IS MESH TERROR ENDEMICAL? A GEOGRAPHICAL ANALYSIS OF TRENDS

Abstract

Abstract Introduction Mesh reinforcement for hernia repair has demonstrated to reduce recurrence rates for many scenarios of ventral and inguinal defects. In recent years, many hernia surgeons from specific geographies have encountered patients who feel strongly against the use of mesh, while physicians from other areas of the world have not reported this situation. This study aims to explore the regional trends associated with this phenomenon. Methods A global Google Trends search using the query “hernia”, “mesh complications” and “hernia mesh lawsuit” was used for data analysis. Search results are normalized to the time and location of a query by the following process: each data point is divided by the total searches of the geography, language, and time range it represents to compare relative popularity. The popularity index is represented as a percentile. Results An increase in popularity of hernia-related topics has been consistent for the past 15 years and this phenomenon has been consistent almost worldwide. The search term “mesh complications” also showed an increase in popularity mainly among English-speaking countries: the average popularity index since 2004 for this term has been 12% for the United States, 8% for the United Kingdom and <1% for Australia. “Hernia mesh lawsuit” has shown a significant increase in its popularity within the United States with an average popularity index score of 4% since 2004 and growing to 10% after 2016; while remaining relatively low (1–2%) for the rest of English-speaking countries. Even after adjusting for proportionality, non-English (Spanish, Mandarin, Portuguese and Hindi) mentions of “mesh complications” and “hernia mesh lawsuit” were significantly less frequent and were, in fact, very often advertising translations of legal firms within the United States. Conclusion Parallel to a global increase in the interest in hernia knowledge, there has been an escalation in the search for mesh complications information especially within the United States. This increase appears to be related to a surge in law firm advertising for hernia related issues. Further studies should focus on improving understanding of the general public perception and refining education mechanisms to assist patients and surgeons.