Hernia clinic in a teaching institution: creation and development.

The hypothesis that a hernia clinic could improve the results of external abdominal wall herniorrhaphy was tested in a teaching institution. From 1980 to 1988, all patients exhibiting external abdominal wall hernias were treated under protocol and separate from general surgical patients in a hernia clinic directed by a dedicated surgeon. The incidence of recurrence, infection, and testicular ischemia was significantly better than our previous institutional results. The incidence of incarceration/strangulation also fell significantly in patients over 65 years of age. Chart documentation was kept up to date for the duration of the project. Insufficient emphasis by the Clinic Director on the benefits of the proposed protocol and other factors contributing to the eventual clinic closure could be circumvented by better alternative planning. In our institution, the outcome of surgery for external abdominal wall surgery was significantly improved by the creation of a hernia clinic; our results equal those reported by other recognized herniorrhaphists. Barring some developmental obstacles, the concept of a hernia clinic should be advantageous to patients and residents alike.