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.

Examining Interpreter Services to Better Characterize Areas for Quality Improvement.

Introduction: Medical providers utilize professional medical interpreters (PMIs) daily. Despite this, the challenges PMIs may experience when translating surgical care has not been well explored. Limited English-language proficiency (LEP) patients depend on PMIs for accurate understanding of their care and the lack of quality control can further disenfranchise an already vulnerable population.

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.

Leadership Experiences and Perceptions of Mid-Career to Senior Clinician-Scientists: A Qualitative Exploration.

Purpose: This study aimed to elucidate the experiences and perceptions of mid-career to senior clinician-scientists in academic medicine regarding pursuing, attaining, or rejecting leadership roles as well as their conceptualization of the influence of leadership in their broader career trajectories.

Method: The authors conducted a qualitative analysis of in-depth, semistructured interviews conducted in 2022 with a diverse sample of clinician-scientists who received new National Institutes of Health K08 or K23 Career Development Awards between 2006 and 2009. A total of 859 of the 915 survey respondents (94%) were eligible to be recruited for the qualitative study.

Implementation science in humanitarian assistance: applying a novel approach for humanitarian care optimization.

Humanitarian assistance is hindered by a lack of strategies to optimize care delivery through research and organized networks. Distinct from global health, humanitarian assistance struggles to address its multifaceted challenges, including duplicative resources, uncoordinated communication, unregulated staff expertise and safety, financial waste, and poor-quality metrics and care delivery. Implementation science provides an exciting and underutilized approach that can be applied to address these challenges, by studying how to effectively design, implement, optimize, and scale evidence-based interventions.

Opportunities and Applications of Educational Technologies in Surgical Education and Assessment.

Objective: Describe the latest technological in surgical education and assessment.Background:Surgical education is challenged by continuously increasing clinical content, greater subspecialization, and public scrutiny of access to high-quality surgical care. Since the last Blue Ribbon Committee on surgical education, novel technologies have been developed, including artificial intelligence and telecommunication.

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).

Mesh overlap for ventral hernia repair in current practice.

Introduction: Sufficient overlap of mesh beyond the borders of a ventral hernia helps prevent hernia recurrence. Guidelines from the European Hernia Society and American Hernia Society recommend ≥ 2 cm overlap for open repair of < 1-cm hernias, ≥ 3-cm overlap for open repair of 1-4-cm hernias, ≥ 5-cm overlap for open repair of > 4-cm hernias, and ≥ 5-cm overlap for all laparoscopic ventral hernia repairs. We evaluated whether current practice reflects this guidance.

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.

Workplace Harassment, Cyber Incivility, and Climate in Academic Medicine.

Importance: The culture of academic medicine may foster mistreatment that disproportionately affects individuals who have been marginalized within a given society (minoritized groups) and compromises workforce vitality. Existing research has been limited by a lack of comprehensive, validated measures, low response rates, and narrow samples as well as comparisons limited to the binary gender categories of male or female assigned at birth (cisgender).

Objective: To evaluate academic medical culture, faculty mental health, and their relationship.

Surgeon behaviors related to engaging patients in smoking cessation at the time of elective surgery.

Background: Despite the abundance of evidence supporting smoking cessation before elective surgery, there is wide variation in surgeon adherence to these best practices.

Methods: This qualitative study used convenience sampling to recruit General Surgery trained surgeons. Surgeons participated in semi-structured interviews based on domains from the Theoretical Domains Framework (TDF).

A qualitative analysis describing attrition from bariatric surgery to identify strategies for improving retention in patients who desire treatment.

Background: Among patients who express interest in bariatric surgery, dropout rates from bariatric surgery programs are reported as high as 60%. There is a lack of understanding how we can better support patients to obtain treatment of this serious chronic disease.

Methods: Semi-structured interviews with individuals who dropped out of bariatric surgery programs from three clinical sites were conducted.