LEARN ABOUT HERNIAS & THE UNDERLYING
CAUSES OF GROIN & PELVIC PAIN

what are the different
types of hernias?

If you have a hernia, you probably have a lot of questions. A hernia is when your tissue pushes through the wall of the muscle that holds it in. This can create a bulge in the abdomen area as most hernias occur in the belly or groin. You may have a hernia if you can feel a soft lump in your belly, groin or scar tissue from a previous surgery. The lump may disappear when you press on it or when you lie down. It might be painful, especially if you bend over, laugh or lift a heavy object.

 

ABDOMINAL WALL
DYSFUNCTION & RECONSTRUCTION

There are a variety of reasons why the abdominal wall may lose function. Childbirth with its resultant stretching and changing of the structure of the muscles and fascia is the most common reason in females. Other reasons in all populations include obesity and weight loss (from surgery or otherwise), prior abdominal surgery, and prior trauma. Any process, in fact, which changes the structural integrity of the abdominal wall can cause abdominal wall dysfunction.

 

What is an Inguinal Hernia &
How Should it be Repaired?

Understanding Inguinal Hernias is not easy. The anatomy in the groin region, is complex, and even for the surgical resident in training, has a three dimensional nature that takes years to understand. The anatomy begins at the level of the umbilicus (belly button) and continues down to the groin crease (the line created by the junction of the leg and the torso). Within this area, there is what is known as the Inguinal Canal, a tube which runs from the inside of the abdominal wall to the outside, in an oblique fashion.

 

Do you fix Ventral Hernias
like Inguinal Hernias?

There are a variety of reasons why the abdominal wall may lose function. Childbirth with its resultant stretching and changing of the structure of the muscles and fascia is the most common reason in females. Other reasons in all populations include obesity and weight loss (from surgery or otherwise), prior abdominal surgery, and prior trauma. Any process, in fact, which changes the structural integrity of the abdominal wall can cause abdominal wall dysfunction.

 

Laparoscopic vs Open
Inguinal Repair: Revisited

A recent article regarding open versus laparoscopic inguinal hernia repair was written by Westin M.D. et al. It is entitled “Less pain one year after total extra-peritoneal repair compared with Lichtenstein using local anesthesia—data from a randomized controlled clinical trial.” In the trial, 384 patients were randomized and operated upon using either laparoscopic or open repair, both with mesh. The patients were examined postoperatively and answered a questionnaire regarding any residual symptoms. The study had excellent follow up as 98% of patients were seen one year out.

 

Why Laparoscopic Inguinal Hernia
Repair Is Better Than Open Repair

Does it matter whether your inguinal hernia is repaired Laparoscopically or with a conventional Open Repair? YES, it absolutely does. Many surgeons, who do NOT perform the laparoscopic repair, will tell you that it does not matter, or that the open repair is better. This, in our opinion, a group that has performed over 3000 laparoscopic repairs over the last decade, is definitely incorrect. From 2008-2011 we reviewed our data, and here is what we found.

 

Ventral Hernia Evolution

Large Ventral Hernias have seen an evolution in surgical care over the last 2 decades. The advent of minimally invasive surgery and robotic surgery has become commonplace for many surgical maneuvers, however, not necessarily so with large Ventral Hernia Repair. While the trend swung heavily toward Laparoscopic Ventral Hernia Repair a decade ago, the recent data is more consistently recommending the Component Separation Technique with Mesh interposition for the larger Ventral Hernias.