Association between cumulative surgeon experience and long-term outcomes in complex abdominal wall reconstruction

Area of Science:

• Surgical Outcomes Research
• Hernia Repair
• Abdominal Wall Reconstruction

Background:

• The impact of surgeon experience on abdominal wall reconstruction (AWR) outcomes remains understudied.
• Understanding factors influencing AWR success is crucial for patient care and risk assessment.

Approach:

• A retrospective review of 650 patients undergoing AWR with biologic mesh from 2005-2019.
• Surgeons were categorized by cumulative hernia repair experience: low (<50), moderate (50-100), and high (>100).
• Primary outcome was hernia recurrence (HR); secondary outcomes included surgical site occurrences (SSOs) and infections (SSIs).

Key Points:

• High surgeon experience (>100 repairs) was associated with a fourfold reduced risk of hernia recurrence.
• No significant difference in surgical site occurrences or infections was observed between experience groups.
• Cumulative surgeon experience is a significant predictor of long-term AWR success.

Conclusions:

• High surgical experience is predictive of significantly lower hernia recurrence rates in complex AWR.
• Findings support the importance of surgeon experience in preoperative risk assessment and patient selection.
• These results have implications for quality improvement initiatives and the designation of centers of excellence.