Redefining success in hernia surgery: The case for patient-reported outcomes

In elective hernia surgery, the primary aim is to improve quality of life, rather than to save life. Therefore, outcome measures should emphasize domains such as pain, function, and overall satisfaction. While some principles also apply to other benign procedures, this perspective article centers on hernia repair as a paradigm for redefining surgical success. We perform hernia surgeries primarily due to quality-of-life concerns, and, consequently, it makes sense that outcome measures should emphasize quality-of-life indicators such as pain, other complaints impacting daily life, and most importantly, overall patient satisfaction with the procedure. Nonetheless, many interventional studies related to hernia disease tend to focus on tangible surgical outcomes like recurrence, infections, hospital stays, and readmissions. Therefore, we advocate for a shift in the evaluation of surgeries to prioritize more relevant patient-reported outcomes when assessing the effects of surgical procedures for benign conditions. These considerations not only apply to hernia surgery but also to other surgical interventions where the indication for surgery is based on quality-of-life issues. We urge the systematic incorporation of patient-reported outcomes into surgical practices and outcomes research to promote a more patient-centered approach, aligning surgical success with the outcomes that matter most to patients.