Bhattacharya K. International guidelines for groin hernia management: Do they have a vested interest? World J Surg Proced 2026; 16(2): 124162 [DOI: 10.5412/wjsp.124162]
Corresponding Author of This Article
Kaushik Bhattacharya, Associate Professor, FACS, FRCS (Gen Surg), Department of Surgery, MGM Medical College and LSK Hospital, G 616 Neelavatika, Uttorayon, Matigara, Siliguri, West Bengal, Kishanganj 855107, Bihar, India. kbhattacharya10@yahoo.com
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Surgery
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Bhattacharya K. International guidelines for groin hernia management: Do they have a vested interest? World J Surg Proced 2026; 16(2): 124162 [DOI: 10.5412/wjsp.124162]
World J Surg Proced. Sep 16, 2026; 16(2): 124162 Published online Sep 16, 2026. doi: 10.5412/wjsp.124162
International guidelines for groin hernia management: Do they have a vested interest?
Kaushik Bhattacharya
Kaushik Bhattacharya, Department of Surgery, MGM Medical College and LSK Hospital, Kishanganj 855107, Bihar, India
Author contributions: Bhattacharya K contributed to the conception and design of the study, acquisition of data, manuscript drafting, critical revision of the content, and final approval of the submitted version.
AI contribution statement: The authors take full responsibility and accountability for all content of this manuscript, including any portions for which AI tools were used as assistive technologies. All AI-assisted outputs were carefully reviewed, validated, and approved by the authors. AI tools were not used to generate original scientific data, perform independent scientific analyses, or draw scientific conclusions.
Conflict-of-interest statement: The author reports no relevant conflicts of interest for this article.
Corresponding author: Kaushik Bhattacharya, Associate Professor, FACS, FRCS (Gen Surg), Department of Surgery, MGM Medical College and LSK Hospital, G 616 Neelavatika, Uttorayon, Matigara, Siliguri, West Bengal, Kishanganj 855107, Bihar, India. kbhattacharya10@yahoo.com
Received: June 9, 2026 Revised: August 3, 2026 Accepted: August 31, 2026 Published online: September 16, 2026 Processing time: 100 Days and 12.2 Hours
Abstract
International HerniaSurge guidelines have standardized groin hernia management, yet uncertainty persists regarding the optimal repair technique because available evidence remains heterogeneous, surgeon-dependent, and frequently influenced by patient selection and expertise. Concerns over industry sponsorship, conflicts of interest, and selective reporting raise questions about the impartiality of existing recommendations. Current evidence suggests that no single technique consistently demonstrates superiority in long-term recurrence, chronic pain, or patient satisfaction across all clinical settings. Therefore, individualized treatment based on patient characteristics, surgeon proficiency, and shared decision-making remains appropriate. Future international guidelines should be developed by independent multidisciplinary panels free from industry funding, with mandatory conflict-of-interest disclosure, transparent Grading of Recommendations Assessment, Development and Evaluation-based evidence synthesis, public consultation, external peer review, publication of complete evidence tables, inclusion of patient representatives, and regular independent updates. Comparative trials should emphasize long-term patient-centred outcomes, decision regret, quality of life, chronic pain, mesh-related complications, cost-effectiveness, and recurrence rather than procedural preference alone.
Core Tip: Current HerniaSurge guidelines provide a structured approach to groin hernia management, but concerns remain regarding industry influence, conflicts of interest, and the absence of definitive evidence supporting one superior repair technique. Greater transparency, independent evidence appraisal, and individualized surgeon-patient decision-making are essential for optimizing outcomes and maintaining trust.
