British Hernia Society publishes first BHS Registry Inaugural Annual Report

The British Hernia Society (BHS) has published the Inaugural Annual Report of its new national hernia registry, the BHS Registry, a milestone achievement that delivers the comprehensive data clinicians have called for. 

Utilising Dendrite Clinical Systems’ intuitive and robust ‘Intellect-Web Registry’ software, the BHS Registry allowed surgeons to collect, analyse, track and report procedural, treatment and outcomes data from 2,262 hernia repairs that were recorded across five hernia categories.

Dendrite’s flexible system can be tailored for any clinical scenario and is designed to support multiple specialties and at multiple locations. Data can be entered safely and securely on smart-phones, tablets or computers anywhere in the world via the internet, with the data automatically updated to the registry. The system’s unique ‘Visual Dashboard’ facilitates real-time data analysis reflecting the required analysis/reporting needs, and the recently launched innovative e-PROMS module allows contacts to receive and answer questionnaires remotely.

“We are delighted to see the publication of the Inaugural Annual Report from the BHS Registry that is producing real world data on hernia repairs. Potentially, the outcomes from these data could significantly change clinical practice and research, leading to better outcomes for patients and a much clearer understanding of this rapidly developing field of surgery,” said Dr Peter Walton, Managing Director of Dendrite. “I would like to congratulate all the surgeons who have contributed to this landmark publication and would encourage every hernia surgeon and unit in the UK and Ireland to join the registry.”

Importantly, the BHS Registry provides the first national dataset on patient reported outcome measures (PROMs).  It captures detailed information on operative techniques, including whether mesh is used, enabling meaningful analysis of outcomes over time.  For the first time, surgeons can compare approaches at a national scale, and identify which techniques deliver fewer complications and quicker recovery. This will help expose unwarranted variation and spread best practice, so patients get consistent care wherever they are treated.

“For the first time, we now have early data to help us understand national hernia outcomes which will ultimately improve the quality of patient care,” said Mr Liam Horgan, Chair of the British Hernia Society (BHS) Registry Subcommittee and Past President of the BHS.  “Surgeons will also be able to learn from each other to deliver better results for patients. We encourage every surgeon who does hernia surgery and all hospitals to take part.”

In its first year, the Registry has captured over 2,200 hernia repairs from more than 230 surgeons across more than 60 hospitals, alongside patient-reported outcomes. Early data shows high patient satisfaction and good quality of life after surgery. 

Key outcomes

The report revealed that groin hernias accounted for the majority of activity (1,494 procedures; 66%), followed by ventral hernias (677; 29.9%), parastomal hernias (42; 1.9%), divarication of the recti (40; 1.8%), and mesh explantation (9; 0.4%).

Across all hernia types, open repair remained the predominant approach (59.9%), with laparoscopic surgery accounting for 27.7% and robotic surgery for 10.2% of procedures. The adoption of robotic techniques was notably higher in ventral hernia repair, and in divarication of the recti (37.5% robotic), reflecting the growing role of robotic-assisted surgery in complex abdominal wall reconstruction. While primary repairs accounted for 89.8% of the total workload, the proportion of cases undertaken for recurrent hernias varied significantly by type, ranging from 7% in groin hernias to 45% in parastomal hernias.

PROMs

PROMs data represent one of the most significant features of the Registry, providing independent patient-generated evidence of surgical outcomes. Across all hernia types, the majority of patients reported high quality of life (QoL) scores at three months post-operatively. For the full cohort, 38.4% reported excellent QoL and a further 34.7% reported very good QoL at three months; at twelve months, only 1.9% reported poor QoL, with the remainder reporting fair or above.

Patient satisfaction with the surgical pathway was consistently high. For all hernia types combined, 91.3% of patients were very satisfied with the surgical team’s preoperative preparation, 85.7% with how their specific concerns were addressed, and 76.1% with the structured follow-up process. Post-operative pain scores were generally low, with only 6.2% of patients reporting pain scores of five or more on a ten-point scale at three months.

The Registry also intends to publish a public-facing outcomes summary to support patient information and shared decision-making, once the longer-term PROMs are collated.

More than 100,000 hernia operations take place across the UK every year, but until now, there has been no national system to measure how patients get on after treatment.  The development of the BHS Registry follows increasing calls for greater transparency and monitoring of surgical outcomes, particularly in response to concerns raised around the use of mesh in surgery, including those highlighted in the Cumberlege First Do No Harm report. The Registry has been designed to provide robust, prospective data to support safer practice and improve patient confidence.

The BHS is urging all surgeons and healthcare organisations performing hernia surgery to contribute and help build a comprehensive national dataset. 

To read the Inaugural Annual Report, please click here

About Dendrite

Dendrite Clinical Systems is a UK-headquartered international company with over a 30-year track record as a specialist provider of secure clinical registries, analysis software and consultancy services for the international healthcare sector, specifically for clinical research, multi-centre real-world studies, observational registries, international, national and hospital clinical databases.

Dendrite has been recognised as a leading provider of clinical registries across various specialties with a unique track record of implementing over 200 major clinical registry systems globally including systems for major research projects for medical device companies, CROs and pharmaceutical companies.