News Feed Discussions Clinical Data on Small Abdominal Wall Hernias Clinical Data on Small Abdominal Wall Hernias

  • drtowfigh

    March 6, 2014 at 2:51 am

    Clinical Data on Small Abdominal Wall Hernias

    First, let me assure you that almost all databases that I am aware of and publications that I have seen and those that I also perform include patient demographics, e.g., gender, height/weight. The height/weight are often reported as body mass index (kg/m2). That is pretty standard.

    That said, you are correct: there is no formula where you can plug in your own info and it will spit out the risks and benefits tailored to your needs. Medicine is not a perfect science by any means. You may find me the same exact findings in a different patient and perform the same exact operation and the outcome may be different. Every patient is truly different. Now, statistically, the risk/benefit may be the same, but the outcome per patient will be different.

    Dr. Bruce Ramshaw is a whiz in this concept of “complex systems” and has been able to show that implanting the same mesh in two different people, for example, can have drastically different outcomes at the mesh and cellular level.

    Hopefully, one day, we can tailor each patient’s care to their own specific needs and body’s interactions, maybe even by genetic evaluation. Today, we cannot do that. Most of us who are interested in this topic, however, do have our own database and do publish. Also, if you go to the website, they have a database that many surgeons also participate in, called the AHSQC. You can find out which surgeons near you participate. Lastly, there are other national databased with the American College of Surgeons, NSQIP, etc., that some surgeons participate in.

    With regard to your 4mm hernia: if you are symptomatic, then I recommend repair. I also do not recommend mesh implantation for such a small hernia.