American Hernia Society Meeting 2022

[Watchful]

It’s unfortunate that there’s no discussion of the Desarda tissue repair. That’s the most significant and innovative development in inguinal hernia tissue repair in recent times, and it has been picked up by a number of surgeons around the world, including the US and Germany.

[MarkT]

Maybe worth noting just to avoid any confusion…there are two recent consensus-themed papers on the Shouldice repair.

This one (Mainprize et al., 2022) is by Shouldice docs, while the one we discussed in the now-deleted Mr. Sea thread (Lorenz et al., 2021) included a dozen docs, two of whom where from Shouldice.

The Shouldice Method: an expert’s consensus
https://pubmed.ncbi.nlm.nih.gov/35939246/

Shouldice standard 2020: review of the current literature and results of an international consensus meeting
https://pubmed.ncbi.nlm.nih.gov/33502639/

[Good intentions]

p.s. if you click on the forward arrowhead beside each title a dropdown menu of the individual presentations will appear. Not obvious. The recent Shouldice Expert Consensus title made the meeting. The majority of the presentations are about mesh. Some talk about the legal situation. But mesh prevails.

The Shouldice Method: an Expert’s Consensus
Cassim Degani, MBBS ,MS,FRCS[C],FACS
Abstract Presenter

Irony. Dr. Felix will be talking about tissue repairs.

Tissue Repairs: The Forgotten Art
Edward Felix, MD
Faculty

The legal issues –

Mesh Lawsuits and How They May Shape Our Practice
Vahagn Nikolian, MD
Faculty

[Good intentions]

Here’s the program, linked below. And a listing of the behind the main scene activities. At a typical meeting like this in other professions, the corporations put together a booth with examples and presentations of their products, with sales people manning the booths to make new contacts, in a large exhibit hall. They also rent out suites in the hotels for happy hours and parties in the evenings.

https://www.americanherniasociety.org/meetings-and-education/annual-meeting/program

It’s worth looking down the list below to see the true extent of corporate influence. Lots of money being spent. Very much like a trade show. Dinners, awards, happy hours. When I was a student attending the trade shows in my profession we would always try to find the best happy hour suite. The biggest corporations typically had the best ones.

https://www.americanherniasociety.org/Documents/Corporate-Support/AHS22-Corporate-Prospectus.pdf

[Watchful]

Indeed, it is disappointing that they feel compelled to make statements like that.

The Desarda technique, though, seems really good based on all the studies that I’ve seen, and also the many patient reports that I read. It definitely has some advantages when compared to Shouldice, including being easier for surgeons to master. Also, it’s a faster surgery, recovery is reported to be quicker, and the cremaster, its associated vessels, and genital nerve are preserved.

I think it’s not discussed at conferences much because almost all the surgeons who practice it or know much about it just happen to be not the type to speak at conferences. This includes Dr. Desarda himself (who is now retired).

It’s surprising that most visible tissue repair experts (including Dr. Bendavid when he was alive) never comment on it with the exception of one or two in Europe. There are some studies, though, including a study from Poland with a 15-year follow-up with great results.

[MarkT]

I would like to see more study and discussion on Desarda too.

I was quite disappointed to read this on the site of Drs. Tomas and Brick: (https://ufirstrejuvenation.com/no-mesh-hernia-and-surgery-center/no-mesh-hernia-surgery-inguinal-umbilical-hernia-surgery-desarda-technique/)

“The Shouldice inguinal hernia repair method has been around for many years and has good results, however they use stainless steel wire. Having stainless steel wire is as bad as having mesh in your groin.”

Really? I would love to see their evidence for that claim.