How a lucrative surgery took off online & disfigured patients

The operation, known as a component separation, is recommended only for large or complex hernias that are tough to close

The bulge on the side of Peggy Hudson’s belly was the size of a cantaloupe. And it was growing.

“I was afraid it would burst,” said Hudson, 74, a retired airport baggage screener in Ocala, Florida.

The painful protrusion was the result of a surgery gone wrong, according to medical records from two doctors she later saw. Using a four-armed robot, a surgeon in 2021 had tried to repair a small hole in the wall of her abdomen, known as a hernia. Rather than closing the hole, the procedure left Hudson with what is called a “Mickey Mouse hernia,” in which intestines spill out on both sides of the torso like the cartoon character’s ears.

One of the doctors she saw later, a leading hernia expert at the Cleveland Clinic, doubted that Hudson had even needed the surgery. The operation, known as a component separation, is recommended only for large or complex hernias that are tough to close. Hudson’s original tear, which was about 2 inches, could have been patched with stitches and mesh, the surgeon believed.

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Component separation is a technically difficult and risky procedure. Yet more and more surgeons have embraced it since 2006, when the approach — which had long been used in plastic surgery — was adapted for hernias. Over the next 15 years, the number of times that doctors billed Medicare for a hernia component separation increased more than tenfold, to around 8,000 per year. And that figure is a fraction of the actual number, researchers said, because most hernia patients are too young to be covered by Medicare.

Continue here: The New York Times