contribute to complications.
Hybrid mesh may be inching us
toward a perfect mesh. The
hybrid idea is to combine stan-
dard synthetic mesh, but at a
much lower density, with biolog-
ic mesh, which has lower inflam-
matory potential. That way
there's less inflammation and
pain related to the biologic mesh.
And once it's absorbed, the
patient still has some synthetic
mesh left to reduce hernia recur-
rence rates.
I also think it's a good thing that
patients have become so vocal
about hernia mesh. That may
force surgeons to think about the
techniques they're using and to
not treat every patient the same
way. I tailor hernia repairs based
on the patient. For example, I
don't treat a thin young female
patient the same as an obese smoking male.
Ultimately, we can't predict with any certainty who may have a com-
plication and who may not. A common scenario is that Patient A and
Patient B have similar hernias and undergo the same operation, but
have different outcomes. That's very hard to explain to patients. While
medicine is a science, it's also an art form. We aren't like McDonald's,
A U G U S T 2 0 1 8 • O U T PA T I E N T S U R G E R Y. N E T • 7 9
Choose the least invasive
operation with the lowest
risk of complications.
Sometimes, that
means a mesh product.
Sometimes, that
means a tissue repair.
Shirin
Towfigh,
MD,
FACS
