Specialist Overview: Advancing the Science of Hernia Repair
California Hernia Specialists serves as a primary hub for clinical innovation in the field of abdominal wall reconstruction. Our research mission is centered on improving patient safety and refining surgical outcomes through the data-driven study of operative techniques and postoperative care. By bridging the gap between high-volume private practice and academic clinical trials, we ensure that our patients benefit from the most current, evidence-based surgical advancements.
- Clinical Trial Leadership: Our center serves as the Principal Investigator for the nationwide NOPIOIDS clinical trial (NCT05929937), focusing on the efficacy of narcotic-free recovery in various hernia repairs.
- Quality Benchmarking: We are active contributors to the Abdominal Core Health Quality Collaborative (ACHQC), maintaining a rigorous database of surgical outcomes to ensure transparency and elite standards of care.
- Peer-Reviewed Contributions: Our clinical findings on opioid-prescribing patterns and surgical pain management are published and indexed in the National Library of Medicine (PMID: 39724506).
The Authority of Evidence
Under the direction of Dr. Todd Harris, an 11-year OCMA Physician of Excellence (2015–2026), our research has fundamentally changed how patients experience hernia recovery. By eliminating the need for surgical narcotics while maintaining high levels of comfort, we have established a new national standard for “Center of Excellence” performance, as recognized by both national surgical societies and patient advocacy groups.
Opioid prescribing after outpatient ventral hernia repair with mesh
Our research includes the recently published study on opioid prescribing patterns in hernia repair (PMID: 39724506). Dr. Harris was a lead author this publication which characterized opioid prescribing patterns after ventral hernia repairs. Through this research, the goal was to help other surgeons recognize patient needs for opioids after ventral hernia repairs, as well as helping surgeons understand how many opioids patients usually consume after ventral hernia repairs.
This article (PMID:39724506) was published in the Journal – Hernia PMID:39724506.
Current Clinical Trials: Advancing Opioid-Free Hernia Recovery
Dr. Harris is currently the Principal Investigator for the Opioid Trial (NCT05929937) (No Opioids vs. Minimal Opioids Following Inguinal Hernia Repair). This nationwide randomized controlled trial is comparing the use of 5 opioid tablets after inguinal hernia repair to the use of zero opioid tablets. The investigators hypothesize that not prescribing opioids after uncomplicated, outpatient IHR will be non-inferior to prescribing opioids (5 tablets of Oxycodone, 5mg; or surgeon preference for intolerance) with respect to requests for opioid refills. Additionally, the investigators believe there will be no significant difference in postoperative readmission for pain quality of life at 30 days in either group.
Patients can learn more about this study NCT05929937 at clinicaltrials.gov
Opioid Reduction Initiatives
Dr. Harris discusses the importance of using less opioids. This video was published on the ACHQC WebsiteThe Abdominal Core Health Quality Collaborative (ACHQC)
Their Mission
“The mission of the ACHQC is to maximize the quality and value of health care for patients who suffer from hernia disease and diseases of the abdominal wall or abdominal core.”
What is the ACHQC?
The Abdominal Core Health Quality Collaborative (“ACHQC Foundation”) is a 501(c)(3) nonprofit organization formerly known as Americas Hernia Society Quality Collaborative Foundation. The Collaborative collects and aggregates health information, including, but not limited to, long term follow up data and patient reported outcomes, and publishes and provides de-identified and limited data sets of health information related to abdominal core and hernia surgical repairs to fulfill its mission to improve outcomes and value in abdominal core and hernia patient care. Through data collection, analysis, and collaborative learning, the ACHQC provides best practices, decision support, care pathways and ongoing performance feedback to participants and partners. The ACHQC is a CMS Qualified Clinical Data Registry and is an authoritative resource for organizations to assess quality metrics and demonstrate a commitment to efficient, value-based patient-centered hernia and abdominal care.
Dr. Harris Selected as ACHQC Verified Surgeon of Quality
The goal of the ACHQC Verified Surgeon of Quality program is to recognize and distinguish participating surgeons for their dedication to improving the quality and value of health care for patients who suffer from hernia disease and diseases of the abdominal wall or abdominal core. Improved quality and value are realized through the consistent entry of data in the ACHQC Registry and participation in ACHQC’s continuous quality improvement programs.
ACHQC leadership believes surgeons focusing on quality improvement efforts will perform at their highest level. We hope that through this verification program, surgeons will be recognized by their peers and broader network for their dedication to improving the quality and value of patient care in their communities.
