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Hernia Repair

What is a hernia?

A Typical hernia is a weakness or tear in the abdominal wall which allows the inner lining of the abdomen to push through and form a sac. The hernia may fill with intestine or tissue which then may become incarcerated or obstructed causing a potentially serious health risk.

Hernias can occur at birth or over time due to stress and strain. There are different types of hernias, but the overwhelming majority occur in the abdominal wall at the groin, the naval, or at the site of imperfectly healed surgical incisions. An easy way to envision a hernia is to think of a tire. When an abnormal opening occurs in a tire, the inner tube protrudes from the opening. Similarly, a hernia occurs when an organ or tissue protrudes through an abnormal opening.

Will I Know If I Have A Hernia?

Hernias are usually easily recognized. You may feel pain when lifting heavy objects, coughing, or straining during urination or bowel movements. You may also feel a bulge under your skin.

How Are Hernias Repaired And What Are My Options?

Hernia repairs are one of the most commonly performed surgeries in the United States. Over 700,000 procedures are completed annually. They can only be completed surgically and are done to relieve the symptoms of pain and to prevent other more serious problems from occurring if the hernia is ignored. However, there are several options available.

Open Surgical Repair

The most common hernia repair being performed today is the open "tension free" repair. This procedure is usually performed under local or regional anesthesia (however, you may be put to sleep) and requires a large muscle cutting surgical incision (two to four inches) to gain access to the hernia. The repair is made by securing a plastic mesh over the hernia defect. The technique is effective, but because the incision cuts through muscle a full recovery can take four to six weeks.

Regular Laparoscopic Repair

A few years ago a minimally invasive procedure to repair the hernia defect became available. This transabdominal approach usually is performed with general anesthesia (you are put to sleep). The surgeon gains access to the hernia internally through the abdomen making three small incisions (one half inch or less). The abdomen is then inflated with Carbon Dioxide gas.

Because these smaller incisions cause less trauma to stomach and groin muscle, post operative pain is usually less and full recovery is achieved much quicker (one week or less). However, one disadvantage of the transabdominal approach is that the laparoscope and other instrumentation needed to complete the repair must be inserted into the abdominal cavity exposing the patient to the risk of possible internal vessel or organ injury.

"Balloon" Laparoscopic Repair

The newest, and most advanced laparoscopic hernia procedure, the extra-peritoneal balloon approach, is now being performed at Norwood Hospital by Dr. Arthur Glasgow, Dr. Peter Lydon, and Dr. Philip Reilly. They have performed over 1500 procedures utilizing this approach over the past five years.

This new balloon device minimizes the risk of transabdominal surgery by creating an operative space outside of the abdominal cavity. This procedure is considered safer for the patient since the surgeon does not have the potential risk of bowel or vessel perforation. Because the operative space created by the balloon approach requires inflating a space much smaller than the abdomen, the use of general or regional anesthesia may be selected. A full recovery can usually be expected within a week.

The instruments used to perform "Balloon" Laparoscopic Surgery, made by ORIGIN©

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