American Hernia Society Meeting 2023

[Good intentions]

Dr. Towfigh just posted about live-tweeting (X’ing?) from the AHS 2023 meeting. I got on to their web site to see the agenda. Here are some links, below.

Check out the Industry Prospectus. You have to click on the green emblem. $250,000 for a corporation to get Diamond status, 1000 for Ruby, 50 for Sapphire. Look at all of the things you get for the money. Wow. A couple of Partner payments probably dwarfs attendance fees from the members. That’s a lot of corporate money.

https://web.cvent.com/event/3eaf141d-2378-4ee0-a457-0faa97167500/websitePage:df84b90b-d756-4b29-93b7-7538c3d3afa7

https://web.cvent.com/event/3eaf141d-2378-4ee0-a457-0faa97167500/websitePage:5c40e350-735a-4e80-b9f9-ec0695b5a3e7

https://custom.cvent.com/9D6126EEBC1B404DA11E747D5B4411CE/files/4bc2762715bd47cba9b27f0da2f8a635.pdf

[Good intentions]

The final program looks pretty good. Packed with ads, plus the topics look interesting. And it is searchable, unlike the SAGES program documents. At least AHS is transparent and easy to access. The conflicts within seem enormous though. Many of the ads are about mesh. It’s everywhere. Strattice, Tela Bio, Phasix, all within the first ten pages. The full list of “partners” fills a page. Mostly bronze with one silver and one gold.

The Program document is also packed with abstracts. Better download before they make it members only. I haven’t gone though the whole thing, it’s 277 pages.

https://custom.cvent.com/9D6126EEBC1B404DA11E747D5B4411CE/files/955da81f74bd4068b0c320dd2aba1bdb.pdf

[Good intentions]

I browsed through the Program for the meeting and was kind of surprised at how much it looks like the program for past meetings. Many of the old topics are discussed, looking at similar questions like lightweight versus heavyweight mesh.

Here’s a study from a part of the world that hasn’t been discussed much. Japan. It’s a poster, so it is brief, but it might be the precursor to a full paper in the future.

From page 188 in the pdf Program file linked above.

P49. The Frequency And Risk Factors Of Chronic Postoperative Inguinal Pain In Japan: A Prospective, Longitudinal Nationwide Survey
M Narita, T Tasaki, Y Miyaki, H Miyagaki, M Kataoka, T Nitta, T Kimura, R Toshiyama, N Hama, Y Kawaguchi, N Shimada, I Sakamoto, K Takehara, Y Oshima, T Kusumoto
National Hospital Organization

Background: Chronic postoperative inguinal pain (CPIP) is known to be the most debilitating complications after inguinal hernia repair, while very few evidence has been reported in Japan. To determine the frequency and risk factors of CPIP, we perform a prospective, longitudinal multicentre observational cohort study.

…

Methods: Between September 2018 and March 2021, patients aged 20 years or more who planned to undergo elective inguinal hernia repair at 22 community hospitals, not hernia specialized centers, in Japan were enrolled. This study was registered in UMIN-CTR (Registry number; UMIN000033936) prior to enrollment of the first subject.

…

The proportion of patients reporting sense of discomfort was 22.5% at 3M, 21.4% at 6M, 18.0% at 12M, and 15.7% at 24M. The proportion of patients reporting hyperesthesia on the skin around the wound was 6.6% at 3M, 6.5% at 6M, 5.7% at 12M, and 4.9% at 24M. The proportion of patients reporting pain at ejaculation was 2.2% at 3M, 2.6% at 6M, 2.8% at 12M, and 3.3% at 24M. Hernia recurrence was observed in 1.1%, 1.5%, 2.3%, and 2.4% of patients at 3M, 6M, 12M, and 24M, respectively.

Conclusion: This is the first large prospective cohort study aimed to demonstrate the frequency of CPIP in Japan. Although its frequency is decreased over time, it can be problematic even at 2 years after surgery. Caution should be paid in patients with preoperative pain at rest, preoperative habitual intake of analgesics, and history of transabdominal prostatectomy. Laparoscopic surgery and/or technique without mesh fixation may be the option to avoid CPIP.

…”

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