Reply To: Need Referral for Non-Mesh Surgeon in Orange County, CA Surgeon
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Here is a new article from General Surgery News about incisional hernias. You are right to be concerned about finding the right surgeon for an incisional hernia. Just like in inguinal hernia repair you will find a range of views on how to repair an incisional hernia. From using mesh prophylactically, to avoiding the use of mesh if possible. Surgeons generally hate recurrences so they will do everything that they can to avoid that happening. Even if it causes constant discomfort for the patient.
A good person to talk to might be Dr. Peter Billing of Transform Weight Loss in Kirkland WA. He uses mesh for hernia repairs but he also removes mesh that is causing chronic pain. So he has a broad understanding of the issues and will focus on avoiding future pain for his patients.
Be very careful in choosing a surgeon. You can end up on the treadmill of repeat surgeries. Good luck.
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:CHARLOTTE, N.C.—Following laparotomy, incisional hernias occur in 5% to 20% of all patients and in up to 30% of high-risk individuals, and their impact on those who acquire them range from nuisance to catastrophic. Numerous factors drive the occurrence of incisional hernias, but surgeons and institutions can follow measures to reduce their numbers.
At the 2022 meeting of the American Hernia Society, experts discussed optimal techniques for abdominal wall closure, explored the possibility of dedicated closing teams and took a deep dive into the financial implications of incisional hernias and their prevention.
So, why is it that only 35% of surgeons follow these guidelines, or that most only follow them to a degree? According to a survey of surgeons on their approach to abdominal wall closure, 72% use small bites and 79% use a 4:1 suture-to-wound length ratio. But it would seem most who adhere to the ideal ratio are eyeballing it, because only 16% indicated they measure the suture and wound lengths (Hernia 2019;23:329-334).
A review of claims data examining the impact of incisional hernias on total healthcare costs found an incidence rate of 9%, adding a cost of $21,000 to $29,000 per patient. The investigators also established that incisional hernias that occur within one year of the initial surgery tend to be more severe, associated with more complications and can double the cost (Surg Endosc 2018;32:2381-2386).
“They make an important point about the costs we are not able to measure, such as loss of productivity and loss of earnings, which are not included in any of these estimates,” Dr. O’Neill said. … ”