Building a Multidisciplinary Hospital-Based Abdominal Wall Reconstruction Program: Nuts and Bolts

Area of Science:

• Surgical Oncology
• Hernia Repair
• Center of Excellence Development

Background:

• Nationwide trend towards "centers of excellence" in surgical care.
• Increasing prevalence and complexity of hernia repairs necessitate specialized practices.
• Focus on the components for establishing a successful tertiary hernia referral center.

Purpose of the Study:

• To review and discuss the essential components for establishing a successful tertiary hernia referral center.
• To analyze factors contributing to the development and impact of hernia specialty centers.
• To provide insights into the coordination, funding, and staffing of such centers.

Main Methods:

• Comprehensive literature review on hernia specialty centers.
• Inclusion of authors' practical experience in hernia center development.
• Discussion and tabulation of factors and outcomes related to center establishment.

Main Results:

• Establishment leads to increased surgical case volume and complexity.
• Centers experience a rise in patient comorbidities and geographic referral range.
• Key drivers include team development, preoperative optimization, and outcomes assessment.

Conclusions:

• Successful tertiary hernia centers require institutional commitment, surgical expertise, and interdisciplinary collaboration.
• Increased case volume and referrals are indicators of success.
• The ultimate measure of success is demonstrated improvement in patient outcomes.