The European Hernia Society’s relationship with major medical device makers

[Good intentions]

Why would everything in the Library of the EHS be for members only?

https://europeanherniasociety.eu/category/video/

Here is what they provide for patients that happen to find the site. Embarrassing to watch. (Beside the word patient being misspelled.)

https://europeanherniasociety.eu/pateint-area/#elementor-action%3Aaction%3Dpopup%3Aopen%26settings%3DeyJpZCI6IjMwMjIiLCJ0b2dnbGUiOmZhbHNlfQ%3D%3D

The EHS also has no Mission Statement. What is its purpose? The more you look the more it looks like a front for the medical device companies.

https://europeanherniasociety.eu/sponsors/

[Good intentions]

An interesting Editorial in Hernia from Dr. Campanelli. I don’t think that he understands that the people that control the narrative, by controlling the money, end up controlling the consensus. It starts with education. The societies funded by the corporations run the schools that he appears to be talking about.

He should write an Editorial suggesting full transparency about where, exactly, professional societies get their funding, in order to allow people to trust the various societies’ motives. Many nonprofits have their accounting information available on their web sites. Free for all to see. There is nothing on, for example, the EHS web site except the Sponsors page, full of logos of the device makers. It is very hard to imagine that there is no connection. Mesh is the EHS logo.

https://link.springer.com/article/10.1007/s10029-023-02788-x

EDITOR’S CORNER
Published: 15 April 2023
Evidence, consensus and schools of hernia surgery
G. Campanelli
Hernia (2023)

“…
And consensus gathering becomes even more commendable when it is supported by the schools of hernia repair and abdominal wall surgery that are run by the relevant national scientific societies. …”

[Good intentions]

And it is linked directly to the International Hernia Symposium, but not directly on the main page. Very similar to “dark money” in politics. Click, click, click… how did I end up on a mesh supplier’s web page?

The surface changes but underneath things are the same.

[drtowfigh]

Hernia U is completely funded by BD/Bard-Davol.

[Good intentions]

Here is a symposium, a virtual meeting, supposedly supported by “societies” (bottom of the main page). But if you click the Surgical Education link under Courses you might get a different impression. They are hidden but still present. How can they be directly linked to the symposium through the main web page?

“Mastering the art of Hernia Surgery”

https://www.herniau.com/events/virtual-ihs-2023/

https://www.bd.com/en-us/resource-and-education/surgical-education

[pinto]

Hey @G is your sudden appearance from Providence or what? You must be an MBA by your use of “business models.” I’m in need of some financial advice, so could you give us a tutorial on business models and medical devices? Particularly which device do you think projects as the most profitable and the business model that would most foster its growth? I’ve got a few $Ks yet earmarked, so your appearance is a knick in time. Maybe your tutorial could go on a separate thread. Also any stockbroker recommendations would be welcome.

• This reply was modified 1 year, 9 months ago by  pinto.

[G]

Good Intentions, business models are an interesting topic for me. So far the mesh, tobacco and breakfast cereal industries have been touched upon. I’d like to add another one that I find fascinating. The light bulb industry, notably the Phoebus Cartel. Apparently in the early 1900s a world wide group of light bulb manufacturers got together to limit the amount of time light bulbs would last. Interestingly there is still a light bulb that is in operation at a bay area fire department that was made before the light bulb cartel was established. It was produced about one hundred years ago. Planned obsolescence. the next “new” and “improved” thing, etc. seems to have been useful in increasing profits for a very long time. It’s just a part of doing business. I’ll try to add a link.
https://en.wikipedia.org/wiki/Phoebus_cartel

[pinto]

Thank you for mention of your original repair as I didn’t know some of those details. I commiserate with all what you had to go through. I understand now how you made your choice– how easy it would be for anyone to do so. Thank you again but I was referring to your most recent surgery by Dr. Belyansky, who by my google search found that he also does mesh implantation. As you have yet disavowed your claim that mesh surgery is an “industry” on par with the tobacco industry, I have to ask then how come Dr. Belyansky gets a free pass apparently. Or do you oppose his use as well?
(As far as myself, I am an IH patient myself having written first-person reviews here of surgeries and am merely challenging your tobacco metaphor claim. You should disavow it as inappropriate, for it is a disservice for patients.)

• This reply was modified 1 year, 10 months ago by  pinto.

[Good intentions]

You’re not really saying anything Pinto. Avoiding the questions I asked, and projecting them back at me.

I was planning to get a tissue repair, at either Shouldice or Dr. Brown’s place, but I believed a good friend of mine who was a surgeon, who believed what he was being told about mesh repairs by the Chair of Surgery at his clinic. Eventually I had the mesh removed, and my friend quit the clinic, a place he had been proud to be a part of, and erased any mention of it from his employment history. Not a word, just a big gap in time. He seems to be doing well at his new place of employment. But I have not talked to him since.

You and I are on the forum for very different reasons Pinto. You seem to be here for your own amusement.

[pinto]

Ah, @Good intentions you broke your own maxim: “There’s not much value in writing more words.” Breaking such is sure to happen when people run out of substantive thought. Your tobacco metaphor is misdirected and so may mislead patients about their options. How is it though that you relied on a mesh surgeon for removal to save you? Is his implantation of mesh ok but not by others? What’s the difference?

[Good intentions]

Nothing useful will come of belaboring the point, trying to “win” the argument. It’s a matter of opinion, and apparently, the use of language in a philosophical discussion, which is always the case in a discussion of philosophy. A person either believes that corporations can influence health care professionals for their own profit over the safety of the patients, or they don’t. And they can have different opinions on whether or not that is evil.

