1. Variation in approach for midsize (4-6cm) ventral hernias across a statewide quality improvement collaborative
- Author
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Anne P. Ehlers, Alex K. Hallway, Sean M. O'Neill, Brian T. Fry, Ryan A. Howard, Jenny M. Shao, Michael J. Englesbe, Justin B Dimick, Dana A Telem, and Grace J Kim
- Subjects
Ventral hernia ,Incisional hernia ,Minimally-invasive repair ,Robotic surgery ,Surgery ,RD1-811 - Abstract
Introduction: Repair of midsize (4–6 cm) ventral hernias is challenging given lack of guidelines. Within this context, we sought to characterize surgical approach among patients undergoing repair of midsize ventral hernias within the only population-level, clinically-nuanced hernia registry in the US. Methods: Retrospective cohort study of patients undergoing ventral hernia repair in the Michigan Surgical Quality Collaborative Core Optimization Hernia Registry (MSQCCOHR). MSQCCOHR is the only US population-level registry that captures clinically-nuanced data pertaining to patient hernia characteristics. We included patients who underwent repair of a 4–6 cm hernia from January 1, 2020-June 30, 2022. We stratified repair type as open or minimally invasive and used a multivariable logistic regression model to identify factors associated with MIS approach. Secondary outcomes included complications rate. Results: Among 771 patients, mean hernia width (SD) was 4.7 cm (0.8) and 339 (44 %) underwent MIS approach. Patients with MIS approach had lower BMI (33.5 vs 34.8, p = 0.02) and less often were ASA class III (47.5% vs 54.6 %, p = 0.02) or ASA class IV (2.4% vs 4.2 %, p = 0.02). MIS approach was associated with smaller mean hernia width (4.71 cm vs 4.84 cm, p = 0.02) and was used more often in the elective setting (94.4% vs 84.0 %, p more...
- Published
- 2024
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