News Feed Discussions European Hernia Society – a bit more transparent

  • Good intentions

    March 2, 2022 at 8:12 pm

    I just came across a really fascinating comment from Dr. Guy Voeller about guidelines. Hard to figure out where he is coming from. He says that most guidelines are too long and too hard to read and nobody pays attention to them. Which kind of fits with his past comments implying that the chronic pain problem was just too big to deal with. He seems to be getting overwhelmed, in general.

    Dr. Voeller is a big name in the hernia repair field. That’s why he is in many of these types of interviews. Hard to believe.

    Excerpt (statements are made and the surgeon responds) –

    “Guidelines for hernia repair are valuable.”

    “Guy Voeller, MD: Disagree I am really tired of all these guidelines. Hernia, lap cholecystectomy, whatever—I hate them. They are too long and tiring to read, and are usually based on flimsy data. Laypeople (i.e., lawyers and hospitals) see them as “standard of care,” which they are not. They are a waste of time for the most part. Practicing surgeons never read them and it has become an ego thing for the many of the people who make up the guidelines. They serve no real purpose and need to be stopped, now! That’s how I really feel. Does that mean some of what is in guidelines is not useful? Not at all. I think some of the points in so-called “guidelines” could be more effectively communicated than what occurs with guidelines as they are presently done. It is like putting something on the OR wall for all to read because it is important for all to read. No one reads that stuff.”

  • Good intentions

    February 7, 2021 at 12:43 pm

    Here is the start of the Guidelines summary. Seems worded to imply that mesh is better and that Shouldice results are unknown, when anyone who follows the field knows that the opposite is true. Disingenuous, but, look at the sponsors.

    Non-mesh repair is an option if mesh is not available or in shared decision
    situations with patients that do not want mesh. The Shouldice is best tissue
    repair although in general practice the recurrence rate is higher than mesh
    repair and risks of pain are comparable. More research is needed into the
    value of non-mesh in cases where risk of recurrence is low (for example
    young men with indirect hernia) and into the results of expert clinics. ….”


    STRONG: The Shouldice technique is recommended in non-mesh inguinal
    hernia repair.

    Mesh is recommended as first choice, either by an open procedure or a
    laparo-endoscopic repair technique. One standard repair technique for all
    groin hernias does not exist…”

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