Implementing a Multidisciplinary Team for Complex Abdominal Wall Hernias: First-Year Outcomes From an Australian
S Salih1, S Kanakaratne1, L Wigston2
1Department of Surgery, Northern Adelaide Local Health Network (NALHN), Elizabeth Vale, South Australia, Australia.
Background:
Complex abdominal wall hernias (CAWH) are associated with significant operative complexity and patient comorbidity. International literature suggests multidisciplinary team (MDT) management may improve peri-operative planning, patient optimisation, and operative outcomes; however, Australian data remain limited. This study describes the implementation and first-year outcomes of a CAWH MDT within an Australian tertiary centre.
Methods:
A retrospective cohort study was conducted of all patients discussed at a dedicated CAWH MDT at Lyell McEwin Hospital between May 2024 and May 2025. Clinical records, operative reports, and MDT documentation were reviewed. Operative concordance with MDT recommendations and early postoperative outcomes were assessed.
Results:
Eleven MDT meetings were held over 12 months, with 71 patients discussed. Mean age was 61.6 years and mean body mass index was 37.5 kg/m2. Fifty-two patients (73.2%) were recommended for operative repair. Seventeen patients underwent surgery during the study period. Overall concordance between MDT recommendations and operative management was 76.4%. Adjuncts including botulinum toxin and mechanical traction devices were utilised in selected patients. There were no intra-operative or 30-day mortalities, no Clavien-Dindo grade IV complications, and no hernia recurrences identified at six-month follow-up. Mean postoperative length of stay was 3.05 days, with all patients discharged within 1 week.
Conclusion:
Implementation of a dedicated CAWH MDT within an Australian tertiary institution is feasible and associated with high concordance between MDT recommendations and operative management, alongside favourable early postoperative outcomes.