Use of Biologic and Biosynthetic Mesh for Ventral Hernia Repair in Current Practice.

Importance: Originally developed for use in contaminated fields, there is growing evidence against the use of biologic and biosynthetic mesh in ventral hernia repair. However, its prevalence and patterns of use in current practice are largely unknown.

Objectives: To describe the prevalence of biologic and biosynthetic mesh use in ventral hernia repair and to identify factors associated with its use.

Long-Term Outcomes of Component Separation for Abdominal Wall Hernia Repair.

Importance: Component separation is a reconstructive technique used to facilitate midline closure of large or complex ventral hernias. Despite a contemporary surge in popularity, the incidence and long-term outcomes after component separation remain unknown.

Objective: To evaluate the incidence and long-term outcomes of component separation for abdominal wall hernia repair.

Comparisons of 30-day outcomes after ventral hernia repair by body mass index and surgical approach: a retrospective cohort study.

Introduction: Obesity is a known risk factor for postoperative complication after ventral or incisional hernia repair (VIHR). Whether minimally invasive techniques can mitigate this risk for certain patients remains unknown. This study investigates whether MIS approaches offer advantages in reducing any medical or surgical complication after VIHR across clinically meaningful BMI categories.

Understanding patient experiences to improve care for females groin hernia.

Background: Thousands of females undergo inguinal hernia repair annually, yet females have been excluded from prior clinical trials evaluating inguinal hernia repairs. Research shows females face worse outcomes after hernia repair compared to males, including higher recurrence rates, increased chronic pain, and limited data to guide treatment. Prospective studies focused on optimizing outcomes for females are critically needed.

Long-term patient reported outcomes after robotic, laparoscopic, and open ventral hernia repair.

Introduction: Current evidence demonstrates questionable incremental benefit of robotic abdominal wall (ventral) hernia repair when compared to other approaches. However, data are mainly limited to 30-day outcomes and do not capture long-term patient reported outcomes (PROs) where the robotic may provide distinct advantages.

Methods: We analyzed patients who underwent ventral hernia repair from January 2020-September 30, 2022 in the Michigan Surgical Quality Collaborative Core Optimization Hernia Registry (MSQC-COHR).

Heterogeneity in the surgical approach to recurrent abdominal wall hernias: an opportunity for quality improvement.

Background: Despite being a challenging and morbid clinical problem, operative approaches to recurrent abdominal wall hernia repairs receive little attention. Given this, we performed a retrospective study to evaluate surgical techniques of recurrent abdominal wall hernias requiring reoperation.

Methods: Adult patients from the Michigan Surgical Quality Collaborative Core Optimization Hernia Registry (MSQC-COHR) were included in this study.

Variation in surgical approach and postoperative complication among older adults undergoing ventral hernia repair.

Background: Surgical decision-making for preference-sensitive operations among older adults is understudied. Ventral hernia repair (VHR) is one operation where granular data are limited to guide preoperative decision-making. We aimed to determine risk for VHR in older adults given clinically nuanced data including surgical and hernia characteristics.

Barriers to Participation in a Structured Quality Improvement Initiative to Reduce Avoidable Emergency Department Visits-A Qualitative Study.

Introduction: Barriers to quality improvement (QI) initiatives in multi-institutional hospital settings are understudied. Here we describe a qualitative investigation of factors negatively affecting a QI initiative focused on reducing avoidable emergency department (ED) visits after bariatric surgery across 17 hospitals. Our goal was to explore participant perspectives and identify themes describing why the program was not effectively implemented or why the program may have been ineffective when correctly implemented.

Association of Sex Differences on Weight Loss and Complications Following Bariatric Surgery.

Introduction: Sex as a biologic variable remains largely understudied, even for the most commonly performed operations. The most effective treatment for obesity and obesity-associated comorbidities is bariatric surgery. There are limited data to describe potential differences in outcomes between male and female patients, particularly with regards to weight loss.

Conversion of sleeve gastrectomy to Roux-en-Y gastric bypass: impact on reflux and weight loss.

Background: Sleeve gastrectomy (SG) is the most commonly performed weight loss operation, and its 2 most common complications are postoperative reflux and weight recurrence. There is limited evidence to guide decision-making in treating these conditions.

