1. At Shouldice Hospital, we set high standards. Our surgeons are fully qualified and licensed to perform surgery by the appropriate Canadian authorities. Then they are required to spend up to 6 months of intensive training in the Shouldice Technique to perfect their skills before they are approved to lead a Shouldice surgical team. Only surgeons practicing at Shouldice Hospital receive this training. The Shouldice technique is very detailed and must be practiced in high volumes to ensure consistently superior results.
2. Most general surgeons will repair 20 to 30 hernias in a year. Shouldice surgeons average over 700 cases a year, which provides the highest level of practice and experience in the world. This is why Shouldice surgeons are the world‘s most experienced leaders in hernia repair
3. Surgeons come from around the globe to observe the Shouldice technique. For two or three days, they can watch as the Shouldice repair is performed by Shouldice specialists. However, this is not training. Although many surgeons perform hernia repairs, we cannot offer a training program for them. As a result, we cannot guarantee the quality of any hernia repair said to be a Shouldice repair when it is performed by doctors outside of our hospital.

No, you do not need a referral or an appointment for a hernia examination at Shouldice. All you have to do is to come to our examination clinic for a hernia examination. Or, if you live more than one hour away from the hospital (60 miles/100 km), simply complete the medical questionnaire and fax, mail or e-mail it to us for review.

First, you must have an examination at our hospital or submit a completed medical questionnaire for review by one of our surgeons. Admission dates are scheduled as conveniently as possible and we will make every effort to accommodate your preferred admission date. Please keep in mind that your admission will depend on the space we have available and on specific medical criteria, such as your general health, your weight and the status of your hernia.

Pain and swelling in the groin can have many different causes. A hernia can sometimes be quite difficult to identify and diagnose. In fact, over 1,000 patients a year come to Shouldice, convinced that they have a hernia when they really have a groin strain. If you think you have a hernia, come to our walk-in clinic for an examination by one of our hernia specialists. They have the experience and expertise to give you a proper diagnosis and may even be able to help you avoid an unnecessary operation.

At Shouldice Hospital, we specialize exclusively in external abdominal wall hernias. We are experts in treating the following types of hernias:

• Indirect and direct inguinal hernias
• Recurrent hernias
• Femoral hernias
• Epigastric hernias (sometimes known as ventral hernias)
• Incisional hernias
• Spigelian hernias
• Umbilical hernias

However, there are several types of hernias that we do not repair. If you have one of the following hernias, contact your doctor for treatment or referral to an appropriate specialist:

Hiatal or hiatus hernia
In this type of hernia, the stomach bulges up into the chest through the hiatus. The hiatus is an opening where the esophagus (food pipe) passes through to connect the throat to the stomach.

Parastomal hernia 
A parastomal hernia occurs when part of the intestine bulges through the abdominal muscles around a stoma. A stoma is an artificial opening in the abdomen, used to transfer waste products, such as feces or urine, to a small pouch outside the body. A stoma may be necessary for people with certain types of medical conditions, such as bowel cancer, Crohn’s disease or kidney disease.

Herniated Disc
The bones in the spine are cushioned by soft, spongy discs. When one of these discs is damaged, some of the soft, inner material may bulge out, causing back pain and irritation. This is known as a herniated or ruptured disc.

Flank or Lumbar Hernia
This type of hernia is fairly rare and usually develops after an operation or injury to the side of the abdominal wall. It usually causes pain in the low back and leg.

Sports Hernia
This condition, known also as Gilmore’s Groin, is not actually a hernia, but more of a severe groin strain and can be treated with therapeutic management. It may not require surgery.

Hernias can, on occasions, be difficult to diagnose. They can be present and then disappear. When this happens, the hernia does not repair itself, rather, the hernia defect, or hernia sac, simply goes back inside your abdomen through the same weakness in the abdominal wall - the weakness however, remains until it is surgically repaired.

Hernias may be identified by Ultrasound, CT scan or MRI (all of which are rarely needed) but the most reliable way is by a physical exam by a surgeon experienced in hernia repair. Diagnostic imaging “may” show that there are protrusions in the abdominal wall, but they cannot always differentiate the size of the actual hernia defect, or, whether the protrusion is a hernia versus a natural fold of the abdominal wall. Shouldice surgeons see hundreds of patients a year where initial diagnosis based on imaging confirmed the existence of a hernia, when in fact no hernia was clinically present. In these cases it may be better to wait and see if an actual hernia presents itself rather committing to unnecessary surgery.

As well, the absence of a hernia on a diagnostic image does not in itself mean there is no hernia, as surgeons at Shouldice encounter cases where imaging was negative for a hernia when, in fact, a hernia was present on examination.

The patient-centred recovery program at Shouldice has been specially designed to promote healing in hernia patients. You should plan to stay at Shouldice the afternoon and evening before, and for three (3) nights after surgery to take part in this program.

During your recovery, our nurses will provide the specialized care you need to avoid any post-surgical complications. Most complications develop in the first 48 hours after surgery and a short hospital stay alleviates any concerns or anxiety for patients and their families. You will also get the rest, nutrition and exercise necessary for healthy healing. More importantly, you‘ll enjoy a confident recovery with a rapid return to normal activities.

You‘ll meet other patients who have been through the operation already and are happy to reassure you and answer your questions. Peer-to-peer mentoring is important because it relieves stress and promotes a positive attitude to recovery. We have found that this unique approach to post-operative treatment is the best way to prepare patients for a quick return to a normal lifestyle.

Your spouse or partner cannot stay at the hospital but we will provide a list of local hotels and bed and breakfasts for you.