Age and Regional Trends in Groin Hernia Surgery in Japan: An Analysis of Laparoscopic Repair, Outpatient Surgery, and Manual Reduction Using National Database Open Data

Ann Gastroenterol Surg. 2026 Mar 17;10(4):1346-1355. doi: 10.1002/ags3.70217. eCollection 2026 Jul.

ABSTRACT

PURPOSE: Groin hernia repair is one of the most common surgical procedures worldwide. In Japan, nationwide studies have described overall surgical volumes and procedural characteristics; however, comprehensive analyses focusing on age- and sex-specific patterns across multiple aspects of groin hernia management remain limited.

METHODS: We analyzed publicly available open data from the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB) for fiscal years 2014-2023. Age- and sex-specific surgery rates and lifetime surgical burden were estimated using population-based rates. Trends in laparoscopic and outpatient surgery were examined by age and sex. Manual reduction was evaluated using population-based rates per 100 000 population and a relative indicator in relation to surgical volume.

RESULTS: Total groin hernia surgery volumes declined during the COVID-19 pandemic and recovered thereafter. Age-specific surgery rates showed characteristic patterns, including a bimodal distribution for inguinal hernia and a progressive age-related increase for femoral hernia. Lifetime surgical burden in males was estimated at approximately 21 per 100 individuals, substantially higher than in females. Laparoscopic and outpatient surgery demonstrated distinct age- and sex-specific patterns. Population-based manual reduction rates were highest in early childhood, were minimal from adolescence through mid-adulthood, and increased again in advanced age.

CONCLUSIONS: Nationwide claims-based data reveal pronounced age- and sex-specific patterns in groin hernia management in Japan. These findings highlight substantial demographic differences in surgical burden, procedural selection, and manual reduction activity, underscoring the value of population-based data for understanding contemporary groin hernia care in an aging society.

PMID:42395125 | PMC:PMC13326824 | DOI:10.1002/ags3.70217