# Choice of Surgical Technique in Groin Hernia Surgery Among Residents in Senegal: Experience and Influencing Factors

## TL;DR

Senegalese surgical residents prefer open techniques for groin hernia repair due to cost and training limitations, with minimal use of minimally invasive methods.

## Contribution

Identifies training, cost, and resource limitations as key barriers to adopting minimally invasive hernia repair techniques in Senegal.

## Key findings

- Bassini and Lichtenstein techniques are most commonly known and performed by residents.
- Minimally invasive techniques like TAPP and TEP are less familiar and rarely used.
- Training, ease of performance, time, and cost are primary factors influencing technique choice.

## Abstract

Groin hernia repair is a common surgical procedure globally, with several techniques developed to minimize complications, pain, and recurrence. In Senegal, despite advancements, the adoption of minimally invasive techniques remains limited. This study evaluates the factors influencing surgical technique choice among surgical residents in Senegal.

We conducted a national cross-sectional survey from July 1 to July 15, 2024. The survey targeted surgical residents in Senegal specializing in general surgery and urology, utilizing contact information from resident associations. A structured questionnaire covered demographic data, knowledge and experience with hernia repair techniques, and factors influencing technique choice. Statistical analysis was performed using R software, with descriptive statistics summarizing the data.

A total of 74 residents participated, with an average age of 31.3 ± 3.5 years. The Bassini repair was the most commonly known (100%), witnessed (97.3%), and performed technique (94.2%) among residents, followed by the Lichtenstein technique. Minimally invasive techniques, such as TAPP and TEP, were less familiar and rarely performed. Factors influencing technique choice included training (90.5%), ease of performance (63.5%), time required (58.1%), and cost (51.4%).

This study highlights a preference for open hernia repair techniques among residents in Senegal, particularly the Bassini and Lichtenstein techniques, due to cost-effectiveness and accessibility. Limited training and resources constrain the adoption of minimally invasive techniques, underscoring the need for enhanced access to resources and training to align with global standards.