Patient Views Around Their Hernia Surgery: A Worldwide Online Survey Promoted Through Social Media

Abstract

Introduction: Hernias are one of the most common surgical diagnoses, and general surgical operations are performed. The involvement of patients in the decision making can be limited. The aim of this study was to explore the perspectives of patients around their hernia and its management, to aid future planning of hernia services to maximise patient experience, and good outcomes for the patient.Methods: A SurveyMonkey questionnaire was developed by patient advocates with some advice from surgeons. It was promoted on Twitter and Facebook, such as all found “hernia help” groups on these platforms over a 6-week period during the summer of 2020. Demographics, the reasons for seeking a hernia repair, decision making around the choice of surgeon, hospital, mesh type, pre-habilitation, complications, and participation in a hernia registry were collected.Results: In total, 397 questionnaires were completed in the study period. The majority of cases were from English speaking countries. There was a strong request for hernia specialists to perform the surgery, to have detailed knowledge about all aspects of hernia disease and its management, such as no operation and non-mesh options. Chronic pain was the most feared complication. The desire for knowledge about the effect of the hernia and surgery on the sexual function in all age groups was a notable finding. Pre-habilitation and a hernia registry participation were well-supported.Conclusions: Hernia repair is a quality of life surgery. Whether awaiting surgery or having had surgery with a good or bad outcome, patients want information about their condition and treatment, such as the effect on aspects of life, such as sex, and they wish greater involvement in their management decisions. Patients want their surgery by surgeons who can also manage complications of such surgery or recommend further treatment. A large group of “hernia surgery injured” patients feel abandoned by their general surgeon when complications ensue.

Midline incisional hernia guidelines: the European Hernia Society

“…The technique should be performed in the correct way, with a focus on preservation and restoration of abdominal wall function and careful tissue handling. Furthermore, the decision to operate and the choice of technique should involve the informed consent process and should be a shared decision between the patient and their surgeon 147 .…”

Quality of Life With a Hernia—A Novel Patient Led Study

“…Whilst often viewed as a taboo subject, patients waiting for surgery may benefit from practical support such as information on different sex positions, advice on pain management, comfortable support garments or details of flattering underwear. Patients also want to know if their hernia surgery may impact on sexual function ( 11 ). Some patients may need counselling, particularly if their hernia was due to trauma, a traumatic event or cancer, as their physical appearance may be a reminder of an event or disease ( 12 ).…”

“…Further limitations lay in the design and distribution of the study. The survey was written by patient authors who have limited experience in research design, and the survey was distributed through social media, which although a useful tool when accessing large populations ( 11 ) this may influence the demographics of the respondents.…”

Computational Intelligence in Hernia Surgery with Classification of Repair Types

“…Our conclusions correspond with other published evidence, focusing on a comparison of various patient groups and operative alternatives, especially the robotic-assisted minimally invasive and open techniques 31 . However, all of these studies lack patient involvement, as highlighted by East et al 32 .…”