**8. Next step for hernia**

**6. Improving research**

18 Hernia Surgery and Recent Developments

**7. Certification processes**

proven through extensive site inspections and reviews.

and especially to ensure quality treatment to all patients.

Hernia centers can improve research. Through hernia centers, surgeons will be able to record all their activity from the type of interventions, whether mesh was used or not, patient comorbidities, postoperative complications, long-term follow-up of patients, in other words, a highquality databases. Hernia centers will be an ongoing initiative to motivate all surgeons to report their operations in order to increase the national reports. It is critical to ensure quality databases by maintaining a high registration rate. All data can be published every year or a multicentric study can be carried out which will provide scientific evidence to generate further recommendations, unanimous protocols, and guidelines. A dedication to continuous improvement and higher levels of excellence sets forth that requirements be research focused,

Treating patients by nongovernmental organizations, performing surgery procedures that are not in conformance with the guidelines of the hernia societies, and by different volunteers, who are not properly trained sometimes under conditions not so favorable can lead to consid-

A primary necessity for valid certification of hernia centers includes a clear explanation of associated regulations and requirements and verification through either hernia societies and/or nonprofit organizations to ensure the optimal quality for hernia surgery. In addition, treatment quality must be verified through a certified center and it must be acquired through mandatory participation within a quality guarantee program or registry that includes a follow-up with patients.

Certified Center of Excellence in Hernia Surgery (COEHS) means a rigorous center of excellence program based on the effectiveness of the experts—well-trained hernia surgeon members of hernia societies fully committed to hernia field and properly equipped to ensure efficiency of technical care worldwide. Hernia centers will improve the follow-up of the patients gathering data through which we can create an international database. Health-care system is changed by international protocols which are deliberated after a long research with significant impact. That is why we need hernia centers to support us by facilitating our work

Hernia centers should be certified by the European Hernia Society (EHS)/Americas Hernia Society (AHS)/Asia Pacific Hernia Society (APHS) depending on the country in which the center will be built. Member representation and participation in these committees is of critical

German Hernia Society presents a model on how hernia centers should become certified through a Certified Hernia Center program which is very well explained in an article [9] published in 2014. We can also take the model of cancer institutes, which focuses only on cancer pathology. There are not many definitive consensuses in hernia field concerning prevention,

value and can serve as a stepping stone for senior leadership roles within the society.

erable complications for the patient and therefore additional costs for the society.

Although surgery requires more specialized human resources and infrastructure than many traditional public health interventions, when these challenges are met, surgery can produce health benefits with similar cost-effectiveness ratios [12].

There are surgeons who dedicate the majority of their surgical practice to abdominal reconstructive surgery and others who perform ventral hernia repair infrequently or refer the more complicated patient to another surgeon. No matter the patient, surgeon, or acute care facility, all HealthCare Systems need to provide value to patients for all surgical care episodes, promote collaboration across the health-care system, stimulate sharing of best practices, and initiate changes in the health management. Professional cooperation is needed. The professionals involved in its inception all share a passion for global health in addition to hernia surgery.

An important step in taking action for hernia collaboration was made by Dr. Brian Jacob, the founder of The International Hernia Collaboration Facebook™ Group being the new example of a professional-to-professional-to-industry group where exchange of information is centered on the concept of improving patient outcomes. Members, either surgeons or members of an academic institution, from all over the world, UE and non-UE, join this group, and their number is growing every day.

International Hernia Collaboration Facebook™ group demonstrates that social media can be used professionally as an extremely effective educational tool that provides rapid global collaboration with limitless possibilities, all designed to optimize patient care.

Research demonstrates that a high-volume experience results in improved patient outcomes. Task-sharing is greatly needed to grow the global surgical workforce, to enhance international collaboration, leverage technology, and optimize health systems. The challenge includes all surgeons and hospitals in a concerted effort to improve the quality of care across the board.

Creation of these institutional partnerships and trainee exchanges can enrich training, stimulate commitment to patient care, and promote the equal exchange of ideas and expertise.