Dr. Harris was presented with the ACHQC Verified Surgeon of Quality recognition for fulfilling the qualities and traits outlined above. This designation provides a recognition that the quality of care being provided is above and beyond the typical care being provided at other surgeons offices in the community.
Through participation in research with the ACHQC, our hernia center can ensure that we are following the highest standards of care for our patients, as well helping to define parameters for quality for future patients. Without being active in research and outcome tracking, an individual surgeon could not validate his or her level of care.
The Editor of Journal ‘Hernia’ Discusses Finding Quality Hernia Care
Dr. Giampiero Campanelli, the editor of the medical journal ‘Hernia’, wrote an editorial in their most recent publication discussing how patients are supposed to find quality care in today’s age of increasinging complex medical care. In the end he advises patients to:
“research the background of any surgeon the patient has identified—their academic and hospital qualifications, actual scientific output (articles published in peer-reviewed journals), and experience (documented cases of patients in the same situation who they have treated using the same procedure). It is only by—patiently once again—making a choice based on progressively acquired and increasingly detailed knowledge of the chosen surgeon that the patient can realistically expect seriousness and competence. And reduce the risk of failure and complications.”
Our center has leaned into this type of process for over 10 years by being part of a national collaboration on hernia research and outcomes. By publishing our data year over year, patients can make more educated decisions on choosing a surgeon who will help reduce their chances of having a poor outcome.
Hernia Conferences – Dr. Harris National Speaker
Dr. Harris was invited to speak at the 2024 Abdominal Core Health Quality Collaborative Improvement Summit as a national leading expert in laparoscopic inguinal hernia repairs. His volume of surgeries allows him to provide a significant amount of data to the collaborative to help drive guiding policies and procedures.
His expertise in this type of surgery was recognized by the ACHQC and he was asked to share his experiences with the international guests for the summit. He is one of the leading hernia surgeons in a number of different areas including laparoscopic hernia repairs.
Dr. Harris – Member ACHQC Opioid Task Force
Dr. Harris was asked to participate in the national opioid task force set up by the ACHQC (see below). The task force is in charge of collecting data on opioid prescribing habits of surgeons as well as the reciprocal opioid use by patients after hernia surgeries. By determining the standard usage for opioids after surgery, the task force can help change prescribing behavior in surgeons around the country in an effort to combat the opioid epidemic.
It was through involvement with this committee that Dr. Harris helped shape the comprehensive pain management protocol that our patients currently follow after their hernia repair. This is also the reason that 99% of our patients do not need a single opioid after their surgery.
Visit our Opioid’s & Post Surgery Pain Management page to see how we manage pain after surgery.
Hernia Research – Patient Involvement
Patients often want to know what their involvement is with research being done at California Hernia Specialists. The first important point is that hernia research is voluntary. This means that if a patient wishes to not participate in any of the studies that are being done, they are not obligated to do so.
Patients who do wish to be involved in advancing hernia care, are required to provide an email address. This email address is entered into the ACHQC database after the surgery is completed. The ACHQC then sends an email to the patient with a form about how they felt before the hernia surgery. The same forms are sent to patients at specific intervals after the surgery to check on recovery, and the long term success (or failure) of the surgery itself.
Dr. Harris is the Principal Investigator for the clinical trial NCT05929937 (No Opioids vs. Minimal Opioids Following Inguinal Hernia Repair). Our scientific output includes the published study ‘Opioid prescribing after outpatient ventral hernia repair’ (PMID: 39724506).
Hernia Research – Long Term Benefit
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.
Benefits From Participating in Research:
Both patients as well as California Hernia Specialists benefit extensively from ongoing active research in several important ways:
- Cutting edge technology and technique: By participating in research, Dr. Harris is constantly in touch with the most up to date data on hernia surgery. This of course translates into better care for all of our patients.
- Advancing medicine: Patients are able to contribute to the advancement of hernia surgery. Without individual patients’ participation, no research studies would ever be completed. Patients are the most important aspect of the research team.
- It’s Free! Although California Hernia Specialists provides financial resources for the research it performs, it is obviously free to patients. All that is required is time to complete an occasional survey from ACHQC.
- All data is confidential: All patient information is 100% confidential. No names, birth dates, or other identifying information will be published or released. Your contact information is all that is required for participation. Any studies that are published in the future will certainly not have any reference to individual participants.
Hernia Research – Patient Survey
The following is the survey that we ask patients to complete in the office at the time of their initial consultation, as well as at their follow up visit 30 days after surgery.
Dr. Harris, Thank you for saving Justin’s life. You saw how much he suffered. When no pediatric surg/gi would touch him, you saved him!
