Greenville Health System (GHS) launched The Hernia Center to deliver protocol-driven care in a collaborative environment.
The Hernia Center is as a regional referral and teaching center for specialized hernia care and hernia repair surgery. Serving Greenville, Asheville, Columbia, and areas throughout the Southeast, The Hernia Center is raising the bar in patient safety and successful outcomes. For more information or to refer a patient, call 864-234-7540.
“A hernia is not just a hole that requires a patch. Proper treatment requires a specialized, sometimes multidisciplinary approach.”
Alfredo Carbonell, DO, FACS, FACOS
Hernia cases are on the rise, driven in part by the morbid obesity epidemic and also by hernia recurrence brought on by initial hernia repair procedures. Tobacco abuse, diabetes and collagen disorders are just a few other factors leading to the surge in hernia problems.
For general surgeons nationwide, hernia repairs are behind only endoscopy as the most common outpatient procedure. In the Upstate, hernia inquiries are the third most requested topic posed to the GHS information telephone line, and GHS projects that the number of outpatient hernia surgeries will increase 23 percent between 2007 and 2012.
With the establishment of The Hernia Center, GHS has standardized the approach to hernia surgery through a focus on minimally invasive surgery techniques, surgical education, procedure outcomes analysis and involvement in clinical trials and biomaterials research.
The center has allowed several other general surgeons with an interest in hernia care to participate by contributing their hernia surgery outcomes data to help identify best practices and potential problems in approaches to hernia repair. They also can participate in hands-on training and education with GHS’ top hernia specialists, including the center’s co-directors, Alfredo Carbonell, D.O., FACS, FACOS, and William Cobb, M.D., FACS.
With a goal of improving hernia surgery quality through better understanding of the specialty, the center wants to collect outcomes data for all types of hernia surgeries, including operations for first-time inguinal or ventral/incisional repair (the most common type of hernia surgery) as well as procedures for more complex repairs.
The Hernia Center offers training in GHS’ minimally invasive operating suites, a cadaver lab at Patewood Medical Campus and an animal lab at Clemson University. It presents a way for surgeons to stay current by observing and practicing new and innovative hernia repair techniques. Complex hernia cases include recurrent inguinal or ventral hernias, hernias located in an unusual anatomical location and hernias associated with a complicated abdominal wall problem, such as infection or fistula. Surgeons who are active participants in the center often scrub-in with Drs. Cobb or Carbonell to observe their techniques.
Participating surgeons agreed to several core requirements, including a willingness to prospectively track surgical outcomes, membership in the American Hernia Society (AHS) and attainment of continuing medical education (CME) credits with a focus on hernia repair (such as CME credits earned at AHS meetings or through advanced hernia repair courses).
This emphasis on hernia-specific education is expected to improve the success rate of first-time hernia repairs. The center actively enrolls qualified patients into one of many trials, tracks overall hernia surgery volumes and growth, and evaluates outcomes for all participating surgeons quarterly.
The surgeons at our Hernia Center are both national and international leaders in the field of hernia surgery. Co-directors, Drs. Carbonell and Cobb underwent specific additional training after surgical residency in the field of advanced laparoscopic and complex hernia surgery. Additionally, they provide a fellowship training program for surgeons who have finished general surgery training. Our fellowship program is the first and only training program of its kind in the state of South Carolina.
They have published numerous scientific articles and medical book chapters on the subjects of minimally invasive surgical techniques and hernia surgery. As frequently invited speakers and visiting surgeons throughout the world, Drs. Carbonell and Cobb bring a unique level of expertise to their patients in the Upstate.
In addition to undergoing high-quality hernia surgery measured by protocols, patients have access to special programs, such as nutritional counseling, to help them address underlying health issues related to hernia problems.
“When we see a patient, we don’t just see someone with a hernia that needs to be repaired,” said Dr. Carbonell. “We often see a person with disease and risk factors for hernia formation and hernia recurrence we can help with other types of intervention.”
The center is collaborating with surgical specialists from other disciplines throughout GHS to treat patients with pelvic and groin pain that may not fall under the realm of the standard diagnoses treated by orthopaedic surgery, sports medicine or female pelvic medicine.
“We want to open up the lines of communication early about our expertise in abdominal issues so that patients hopefully don’t have to make multiple stops within GHS on their way to a definitive diagnosis,” Dr. Cobb said.