Pinto, feel free to start a new Topic defending the influence of the corporations in the field of hernia repair. Why did you decide not to use their mesh products? Why did you choose a tissue repair over a mesh repair? If you believe the marketing campaigns, mesh is “safe” and lowers your probability of recurrence dramatically. You chose a side and now you’re arguing against your own decision. Are you saying that the corporations are ignorant about their own products, and the surgeons that use them also. Can ignorance lead to evil results?

Explain your decision to ignore the mesh hernia repair device marketing, and your opinion will have much more weight. You can’t play both sides.

[pinto]

None whatsoever in terms of the previous discussion. One or more rogue doctors peddling drugs illegally are not “the medical profession”; nor does the matter have anything to do with hernia surgery. “Parallels” can be found between any entities in existence given enough imagination. But let’s have some fun, @Herniated: Demonstrate the “many parallels” between medical mesh and tobacco, making mesh surgery for inguinal hernias unethical. I look forward to the edification.

[Herniated]

Purdue Pharma (Oxycontin, etc.) provides a useful case study for the ethical quagmire that arises when the medical profession interfaces with marketing (Wikipedia has an overview). There are indeed many parallels with the big tobacco story.

[pinto]

@Good intentions, I agree some people have been put into a suffering hell via their mesh implants. Further I am displeased hearing how some surgeons give them a run around, a circumstance acknowledged by surgeons in a recent article discussed here. .

But isn’t it true that the surgeon you highly recommend and who did your own removal surgery also implants mesh as well? How do you rectify it? You cannot say that the whole of medical mesh is an “industry” in the sense that it is based solely on financial gain without concern for patient well-being. Even churches, the most respected religions, ultimately must acquire revenues if they are to survive, to exist.

You speak as though advertising, promotion is solely an activity by tobacco producers. Nor are they the only ones who use powerfully persuasive messages a la Camel. Many a successful product owes much to such advertising including those with solely philanthropic or humanitarian purposes.

[Good intentions]

You raise some good points pinto.

But when you consider the living hell that many people with chronic pain have experienced from mesh implants, and translate that living hell to a young child, an adolescent or teenager or even young adults, I don’t think that Satanic inferences are far off. Remember that Satan is often thought of as the cause for people to do bad things. The person is not inherently bad. They are being manipulated or tempted in to doing bad things.

Aside from the philosophical discussion, the comparison between Dr. Ponsky’s video and the Master’s presenter’s video is pretty stark. But, even Dr. Ponsky stops short of describing what the effects of early mesh implantation might be. People are really afraid to criticize mesh at these corporation-sponsored conferences.

[pinto]

The tobacco metaphor is an unfortunate choice because it is quite ill-fitting the mesh situation but also because tobacco is so steeped in emotional machinations and premature deaths of millions. While mesh use has had millions of successful health outcomes, has there ever been one case of physical health enhancement by tobacco smoke inhalation? I understand you strongly oppose medical mesh but I am sure you will agree that there are certain cases that absolutely have no other choice but mesh. I do not believe that the originators of medical mesh had any other motivation than to effect optimal hernia surgery. I further believe that many mesh surgeons sincerely think they are doing the best medically that they can.

In rebuttal you state: “Profits before health,” as to mean that mesh producers are equivalent with tobacco producers in regard to the safeguarding of health. That’s extremely hyperbolic. Doing so does much disservice for patients considering mesh as well as disrespecting medicine in general. It’s one thing to critique but another when it turns to character assassination. I am not saying that mesh and its adherents are beyond reproach. Of course I agree there are issues that merit serious consideration, but steeping it in hyperbolic imagery of Satanic mesh producers and surgeons having not an iota concern for patient health and welfare hardly can further our understanding of matters of surgery. I just hope we can be dispassionate when considering these topics. 🙂

• This reply was modified 1 year, 10 months ago by  pinto.

[Good intentions]

Here is Dr. Ponsky’s views on mesh in children.

https://youtu.be/VHX62HfVopA

[Good intentions]

Profits before health. Joe Camel. You are correct in that it is not a good direct comparison once you get beyond the motivation. My point was that both big industries really have little concern for the long-term damage that they might be causing. If they can sell product legally they will do it even if they know that they are harming people.

https://www.lung.org/research/sotc/by-the-numbers/10-bad-things-to-entice-kids

You can see in this video that even though they are dealing with children (I consider 12 years old a child) they are still only focused on recurrence. No discussion at all about the long-term effects on the child’s body development. In other fields, like joint injuries, it is well-known, for example, that the growth plate should not be disturbed or it will cause the bone growth to have problems. Always focused on the perfect one-time repair.

This video was accepted by SAGES as representative of “state-of-the-art”. It is the Masters Hernia section of their conference. They are promoting mesh repairs for children. I will post another video from Dr. Ponsky giving his views on mesh repair in children.

The more you explore the more you see mesh being promoted for everything possible. I can’t imagine being a teenager and experiencing what I experienced when I had the mesh implants as a full grown worldly adult. I am sure that I would have ended up dead, by one means or another.

https://youtu.be/Ee95riAuQcI

[pinto]

@Good intentions, please explain how mesh producers are “Very similar to the tobacco companies.” Tobacco companies got medical doctors to endorse cigarette smoking and other uses? Medical societies took monies in support from tobacco companies? Tobacco companies targeted not only adults but young children in their promotion of tobacco? Maybe breakfast cereal producers would have been more apt an analogy than that of tobacco?

[drtowfigh]

Very good find.

The EU doesn’t have as strict a policy as the US on how industry can interact with doctors. Also the EHS has no significant budget or income to support a staff or its publications of guidelines, etc. I think their only income may be from royalties from the journal publisher. So, they are even more reliant than US societies on industry support. And of course. Industry gobbles that up.