Some surgeons have been learning to do complicated hernia repairs from Facebook posts, leading to patient safety concerns, The New York Times reported Oct. 30.
Component separation is a hernia repair technique that can successfully close large hernias. It has grown in popularity since 2006, and the number of claims physicians have billed Medicare for have increased more than tenfold. Although lucrative, the procedure is difficult and can lead to many serious complications.
Michael Rosen, MD, a Cleveland Clinic surgeon who helped develop and popularize the technique, said he regrets teaching others the procedure. He said half his operations today are attempts to repair component separations that went wrong. A University of Michigan study found a third of cases that were treated with component separation did not require it.
The technique must be practiced dozens of times to master, experts told the Times, but 1 in 4 surgeons reported teaching themselves by watching the operation performed on Facebook or YouTube. Many of the videos capture surgeons making appalling mistakes and encouraging "shoddy practices," according to the Times.
In interviews, the Times also found dozens of hernia surgeons said component separations pay significantly more than simpler procedures. Medicare pays at least $2,450 for the component separation compared with $345 for simpler hernia repairs — and private insurers typically pay two or three times more. Some surgeons have also billed insurers up to four times for a single procedure. In 2017, the American College of Surgeons warned them to stop, saying providers could bill twice at most, once for each side of the torso.