Good intentions
Forum Replies Created
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Maybe the “Patients” link is a place for patients that IHC member doctors have referred to the site to sign up and introduce themselves. So that the IHC member doctors can discuss their case.
If I understand what I’ve been reading the site is like an extension of the private Facebook group. A place where surgeons can have formal and informal discussions about various topics.
Maybe Chuck would be one of the patients who fits the purpose of the IHC?
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Thank you for the reply Dr. Towfigh. The web page has a very clearly labeled heading called “Patients” which opens up a form to fill out, that also has a clearly labeled category of “A patient” to choose.
The web page was copyrighted in 2022 so it’s new. Maybe it’s just a poor or misguided job on the web site. Very odd that that would be there if there was no intent to include patients.
Overall, the Herniagroup effort looks a lot like the Herniasurge effort. Herniasurge’s web site and Facebook page used to be open to the public but they closed it up soon after they published the 2018 Guidelines.
Oh well. I was a little bit excited when I thought I had found a new effort to clarify the hernia mesh situation. It looks like it’s more for the surgeons’ health than the patients though. Important, of course, but it’s disturbing that things are that bad, that the surgeons working in the field need their own special well-being efforts. Not really a good sign for the future, for anyone involved.
Good luck with it.
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“Industry has always helped support surgical education and though this funding is dwindling and limited due to the Sunshine Act, most meetings remain very much dependent on industry funding.”
It looks like people are hiding things Dr. Towfigh. “Going to ground” as they say. Supported by the corporations that are under the spotlight. why would the Sunshine Act be a bad thing? The IHC goals talk about “transparency” but then hide everything about the IHC. Makes no sense. It looks like a secret club.
You should take a moment and go to the web site and click through the headings like a person who does not what the IHC is or supposedly does, but wants to learn. The stated goals and the reality are ironic. There is no “immediate feedback” the way it is set up now. Each click brings up a barrier, except the one about what looks like a good time in Costa Rica.
No offense intended, but that is what it looks like from out here.
“Welcome to the IHC
JUNE 28, 2015Value. Redefined.
The IHC is an international platform for all surgeons, healthcare providers, and industry friends interested in the repair of hernia and optimizing outcomes to come together to collaborate, share, discuss, post photos, post videos, and simply post anything related to the disease of hernia. By embracing social media as a collaborative forum, we can more effectively and transparently obtain immediate global feedback that in turn has potential to improve both patient outcomes as well as the quality of care we provide.”https://www.healthaffairs.org/do/10.1377/hpb20141002.272302/full/
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Hello Alephy. It is a confusing area to talk about, I think. The word “absorbable” is a vague word that means different things to different surgeons. It seems to be used interchangeably with resorbable. The nomenclature used in the hernia repair field is a big problem in understanding what people are saying. I linked an article describing the problem in a different area of the field, below.
I think that the same problem exists in describing these absorbable, resorbable, and synthetic materials. Even worse, “synthesis” is used to make all of them. “Synthetic” is another vague word.
Here is some literature that uses a variety of words. “Incorporate” is also there, used in the past to describe synthetic (petroleum-based, plastic) meshes.
https://www.bd.com/assets/documents/pdh/initial/Phasix-Brochure-with-LX.pdf
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Dr. Towfigh was an Associate Professor at Cedars-Sinai Medical Center and is now CEO of a consulting company she started in 2014.
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Dr. Novitsky is a Professor at Columbia University Medical Center.
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Three renowned experts have differing opinions. Which will you decide to believe?
Good luck Jack. The hernia repair field is very chaotic with differing opinions across the board, on numerous aspects. I’m not sure how a person would decide who to believe.
Dr. Chen is an Associate Professor at UCLA Health.
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It sounds like he is questioning the validity of the data used to create guidelines. Others have done the same.
https://herniatalk.com/forums/topic/new-article-questioning-the-validity-of-the-hernia-guidelines/
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Was Dr. Chen talking about open repair or laparoscopic? He does both now, apparently.
I think that the type of repair plays a part in whether or not to fixate, and what type of fixation.
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I think that you meant “pure” tissue repairs, which really just means suture only repair. Another name for no-mesh repair.
Here is something that caught my eye in one of his publications, excerpted below. It will be interesting to see how deep he goes as his career progresses, in discerning what is real and what is not, in the various talking points about the superiority of mesh repairs. The Guidelines use the old studies as the basis for the claim that mesh is the obvious “first choice” over pure tissue repairs.
“Evidence itself is going through its own development. Many papers published in years past would not be accepted for publication today, because of their methodology failings, bias, lack of patient follow-up and the definitions of any complications reported not given. Indeed, one of the most cited papers relating to hernia surgery[13] would have unlikely been published in its current form today. Yet, the Lichtenstein inguinal hernia repair is now in use worldwide and sometimes referred to as the “gold standard.” Many guidelines based the strength of their recommendations on the so-called hierarchy of clinical evidence, from systematic review of randomized controlled trials at the top to expert opinion at the bottom. However, this approach has been questioned and in many cases superseded by other ways of assessing medical knowledge which will be discussed further below.”
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Current trends in hernia surgery in NHS England
M Pawlak, B Tulloh, A de Beauxhttps://publishing.rcseng.ac.uk/doi/full/10.1308/rcsann.2019.0118
Guidelines in hernia surgery – friend or foe
M Pawlak1, B East2, H Gok3, AC de Beaux1
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Hello Alephy. “3D” generally refers to mesh that has a curvature pre-formed in to it. I posted a link below as an example. It is supposed to “automatically” take the desired shape of the space it is meant to cover, supposedly giving better results. But like many new products, it is really just a guess.
A plug product would be “3D” in shape but would not be considered as “3D”.
https://www.bd.com/en-us/products-and-solutions/products/product-families/3dmax-mesh
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Do you know the type of repair and the material that was used? There is a wide variety. If you don’t know you can get the records from your surgeon and/or the medical center where you had the procedure done.
Some materials have an absorbable component that might be affecting your progress. One possibility. But there really are multiple combinations of “open mesh” repair techniques. You need to know the details to make an educated guess.
Good luck.
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Still fascinating how closely tied they are to mesh providers. In the old days, these types of meeting might have significant government funding, from NIST or NIH or NSF or even DoD. Industry seems to be leading the way today. The medical-industrial complex.
This older article is a bit disturbing. Where is the feedback to the regulatory agencies? The ones that keep us safe. The presentation is from 2014. About the time I had my mesh implantation. I hope that things have progressed since then.
Excerpt (“market feedback to industry partners” catches the eye) –
“Whether providing education to students and residents, market feedback to industry partners, tips and tricks to colleagues, referral or technical advice, or even second and third opinions, this group, and other groups like it, are revolutionizing the way the medical community collaborates.”
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Here is a sample of their social media presence. Their web page is very very private, nothing for the public to learn from. The only heading that leads anywhere is the one about the Costa Rica meeting.
Click the “Continue Reading” at the bottom of the page. Apparently it is a private group.
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Here’s the agenda. It looks interesting, covers a range of topics.
https://www.herniagroup.com/wp-content/uploads/2022/02/IHC-2022-Costa-Rica-Agenda-Feb2022.pdf
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The meeting notice. Scroll down to see the sponsors.
https://www.herniagroup.com/ihc-costa-rica-2022/
How to contribute. Nobody went Platinum but Medtronic went for Gold, see above.