Management of a primary ventral incisional hernia: a survey of the International Hernia Collaboration

The Hernia Coding Conundrum: A Potential Benefit of the International Hernia Collaboration Online Social Media Platform

BACKGROUND

Despite various resources on the subject, there remain questions regarding billing and coding hernia surgery. Recently, social media has been used to disseminate information in about surgery. The purpose of this project is to evaluate posts relating to coding through one online social media platform.

MATERIALS AND METHODS

The International Hernia Collaboration Facebook site was queried with terms relating to coding. Inclusion criteria were post discussing coding on the site. Posts relating to coding were reviewed by at least 2 reviewers. Number of comments, main topic of question, and additional information about codes were recorded and descriptive statistics generated.

RESULTS

There were 100 posts found using the search term coding of which 85 met inclusion criteria. Post ranged from 5/2014 to 6/2021. Posts were from 72 surgeons with an average of 12 responses per post. Posts most commonly related to ventral and incisional hernia (53) followed by inguinal (18), other (19), diaphragm (4), and inguinal/ventral (1). For the ventral/incisional hernia, the most common posts were related to myofascial release techniques (29) followed by mesh (6), botox (5), hernia prevention (3), other (3), robotic surgery (2), open surgery (2), rectus diastasis (2), and laparoscopy (2).

DISCUSSION

There remains controversies over coding for hernia repair particularly myofascial releases in ventral and incisional and new techniques using the robot. An online social media platform appears to be a viable way to disseminate coding information and generate discussion. Further study is needed to evaluate the role of social media for coding.

Enhanced-view totally extraperitoneal repair in a patient with incisional hernia after robot-assisted laparoscopic radical prostatectomy: a case report

BACKGROUND

Although laparoscopic incisional hernia repair, especially laparoscopic intraperitoneal onlay mesh, is a widely used technique, it can cause serious complications, including mesh erosion, adhesive bowel obstruction, and chronic pain. The enhanced-view totally extraperitoneal (eTEP) technique has been reported to prevent such complications by placing the mesh in the retrorectus space. Here, we report the case of a patient with post-robot-assisted laparoscopic radical prostatectomy (RARP) incisional hernia repaired using the eTEP technique.

CASE PRESENTATION

A 67-year-old man, who underwent RARP for prostate cancer 4 years ago developed an incisional hernia. Abdominal computed tomography showed the presence of an epigastric incisional hernia measuring 4 cm long and 3.7 cm wide. We performed an eTEP repair. We closed the hernia defect using a 0 barbed suture and placed a self-gripping mesh measuring 20 cm long and 15 cm wide in the developed retrorectus space with no fixation. There were no postoperative complications, and the patient was discharged on postoperative day 2.

CONCLUSIONS

eTEP repair is considered an extremely effective surgical treatment option for incisional hernias because of its few resulting postoperative mesh-and-tacker-related complications.