Objectives: To determine the efficacy of conversion of SG to Roux-en-Y gastric bypass (RYGB) for GERD management and weight loss.

Weight Loss Treatment and Longitudinal Weight Change Among Primary Care Patients With Obesity.

Importance: Among individuals with obesity, 5% or greater weight loss can improve health. Weight management treatments (WMT) include nutrition counseling, very low-calorie meal replacement (MR), antiobesity medications (AOM), and bariatric surgery; however, little is known about how these WMT are associated with weight change among individual patients and populations.

Objective: To characterize weight status and WMT use among primary care patients and assess associations between WMT and weight trajectories.

Variability in surgical approaches to hernias in patients with ascites.

Background: Hernias in patients with ascites are common, however we know very little about the surgical repair of hernias within this population. The study of these repairs has largely remained limited to single center and case studies, lacking a population-based study on the topic.

Study Design: The Michigan Surgical Quality Collaborative and its corresponding Core Optimization Hernia Registry (MSQC-COHR) which captures specific patient, hernia, and operative characteristics at a population level within the state was used to conduct a retrospective review of patients with ascites undergoing ventral or inguinal hernia repair between January 1, 2020 and May 3, 2022.

Outcomes of Emergency Parastomal Hernia Repair in Older Adults: A Retrospective Analysis.

Introduction: Parastomal hernias are common and many are never repaired. Emergency parastomal hernia repair (PHR) is a feared complication following ostomy creation, yet the incidence and long-term outcomes of emergency PHR are unknown.

Materials And Methods: We performed a retrospective analysis of 100% Medicare claims data (2007-2015) to evaluate complications, readmissions, reoperations, hospitalizations, and mortality after emergency PHR.

Use of statewide financial incentives to improve documentation of hernia and mesh characteristics in ventral hernia repair.

Background: Documentation of intraoperative details is critical for understanding and advancing hernia care, but is inconsistent in practice. Therefore, to improve data capture on a statewide level, we implemented a financial incentive targeting documentation of hernia defect size and mesh use.

Methods: The Abdominal Hernia Care Pathway (AHCP), a voluntary pay for performance (P4P) initiative, was introduced in 2021 within the statewide Michigan Surgical Quality Collaborative (MSQC).

Evaluating outcomes among surgeons who changed their technique for gastric bypass: a state-wide analysis from 2011 to 2021.

Introduction: Technical variation exists when performing the gastrojejunostomy during Roux-en-Y gastric bypass (RYGB). However, it is unclear whether changing technique results in improved outcomes or patient harm.

Methods: Surgeons participating in a state-wide bariatric surgery quality collaborative who completed a survey on how they perform a typical RYGB in 2011 and again in 2021 were included in the analysis (n = 31).

Life after "no": barriers to behavior change for persons declined hernia repair due to high-risk features.

Introduction: Delaying an elective operation to mitigate risk factors improves patient outcomes. Elective ventral hernia repair is one such example. To address this issue, we developed a pre-operative optimization clinic to support high-risk patients seeking elective ventral hernia repair.

Comparison of safety and healthcare utilization following sleeve gastrectomy or gastric bypass among medicare beneficiaries using sex as a biologic variable.

Background: Bariatric surgery is a common operation, but differences in outcomes between males and females are unknown.

Objectives: To compare the risk of mortality, complications, reintervention, and healthcare utilization after sleeve gastrectomy or gastric bypass using sex as a biologic variable.

Setting: United States.

The effect of marijuana use on short-term outcomes with bariatric surgery.

Background: Despite increasing marijuana use nationwide, there are limited data on implications of marijuana use on bariatric surgery outcomes.

Objective: We investigated associations between marijuana use and bariatric surgery outcomes.

Setting: Multicenter statewide study utilizing data from the Michigan Bariatric Surgery Collaborative, a payor-funded consortium including over 40 hospitals and 80 surgeons performing bariatric surgery statewide.

Comparative Outcomes of Groin Hernia Repair by Sex Among Medicare Beneficiaries.

Objective: To compare the rates of operative recurrence between male and female patients undergoing groin hernia repair.

Background Data: Groin hernia repair is common but understudied in females. Limited prior work demonstrates worse outcomes among females.