Royal Australasian College of Surgeons

Recommendations from the Royal Australasian College of Surgeons on hernias, blood transfusion, reflux in gastric band patients & appendicitis. RACS is the leading advocate for surgical standards, professionalism and surgical education in Australia and New Zealand. The College is a not-for-profit organisation that represents more than 7000 surgeons and 1300 surgical trainees and International Medical Graduates.

Do not use ultrasound for the further investigation of clinically apparent groin hernias. Ultrasound should not be used as a justification for repair of hernias that are not clinically apparent.

Date reviewed: 1 March 2016

The role of ultrasound in the diagnosis and treatment of groin hernias is limited. When the clinical diagnosis of a groin hernia is uncertain, any sonographic findings should be interpreted in conjunction with clinical judgment and treated conservatively. The diagnostic accuracy of ultrasound is reduced in the absence of any clinically palpable hernia.

Supporting evidence
  • O’Rourke MGE, O’Rourke TR. Inguinal hernia: Aetiology, diagnosis, post-repair pain and compensation. ANZ Journal of Surgery 2012;82(4):201–6.
  • Robinson A, Light D, Nice C. Meta-analysis of sonography in the diagnosis of inguinal hernias. Journal of Ultrasound in Medicine 2013;32(2):339-46.
How this list was made How this list was made

RACS collaborated with General Surgeons Australia (GSA) and the Australian Society of Otolaryngology Head and Neck Surgery (ASOHNS) respectively on the development of lists for Choosing Wisely Australia. Each organisation worked closely with key members including the Sustainability in Healthcare Committee and Professional Development and Standards Board (RACS), and the Boards of Directors (GSA and ASOHNS) to develop the lists of tests/treatments/procedures for general surgery, and head and neck surgery.

Download RACS Recommendations