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December 18, 2019

Abdominal Core Health—A Needed Field in Surgery

Author Affiliations
  • 1Center for Abdominal Core Health, Division of General and Gastrointestinal Surgery, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus
  • 2The Johns Hopkins Hospitals, The Johns Hopkins University School of Medicine, Baltimore, Maryland
  • 3Center for Abdominal Core Health, Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus
JAMA Surg. Published online December 18, 2019. doi:10.1001/jamasurg.2019.5055

Most members of the board of governors at the Americas Hernia Society aim to redefine the field of hernia care as abdominal core health, the discipline as abdominal core surgery, and the identity of associated clinicians as abdominal core surgeons. The abdominal core is defined as the circumferential soft tissues of the diaphragm superiorly, the pelvic floor inferiorly, and the abdominal wall and flank anterolaterally, excluding the abdominopelvic viscera (Figure). This concept has been described before, as outlined by Wood et al.1 The field of abdominal core health encompasses the stability and function of the abdominal core and associated quality of life. Maintenance of abdominal core health may include exercise, physical therapy, medical therapy (including compression garment or truss use), alternative medical therapies (including acupuncture or yoga), surgical intervention, and measures to prevent disease (eg, hernia prophylaxis). Disease processes involving abdominal core health include intrinsic diseases of the abdominal wall (eg, hernia, diastasis, athletic pubalgia or core muscle injury, benign tumors, malignant tumors) and extrinsic diseases of the abdominal wall (eg, prosthetic or intervention-associated complications, benign tumors, malignant tumors).

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