Once you’ve decided to have surgery for your hernia, the next step is choosing who to trust as your surgeon. The ideal Surgeon would provide:
- Low recurrence rates (or chances the hernia will return)
- High quality of life (QOL) and low incidence of chronic pain
- A comprehensive post-surgery pain management protocol with minimal need for opioids
- Low rates of infections and other complications
For years, our center has participated in the Abdominal Core Health Quality Collaborative (ACHQC) which tracks these patient outcomes as well as providing detailed patient outcome data for our center.
As shown below, in each metric our center has significantly better outcomes when compared to other surgeons across our region and the country. Our hernia practice is one of the only centers in the country to provide complete transparency to patients as they are making their decision on who to trust with their hernia care.
Why You Should Choose Your Surgeon Based on Outcomes Data
In the end, the outcome you have after your hernia surgery will be the only thing that matters.
If you choose a surgeon who has high recurrence rates and increased chronic pain you can expect a higher than average chance of having a poor outcome. The opposite is true if you choose a hernia surgeon who has low recurrence rates and high quality of life ratings. Obviously, the problem that many patients face is how to find a surgeon who falls into the latter category. Fortunately, we’ve chosen to solve this problem for our patients.
Transparency and hard data should help drive decision making across all aspects of healthcare and certainly for who you choose as your surgeon. That’s why for over 10 years our hernia practice has been tracking our patients’ outcomes after surgery through our partnership with the Abdominal Core Health Quality Collaborative (ACHQC) research database. Through our integrated involvement with the ACHQC, our practice tracks some of the most important data points that impact patients after their surgery. These include:
- Recurrence rates – or the chance that your hernia will come back after it’s repaired
- Chronic pain after surgery – or the quality of life that you can expect after surgery
- Postoperative infections
- Your expected opioid use during the immediate postoperative period.
By not only tracking the metrics listed above, but by publishing them on our website, we demonstrate to patients our commitment to quality, cutting edge hernia care, and the results they can expect after surgery at our center. This is how we’ve chosen to solve the problem of identifying a high quality surgeon. While there are a lot of surgeons to choose from, patient outcome data is what will impact your chance at having the ideal outcome after your surgery.
Our 2023 Hernia Patient Volume
- Total hernias repaired in 2023: 527
- Patients treated: 442
- Patients with multiple hernias: 85
- Patients with inguinal (groin) hernias: 335
- Patients with bilateral inguinal hernias (both sides): 69
- Patients with right sided inguinal hernias: 158
- Patients with left sided inguinal hernias: 108
- Patients with recurrent inguinal hernias: 41
- Patients with inguinal and umbilical hernias repaired together: 17
- Patients with ventral (including umbilical) hernias: 124
- Laparoscopic hernia repairs: 356
- Open hernia repairs: 171
- 2022 total hernias repaired: 518 – Review 2022 Outcome Data Here
- 2021 total hernias repaired: 491 – Review 2021 Outcome Data Here
- 2020 total hernias repaired: 411 – Review 2020 Outcome Data Here
Our 2023 Hernia Patient Outcome Data
Inguinal Hernia Repair 1-Year Patient Outcome Data:
Recurrence rates – Dr. Harris: 2.88% — National Average: 6.94%
Our patients have a 59% reduction in recurrence rate when compared to the ACHQC as a whole. For general surgeons not involved in the ACHQC and high volume hernia surgery, this number may be even higher.
Quality of Life – Dr. Harris: 0 — National Average: 2
(*Lower EuraHS score means better QoL and higher EurasHS score means worse QoL)
Our patients report feeling completely normal at one year, compared with the ACHQC patients as a whole who describe some discomfort.
Ventral Hernia Repair 2-Year Patient Outcome Data:
Recurrence rates – Dr. Harris: 3.39% — National Average: 21.4%
Our patients have a 84% reduction in recurrence rate when compared to the ACHQC as a whole (see notes below).
Please Note: Our ventral hernia repair data is being compared against other surgeons and patients across the country. Some patients at other centers have much more complicated hernias and are being done at large University type centers. This clearly can skew our data which tends to include healthier patients with less complicated hernias towards having a lower complication and recurrence rate. Ventral hernia repair data can thus be difficult to accurately compare between surgeons and their specific patient populations.
Quality of Life – Dr. Harris: 95 National Average: 90
Our patients are 50% closer to feeling completely normal 2 years after their hernia repair when compared to the ACHQC as a whole.
*Higher HerQLeS score means better QoL and lower HerQLeS score means worse QoL.
Data Quality Drilldown Dr. Harris 2023
There is a slight discrepancy in the hernia volume data in this table and actual yearly volumes due to a very small fraction of patients who are not able to be entered into the database. This is most often due to the surgery having to be performed at a location which does not have an ongoing research agreement with the QC.
Discussion on Patient Outcome Data
Hernia recurrence rates are based on Patient Reported Outcomes (PRO). These PRO are patient’s answers to questions on the follow up surveys provided at 30 days, 6 months, and then yearly thereafter. Patients who indicate that their hernia ‘may have come back’ are considered to have a recurrent hernia.
While this is the most sensitive way to measure hernia recurrences since they identify almost every patient who MIGHT have a recurrent hernia, it is the least accurate way to ensure that a patient actually HAS a recurrent hernia. Many of these patients do not seek care for a hernia that they think might have come back. And those that do often are examined and reassured that their hernia has not returned. Or the appropriate imaging is performed to rule in or out a recurrent hernia.
Thus, the above recurrence rates for all surgeons is skewed towards much higher numbers than is usually reported in medical studies which use physical exam and imaging to diagnose recurrent hernias. Therefore the measured and indicated recurrence rates in the ACHQC data is higher than we know to be accurate and is overall not useful by itself. Medical studies consistently demonstrate a recurrence rate of 1-2% for most initial hernias.
However, what is useful is each surgeon’s data compared with the whole. If a surgeons recurrence rate or pain scores are higher or lowers than the national average in this data, they almost certainly will be higher/lower than 1-2%.
It is also important to keep in mind that surgeons who participate in the ACHQC and track their data are typically surgeons who make hernia repairs a priority in their practice. Even compared against these leaders, our numbers show improved outcomes across the board. When compared to surgeons who do not prioritize hernias and who are not tracking their data, we feel that our outcomes data would be even more compelling.
We strive to have every patient in our practice complete their follow up surveys to ensure that our results are as accurate as possible. As time passes and more past patients complete their follow up surveys, our data will become more accurate and further power our overall results. This is why we strongly encourage and appreciate our patients taking the time to complete their PRO surveys during the years after their surgery with us.
No surgeon today has all the answers to which surgery is the best for every different patient. This goes for hernia surgeons, as well as cancer surgeons, brain surgeons, trauma surgeons, etc. The only way medicine in general will advance is to participate in the latest research. Today’s patients benefit extensively from the active role that patients 10 and 20 years ago took in the long term goals of medicine.
Hernia Research – Patient Reported Outcomes (PRO) Survey
This is the survey that we have patients complete in the office before their consultation and at the time of their follow up visit after surgery. It’s also very similar to the survey that they complete at 6 months, 1 year and yearly thereafter.