Abdominal Wall Surgery (AWS) is a “transferable competency” which requires the acquisition of “knowledge” in basic clinical sciences and operative skills as well as specialised “knowledge and skills” in the prevention and treatment of all types of hernias and abdominal wall defects.
The “transferable competency” AWS covers acute, traumatic and non-acute diseases and injuries, and acute and elective procedures in patients of all ages.
The “transferable competency” AWS provides the “knowledge and skills” for the non-operative and operative management of all types of hernias and abdominal wall defects, i.e., diagnosis, evaluation, decision making, treatment, intensive care, rehabilitation of patients with pathological processes and acute and chronic pain treatment, as well as prevention of any abdominal wall defect when performing any surgical procedure.,
It also involves the necessary knowledge and expertise leading to referral to specialised centres when this is indicated and possible, and where this is not possible because of time or geographical considerations, to possess the multi-specialty skills to carry out these interventions safely.
Abdominal Wall Surgery cooperates with other surgical and medical specialties, e.g. anaesthesia and intensive care medicine, emergency surgery, gastroenterology, general surgery, plastic surgery, internal medicine, radiology, neurology, endocrinology, paediatrics, urology and others in the management of patients.
The focus is on diagnosis, treatment and postoperative management, which comprises all non-instrumental and instrumental techniques including radiology, sonography, computer tomography and magnetic resonance imaging.
The abdominal wall surgeon must be capable of employing laparo-endoscopic and open techniques for therapeutic purposes and must have the opportunity to gain knowledge and experience in evolving technological methods.
The abdominal wall surgeon must be also capable of interpreting all types of surgery-related radiological examinations.
The AWS activity covers the pre-, peri- and postoperative period including the principles of enhanced recovery and follow-up of patients. The specialty also includes individual and general preventive activities, rehabilitation, and management of pain.
Abdominal wall surgery is often performed in specialised centres, especially in complex cases. When transferal is not possible because of time or geographical considerations, the abdominal wall surgeon should possess the multi-specialty knowledge and skills to carry out these interventions safely.
Additionally, abdominal wall surgeons are expected to have a knowledge of anatomy, physiology and biochemistry which enable them to understand the effects of common surgical disease and injuries upon the normal structure and function of the various systems of the body.
They are expected to have a knowledge of cell biology which enable them to understand normal and disordered function of tissues and organs.
They should have an understanding of the pathogenesis of the common correctable congenital abnormalities.
They are expected to know the actions and toxic effects of drugs commonly used in perioperative and intraoperative care and in the management of critically ill surgical patients.
They must also have an understanding of general pathology including the principles of immunology and microbiology in relation to surgical practice.
The abdominal wall surgeon should have certified knowledge in basic technology of the used laparo-endoscopic instruments, especially insufflation devices, monitors, cameras and light sources, ultrasound- and other energy-driven instruments and stapling and fixation devices.
The abdominal wall surgeon must be trained in the economics of health care, in the assessment of research methods and scientific publications and be given the option of research in a clinical and relevant field of further training in another related specialty.
Foundation Chairman, Working Group of AWS
President of the European Board of Surgery