% (n = 6045) of the patients. At JHS-registered institutions, 81.6% of bilateral hernias were treated by endoscopic repair; 68.1% were lateral hernias. The most commonly used method was the TAPP method, which was applied in 48.8% of cases.

Although endoscopic repair is widely used in Japan, day surgery rates remain low. Improving data collection and increasing NCD participation are crucial for aligning with international standards.