Archive March 2019 XX, No. 3

Mesh-y Situation

Controversy in hernia repair puts you and your surgeons at the front lines of patient education.

Matthew Nojiri

BIO

INFORMATION OVERLOAD
INFORMATION OVERLOAD Patients need help sorting through all the information that's available online about surgical mesh in hernia repair.

Why are more patients asking their surgeons not to use mesh in their hernia repair? That’s how Sharon L. Bachman, MD, FACS, opened her presentation at the 16th World Congress of Endoscopic Surgery. Dr. Bachman, of Inova Medical Group in Falls Church, Va., and other hernia specialists addressed a growing topic of interest among surgeons and patients alike: no-mesh hernia repair. Here’s a recap.

“It’s not as simple as mesh repair versus non-mesh repair. I think it’s way more complex than that,” says Mohammed Al-Mahroos, MD, FRCSC, a minimally invasive and advanced gastrointestinal surgeon at McGill University in Montreal, Canada.

For patients, there’s a trove of online information about mesh repair — and some of it can be pretty scary. A simple Google search yields millions of results related to possible complications. Hernia mesh lawyers hawk litigation related to previously recalled products, with warnings of post-op pain, infections, recurrence, adhesion, bowel obstruction and perforation. So how does this affect care in 2019? The information patients click through may not always come from scientific sources, and it can be overwhelming for patients to comb through it all, says Dr. Bachman.

“How do you sort through that? How do you decide what’s real and what’s not?” says Dr. Bachman, who has an active research interest in prosthetic materials used in hernia repair.

The U.S. Food and Drug Administration estimates that more than 1 million hernia repairs are performed annually in the United States. With time, mesh has become the commonplace option for many surgeons, who cite reduced recurrence rates and the hope of better recovery times. By 2000, non-mesh repairs accounted for less than 10% of groin hernia repair techniques, according to the FDA.

Here are 3 strategies for surgeons and surgical facility leaders to consider when it comes to educating patients about mesh.

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