Open and Laparoscopic repairs and resections of:
- Appendix
- Colon
- Gallbladder
- Liver
- Pancreas
- Small Bowel
- Spleen
- Stomach
- Hernias of the abdominal wall, esophageal, hiatus & groin
Abdominal Wall Reconstructions for Complex Hernias
Understanding Hernias
A hernia is a weakness or defect in the wall of the abdomen. This weakness may be present at birth, or it could develop later on in life. Hernias may appear to develop overnight, but in fact, they take years to develop. They grow larger as pressure inside the body presses the intestines or other tissue out through a weak area. Even though men are more likely to have a hernia, they also occur in women and children as well. Most hernias are not life threatening, but treatment can help eliminate discomfort and prevent complications.
Symptoms
- A bulge in the groin, abdomen, thigh, or genitals. The bulge may get bigger when you stand and go away when you lie down.
- Discomfort or pain that is worse at the end of the day or after long periods of standing.
- A feeling of weakness or pressure in the groin.
- Discomfort or pain during urination or bowel movements.
Types of Hernias
Incisional Hernia
An incisional hernia happens when a weakness in the muscle of the abdomen allows the tissues of the abdomen to protrude through the muscle. The hernia is caused by a weakness in the muscle by an incision made in a prior abdominal surgery.
Incisional hernias may be repaired using sutures or tension-free repairs using mesh. Tension-free is surgery that uses special mesh materials to repair the weak area. Unlike traditional repairs, the mesh covers the weak area like a patch on a tire. It also makes the recovery faster and less painful. The mesh is made of strong, flexible plastic that stays in the body. Over time, nearby tissues grow into the mesh to strengthen the repair.
Indirect Inguinal Hernias
An indirect inguinal hernia forms at the inside opening of the inguinal canal. This is an area that is naturally prone to weakness. With time and the effects of gravity, the intestine can press into the canal and fom a bulge in the groin. Indirect inguinal hernias may be repaired using sutures or tension-free repairs using mesh. Tension-free is surgery that uses special mesh materials to repair the weak area. Unlike traditional repairs, the mesh covers the weak area like a patch on a tire. It also makes the recovery faster and less painful. The mesh is made of strong, flexible plastic that stays in the body. Over time, nearby tissues grow into the mesh to strengthen the repair.
Indirect inguinal hernias may be repaired using sutures or tension-free repairs using mesh. Tension-free is surgery that uses special mesh materials to repair the weak area. Unlike traditional repairs, the mesh covers the weak area like a patch on a tire. It also makes the recovery faster and less painful. The mesh is made of strong, flexible plastic that stays in the body. Over time, nearby tissues grow into the mesh to strengthen the repair. Sometimes a mesh plug is used to fill the hole in the abdominal wall. A mesh patch is then secured above the defect to provide strength. On occasions it is necessary to use a combination device. With a combination device mesh patches are place in front and behind the defective area. They are connected together using a mesh bridge that goes through the opening in the abdominal wall.
Direct Inguinal Hernias
Direct inguinal hernias are similar to indirect inguinal hernias, but less common. They form ata weakness in the abdominal wall next to the opening of the inguinal canal. Over time the intestine can press through the weak area and bulge into the groin. Direct inguinal hernias may be repaired using sutures or tension-free repairs using mesh.
Tension-free is surgery that uses special mesh materials to repair the weak area. Unlike traditional repairs, the mesh covers the weak area like a patch on a tire. It also makes the recovery faster and less painful. The mesh is made of strong, flexible plastic that stays in the body. Over time, nearby tissues grow into the mesh to strengthen the repair. Sometimes a mesh plug is used to fill the hole in the abdominal wall. A mesh patch is then secured above the defect to provide strength. On occasions it is necessary to use a combination device. With a combination device mesh patches are place in front and behind the defective area. They are connected together using a mesh bridge that goes through the opening in the abdominal wall.
Umbilical Hernias
An umbilical hernia occurs when part of the bowel or fatty tissue pokes through an area near the belly button, pushing through a weak spot in the abdominal wall. While the developing fetus is in the whom, the umbilical cord passes through an opening in the abdominal wall, which should close before the baby is born.
However, sometimes the muscles do not completely seal leaving a weak spot. The hernia looks like a lump in the navel. The majority of the time an infant’s umbilical hernia closes on its own by the age of 12 months. If the hernia is still there by the time the child is 4 years old, surgery may be recommended.
Umbilical hernias may also develop in adults, especially if they are very overweight, lifting heavy objects, or have a persistent cough. Women who have had multiple pregnancies have a higher risk of developing an umbilical hernia.
Umbilical inguinal hernias are repaired using stension-free repairs using mesh. Tension-free is surgery that uses special mesh materials to repair the weak area. Unlike traditional repairs, the mesh covers the weak area like a patch on a tire. It also makes the recovery faster and less painful. The mesh is made of strong, flexible plastic that stays in the body. Over time, nearby tissues grow into the mesh to strengthen the repair. Sometimes a mesh plug is used to fill the hole in the abdominal wall. A mesh patch is then secured above the defect to provide strength.
Femoral Hernias
A femoral hernia is caused by a protrusion of a viscus through a weakness in the containing wall. Femoral hernias occur just below the inguinal ligament, when abdominal contents pass through a naturally occuring weakness called the femoral canal. Femoral hernias are much more common in women than they are in men. This is due to the wider bone structure of the female pelvis.
Hernia Repair
Laparoscopic Inguinal Hernia Repairs
How do Hernias Happen?
Men and women of all ages can have hernias. A hernia is a weakness or tear in the abdomen. There are two ways that a hernia can happen. An acquired hernia are caused by wear and tear over the years. A congenital hernia is the result of weakness in the abdominal wall that is present at birth.
Symptoms
- A soft lumb in the groin, near the navel, or near a surgical scar
- Pain may be present which can range from mild tenderness to severe pain
- Cause nausea and vomiting when a part of an organ, usually an intestine, bulges outside the abdomen and becomes trapped.
Laparoscopic Hernia Repair
The laparoscope is a tiny telescope that lets your doctor see inside of your body. Laparoscopic surgery offers many benefits over open surgery. There is less pain, a faster recovery, and tiny scars instead of a long scar. Because laparoscopic surgery usually takes 1 to 2 hours and you can likely go home the same day. Since large incisions are not required, recovery from laparoscopic surgery is often faster and less painful than open surgery.
The Procedure
You will be given general anesthesia. This will keep you free from pain during surgery. Depending on the type of surgery, the number of incisions and placement will vary. The laparoscope and other instruments vital to the surgery are inserted through the incisions.
Carbon dioxide gas is injected into your abdomen through an incision near your navel. The gas inflates your abdomen, allowing the surgeon to work.
After the hernia is repaired, your surgeon places strong mesh directly over the weak spot in your abdominal wall. The mesh acts just as a patch would on a tire wall. The mesh is secured with surgical staples. These stay in place permanently. Neither the mesh nor the staples are harmful to your body.
Risks and Complications
- Bleading
- Infection
- Numbness or pain in the groin or leg
- Urinary retention
- Bowel or bladder injury
- Recurrent hernias
- Deterioration of testes
- Risks of anethesia
