Society of American Gastrointestinal and Endoscopic Surgeons

View all recommendations from this society

January 9, 2019

Avoid the routine use of ultrasound in evaluating clinically apparent inguinal hernia.

The diagnosis of, and subsequent treatment decisions for, palpable abdominal wall hernias are reliably made by patient history and physical examination alone. While the use of ultrasonography has been shown to be of some benefit in the diagnosis of occult hernias, there is no place for its routine use in the setting of a clearly palpable defect, as it only adds unnecessary cost and treatment delay with no useful contribution to definitive surgical care.


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How The List Was Created

The SAGES Quality, Outcomes and Safety (QOS) Committee appointed a task force (comprised of active members of the committee) to develop a list of potential recommendations after being provided with information and links to the Choosing Wisely website. This group compiled a list of recommendations which fit the criteria outlined by the ABIM. A literature search was performed to ensure the recommendations were evidence-based. The task force then distributed the list to the full membership of the SAGES QOS Committee, asking the members of the committee to rank the recommendations by level of importance and clinical relevance. The top five recommendations were then selected for inclusion in this list.

Sources

SAGES guideline for laparoscopic ventral hernia repair. Available at: https://www.sages.org/publications/guidelines/guidelines-for-laparoscopic-ventral-hernia-repair/.

Matthews RD, Neumayer L. Inguinal hernia in the 21st century: an evidence-based review. Curr Probl Surg. 2008 Apr. 45(4):261-312.

Robinson A, Light D, Kasim A, Nice C. A systematic review and meta-analysis of the role of radiology in the diagnosis of occult inguinal hernia. Surg Endosc. 2013 Jan;27(1):11-8.

Miller J, Cho J, Michael MJ, Saouaf R, Towfigh S. Role of imaging in the diagnosis of occult hernias. JAMA Surg. 2014 Oct;149(10):1077-80.