STANDARD GAMBLE SURGEON SURVEY Step 1 of 10 - SURGEON INFORMATION 0% SpecialtyAgeChoose oneUnder 1818-2425-3435-4445-5455-6465 or AbovePrefer Not to AnswerGenderChoose oneMaleFemaleOtherPrefer not to sayCityStateChoose oneAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificHow many laparotomies do you perform per year? (Provide an estimation)How many ventral hernia repairs do you perform per year? (Provide an estimation)What percentage of your non-hernia abdominal cases do you use prophylactic mesh for?Please enter a number from 0 to 100.How many laparoscopic surgeries do you perform per year? (Provide an estimation)What are the reasons you use or avoid the use of prophylactic mesh for prevention of incisional ventral hernias?How did you find this survey?Via the online ACS forumThe International Symposium on Incisional Hernia Prevention ConferenceDirect email The following three hypothetical scenarios are surgical cases in which prophylactic mesh could be considered to reduce risk of developing an incisional hernia. Laparoscopic Cholecystectomy: Low Risk Scenario ⚬ This patient is a 42-year old woman here for an elective laparoscopic cholecystectomy. ⚬ BMI = 24 kg/m2 ⚬ Past Medical History: • Diabetes mellitus • Hypertension ⚬ Labs: • WBC normal • LFTs normal ⚬ Imaging • Ultrasound shows a 3 cm gallstone, GBW 0.3 cm, CBD 0.3 cm. At the moment of gallbladder extraction, incision had to be extended to 3 cm Below is a flow diagram of possible complications with current care. Below is a flow diagram of possible complications with prophylactic mesh. The patient is a 42-year old woman here for an elective laparoscopic cholecystectomy. She has a BMI of 24 kg/m2 and past medical history of diabetes mellitus and hypertension. Her labs show normal WBC count and normal LFTs. Ultrasound shows a 3 cm gallstone with GBW 0.3 cm and CBD 0.3 cm. At the moment of the gallbladder extraction, the incision has to be extended to 3 cm. CURRENT PRACTICE Risk of hernia → 5% Risk of wound complication → 2% PROPHYLACTIC MESH Risk of hernia → 1.6% Risk of wound complication → ? Considering the risks with prophylactic mesh compared to current practice, do you accept the mesh therapy at a 2% risk of wound complication?YesNo PROPHYLACTIC MESH Risk of hernia → 1.6% Risk of wound complication → 3% Considering the risks with prophylactic mesh compared to current practice, do you accept the mesh therapy at a 3% risk of wound complication?YesNo PROPHYLACTIC MESH Risk of hernia → 1.6% Risk of wound complication → 4% Considering the risks with prophylactic mesh compared to current practice, do you accept the mesh therapy at a 4% risk of wound complication?YesNo PROPHYLACTIC MESH Risk of hernia → 1.6% Risk of wound complication → 5% Considering the risks with prophylactic mesh compared to current practice, do you accept the mesh therapy at a 5% risk of wound complication?YesNoChoose the highest % risk of wound complications with mesh therapy that you are willing to take. PROPHYLACTIC MESH Risk of hernia → 1.6% Risk of wound complication → 6% Considering the risks with prophylactic mesh compared to current practice, do you accept the mesh therapy at a 6% risk of wound complication?YesNoChoose the highest % risk of wound complications with mesh therapy that you are willing to take. PROPHYLACTIC MESH Risk of hernia → 1.6% Risk of wound complication → 7% Considering the risks with prophylactic mesh compared to current practice, do you accept the mesh therapy at a 7% risk of wound complication?YesNoChoose the highest % risk of wound complications with mesh therapy that you are willing to take. PROPHYLACTIC MESH Risk of hernia → 1.6% Risk of wound complication → 12% Considering the risks with prophylactic mesh compared to current practice, do you accept the mesh therapy at a 12% risk of wound complication?YesNoChoose the highest % risk of wound complications with mesh therapy that you are willing to take. PROPHYLACTIC MESH Risk of hernia → 1.6% Risk of wound complication → 17% Considering the risks with prophylactic mesh compared to current practice, do you accept the mesh therapy at a 17% risk of wound complication?YesNoChoose the highest % risk of wound complications with mesh therapy that you are willing to take. PROPHYLACTIC MESH Risk of hernia → 1.6% Risk of wound complication → 22% Considering the risks with prophylactic mesh compared to current practice, do you accept the mesh therapy at a 22% risk of wound complication?YesNoChoose the highest % risk of wound complications with mesh therapy that you are willing to take.What is the highest risk of wound complications with mesh therapy that you are willing to take5%6%7%12%17%22% MEDIUM RISK INITIAL INFORMATION MEDIUM RISK FLOW DIAGRAMS MEDIUM RISK QUESTIONS HIGH RISK INITIAL INFORMATION HIGH RISK FLOW DIAGRAMS HIGH RISK QUESTIONS Share this:TwitterFacebookLike this:Like Loading...