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Q&A with Australian Health Practitioners
How are hernias treated?
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Prof Ramana Balasubramaniam
Bariatric (Obesity) Surgeon, General Surgeon, Laparoscopic Surgeon, Upper GI Surgeon (Abdominal)
Prof. Ramana specialises in a wide range of surgical procedures, including minimally invasive laparoscopic surgery and robotic surgery. He has 30 years of experience and … View Profile
There are no magic pills for hernias! Surgery is the only way out to treat a hernia. In groin hernias, a space underneath the muscles is created so as to allow the placement of a large piece of synthetic or biosynthetic mesh that stays permanently in place and prevents the hernia from recurring. That said, there is an increasing fashion of using meshes that may be partially or completely absorbed in a couple of years or so. If you wish to know about the utility of such products in your particular case, take it up with your surgeon. In ventral and incisional hernias, the defect is closed with stitches after the contents are safely placed back into the abdominal cavity. An appropriately large mesh is placed under or over the abdominal muscles. This protects the repair. At present, laparo-endoscopic (keyhole) approaches have made recovery very quick, safe and pain free, with minimal hospital stay. To a large extent, laparoscopic surgery has helped reduce the fear involved with open surgery, e.g. long cuts, prolonged and severe pain, delayed recovery, loss of work and wages. Using a mesh is the standard of care in most cases. As the size of the hernia increases, or if it occurs as a recurrence, more elaborate reconstruction techniques are employed, These procedures may take a long time to complete in the operating theatre, But that is a necessary right of passage for the complex hernia patient on the way to recovery! Among the various operations currently employed by experts for the complex or recurrent hernia, the following may be particularly relevant or important:
1. eTEP Rives-Stoppa/TAR
2. Open preperitoneal ventral hernia repair (Heniford operation)
3. Fasciotens
4. Open TAR
5. Abdominoplasty
6. RoboTAR
These are by no means the complete list of procedures for the patient with a troublesome hernia. There are many others that may be called upon depending on the situation. It is the hallmark of a hernia expert to be facile with most approaches (if not all) and know when to use a procedure and when not to. It is very important for the patient to understand the pros and cons of the operation being considered for him/her and the alternatives thereto. There is no better way to get past this than to have a frank conversation with your surgeon.Report this post
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