This is just a set of general questions, but where do surgeons learn tissue repair techniques for hernias nowadays? Why is it not routinely taught anymore? How can this be changed in medical schools so that tissue repair returns as an option when patient appropriate?
A quick glance at the internet shows obvious strong patient interest in various tissue hernia repairs when performed by experts, you’d think it would be proliferating based on market interest alone.
Tissue repair was taught before the 1990’s. Mesh repair started to be applied in the 1980’s. Once we saw that patients were having less pain with this procedure, had less recurrences, and it could even be done as an outpatient surgery, tissue repair fell out of favor. It was used only in situations where mesh was contraindicated (e.g., strangulation, infection).
The current wave of mesh-related complications and pain was not notable until this century. It’s debatable why we are seeing it.
There is for sure a need for more education and practice with the different tissue repairs. I agree with you. I offer it and a handful of surgeons older than me. The younger generation of surgeons are not adequately trained in it.
I hope you can convince more surgeons and new medical students to learn the technique, it is still clearly applicable in the modern era for a fair number of cases anyway. Maybe you can teach it? Do you still teach med students?
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