New Zealand Submission to Health Select Committee Surgical Mesh

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5 May 2015

The Royal Australasian College of Surgeons acknowledges that the use of synthetic nonabsorbable mesh for the treatment of urogynaecological conditions carries with it a relatively high complication risk particularly because of erosion of the vaginal wall. It should be noted that synthetic non-absorbable surgical meshes have been widely used by General Surgeons, Paediatric Surgeons, Urologists, and Plastic and Reconstructive Surgeons for more than thirty years in the repair of hernias (cavity wall defects) involving the abdomen and chest. The use of surgical mesh in these situations has been associated with a lower risk of hernia recurrence than where techniques without mesh have been employed. There is little evidence to suggest that substituting synthetic non-absorbable surgical mesh with biologic materials offers any advantage in these circumstances.

  • The College would support the recommendation that surgeons should undertake caution when placing mesh devices near hollow visceria where erosion might occur.
  • The College would support ongoing audit and research into the safety of surgical mesh devices used in New Zealand.
  • The College would support patients making claims to ACC for treatment injury following mesh related adverse events.
  • The College would support the ongoing education of surgeons on the use of surgical mesh in all surgical sites.
  • The College believes that it would be inappropriate for surgeons using mesh in situations other than urogynaecological surgery to be credentialled along lines proposed by the Urogynaecological Society of Australasia and it would also be inappropriate to use the Urogynaecological Society pelvic floor database to record surgery and any complications related to sites distant from the pelvic floor if that database was limited to only members of that society. 
  •  The College would support the listing of mesh devices on the PHARMAC Hospital Medicines List (HML) and would support the monitoring of adverse events by Medsafe.