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Hernias: treatments
What are the types of procedures used to repair hernias?

There are many ways to repair a hernia. The conventional method: the hernia sac and defect are dissected out and the sac is either removed or reduced. Next using suture material, the muscle tissue surrounding the hernia defect is reapproximated. Tension free repair using mesh: This is our procedure of choice. Once again the hernia defect and sac is dissected out and the sac either removed or reduced. The mesh is then inserted and covers the abdominal wall defect. Since the hernia is repaired without tension and minimal suturing used, there is a less pain. The mesh is a polypropylene substance that has been around for years and is well tested. It is well accepted by the body’s natural tissues which grow into the mesh. Recovery is rapid and the likelihood of a recurrence is low. The laparoscopic method: this is a similar to the tension free repair. A laparoscope which is a camera and light source is inserted in the vicinity of the hernia. The surgeon can then visualize the procedure on a television monitor. Surgical instruments are then inserted through separate incisions. The hernia defect and sac are dissected out and the hernia sac and its contents reduced back through the defect. Mesh is then used to cover the defect and is held in place with surgical staples.

What is the best method for repairing a hernia?
Repairs are judged as good or bad depending on their recurrence rates. Obviously every surgeon strives to have a recurrence rate as close to 0% as possible. In reality however there is no such thing as a hernia repair that has a 0% recurrence rate. A tension free repair has a recurrence rate of approximately one half to 1%. A conventional repair, that is using suture material to close the hernia, can be associated with a recurrence rate as high as 10%. Recent studies have shown that a tension free repair using mesh as well as a laparoscopic repair have similar outcomes in terms of recurrence rates and complication rates. There are some patients that may be candidates for a laparoscopic repair depending on the type of work they do and their body habitus. Every patient is different and we try to tailor our recommendations based on the individual.
 
     
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