who didn't have a say in the process. Some facilities simply do it
by decree: "We're using these mesh products, and we're not
using anything else." I believe this is the wrong way to roll out
the change. In my opinion, the proper way is to send the pro-
posed change to any physician who performs hernia repairs and
give them an opportunity to comment.
3. Listen to feedback
If a surgeon has a legitimate case for using a mesh that's not
included in your proposed consolidation, you may want to consid-
er adding a limited amount of a specific type of mesh to account
for that exception. For instance, you might decide to make an
exception for a surgeon who claims to need a biologic mesh that's
been shown to reduce morbidities such as post-op wound infec-
tions and recurrence rates during infected cases.
In this case, your committee may decide to make an exception,
or they may not. The important thing is allowing surgeons to pro-
vide their input on a policy change that may have major implica-
tions for them personally — and then actually listening to that
feedback.
If you're asking surgeons to change the way they operate, partic-
ularly surgeons with outstanding outcomes who have been using
the same mesh product for years, they're bound to have some
concerns and complaints. They will wonder whether different
M A Y 2 0 2 0 • O U T PA T I E N T S U R G E R Y. N E T • 6 9
• Hybrids. Hybrid mesh attempts to bridge the gap between
pure synthetics and biologics — a middle option in terms of
cost and material. The mesh is made from a biosynthetic or
biological material coupled with a synthetic or non-absorbable
structure. — Mark Reiner, MD, FACS
