Preperitoneal Hernia Repair: Robotic v Open Study Shows Open Repair Delivers on Value Based Care
Wednesday, May 29, 2024
Boston Hernia - Wellesley, MA
Newly published review of outcomes after open preperitoneal v robotic inguinal hernia repair is further evidence of value in providing the open technique - offering the highest quality care with lower cost to the healthcare system
Open preperitoneal and robotic surgery are two approaches to repairing inguinal hernias. Both aim to place mesh in the same location, but the methods differ significantly. Robotic surgery requires three incisions higher up on the belly, general anesthesia, and inflating the abdomen with gas. Surgeons go into the abdominal cavity to get to the groin where they work back out through a layer of the abdominal wall to get to the location of the hernia. Conversely, the open preperitoneal approach utilizes just one groin incision, local anesthesia with sedation, and directly reaches the repair space without entering the abdomen.
In a recent paper by V. Rodrigues-Goncalves, in which Boston Hernia’s work was cited, the effectiveness of these two approaches and the associated risk of complications were evaluated. This study suggests that open and robotic preperitoneal inguinal hernia repairs performed by experienced surgeons achieve similar long-term outcomes with respect to risk of complications like chronic pain and recurrence. Open repairs also offered advantages of shorter surgery and less anesthesia. These are factors that improve the experience of all patients undergoing inguinal hernia repair and are also of particular benefit to those with more medical conditions.
They conclude that the best approach may depend on the patient's health, surgeon's experience, and healthcare resources. In this time when healthcare costs are soaring and outpacing society’s ability to afford this care, providers have to consider the costs of the care they provide and ensure the high quality of that care.
The open preperitoneal approach to inguinal hernia repair takes less time, costs less in equipment and supplies, and requires fewer resources to care for these patients all the while providing the highest quality of care without increase in associated risks.
This study supports the emergence of the open preperitoneal approach as a minimally invasive, faster, and more cost-effective solution for inguinal hernia repair, especially when performed by experienced surgeons. This method provides excellent patient outcomes while being mindful of the current healthcare landscape.
Boston Hernia Surgeons Present Patient Reported Outcomes Data for the American College of Surgeons
Wednesday, October 25, 2023
Boston Hernia - Wellesley, MA
This morning, one of the outstanding residents of the Mass General Hospital Residency program presented our group data at the American College of Surgeons annual Clinical Congress.
Here is a summary of the presentation and pertinent findings
Boston Hernia Surgeons Recognized as National Leaders in Quality Hernia Care
Wednesday August 2nd, 2023
Boston Hernia - Wellesley, MA
Boston Hernia has always been focused on improving the quality of hernia care. As active members of the Abdominal Core Health Quality Collaborative (ACHQC), a coalition of hernia surgeons committed to quality and value of care for patients with hernia or other abdominal wall diseases, Boston Hernia surgeons have dedicated time and effort to constant quality improvement. The ACHQC recently developed a Verified Surgeon program which distinguishes certain participating surgeons for their outstanding level of dedication to the organization’s mission. Both Boston Hernia surgeons, the only two surgeons recognized in New England, were included on this short list.
Boston Hernia was founded on the belief that the quality of hernia care can and should be improved- that dangerous and life altering complications like the development of chronic pain (afflicting 5-15% of patients after hernia repair) should not occur. Through their efforts to better tailor surgeries to patients’ needs, dedication to patient education and awareness, and employment of surgical approaches with significant advantages in recovery and reduction of complication risks, Boston Hernia has set the bar for quality in hernia care. We are very proud to have our hard work recognized by the ACHQC and are most proud of how this work has led to better outcomes for our patients. Read more…
Boston Hernia publishes outcomes in Journal Hernia
Tuesday March, 14, 2023
Boston Hernia - Wellesley, MA
After years of collecting post-operative data in the ACHQC, the team at Boston Hernia finally published their research showing short- and long-term advantages of the open preperitoneal hernia repair compared to robotic and laparoscopic for inguinal hernia when performed in a high-volume center. The open preperitoneal (OPP) repair, performed by Drs. Fullington and Reinhorn about 750 times per year, virtually eliminates chronic postoperative inguinal pain, an all too common complication after traditional hernia surgery. When compared to laparoscopic and robotic hernia repairs, OPP results in lower opioid use and improved patient reported quality of life. The open preperitoneal repair is typically done under local anesthesia with sedation (avoiding general anesthesia), and without expensive laparoscopic or robotic equipment, which makes it more cost effective.
Our published paper in Journal Hernia is quite technical, but the data shows what we have known anecdotally for years: patients recover faster with less pain, less opioids, and lower complication rate when they have an open preperitoneal repair performed by a high volume hernia surgeon like Dr. Fullington or Dr. Reinhorn.
NBC 10 Boston pays Boston Hernia a visit - Summer 2019
Summer 2019 -
Dr. Reinhorn was recently interviewed by Kristy Lee of Boston NBC Chanel 10. She asked some very insightful questions about the approach we use to inguinal hernia repair. Kristy shows an actual bicycle tire, in order to explain the differences between the way we fix a hernia and the way most surgeons repair a hernia.
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Publication on Opioid Prescribing - Summer 2017
Lauren Ott and Michael Reinhorn partnered with surgeons from the MGH to study the number of opioid tablets prescribed for hernia surgery. They were innterviewed in the local Newton Tab while the MGH published an article about their work. As a result of this work, Dr. Reinhorn is helping lead an effort to measure and reduce opioid prescribing nationally through the Americas Hernia Society.
