Q
: 1
01/26/2009 |
How many laparoscopic diaphragmatic hernia surgeries do you perform in your hospital and which surgeon do you recommend?
On average, we are doing about 4-6 of these types of cases a week. This a specialty and focus for Dr. Adrian Park. His office can be reached at 410-328-6187.
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Q
: 2
01/01/2009 |
Since a sports hernia is not detectable, how does the surgeon know where to operate?
You can do imaging studies beforehand, but laparoscopy (camera) allows you to see the hernia before doing any sort of procedure.
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Q
: 3
04/01/2008 |
I've had an inguinal hernia for a few months now. Is this type of hernia repairable using minimally invasive techniques or does it require an open incision?
Most inguinal hernias can be repaired laparoscopically. It is essential that you identify a surgeon that is experienced with this technique. There are many advantages to laparoscopy including quicker recover and less pain. Long term recurrences rates are comparable between open and laparoscopic repairs. If you wish to come to the University of Maryland Hernia Center, I would be happy to see you.
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Q
: 4
03/16/2008 |
I have a hital hernia. My doctor said that I should get treatment via laparoscopic nissen fundoplication but I don't feel all the symptoms. I just burp more often than before and sometimes my chest hurts right in the center, and also I've noticed that my stomach is a bit swollen. I've searched in the Internet and some articles say I shoud get it treated and some that I should not. What should I do?
You should undergo a 24-hour ph probe to determine if your symptoms are related to reflux. If you are controlled with medications then surgery is an option, but continued medications is also reasonable. If you have persistent symptoms while taking medications, then surgery may be your only option. If you have developed any complications of reflux, then surgery should also be considered. If you have not had an endoscopy, this should also be performed at this time.
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Q
: 5
03/11/2008 |
I am 7 months pregnant and have a ventral hernia. I saw a surgeon and he said he would like to operate to repair it 2 months after my baby is born. Is this a common thing to do right after giving birth? I had an ultrasound done over a month ago to determine the size which at the time was 2cm. The surgeon said it would grow in size due to my growing belly. I'm weary about putting anything foreign into my body (i.e. mesh) and my husband and I may want to have more children. Would the hernia come back if I repaired it before becoming pregnant again or should I wait and repair it until after I am done having kids?
If the hernia is not symptomatic, it is not unreasonable to wait until you have completed having all of your children. There is a small risk of an incarcerated hernia with pregnancy which could require emergency surgery. However, if repaired, the hernia could reoccur with pregnancy. I would not place a mesh in a woman that desires to have further children. The mesh will not stretch and can potentially prevent the uterus from expanding and can also cause pain.
These are general guidelines, but this is a highly controversial area.
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Q
: 6
03/09/2008 |
I had a umbilical hernia repair five years ago. Now I'm having the same pain above my belly button again. There's a small lump just like before. The only difference is I'm in severe pain, and feel sick to my stomach. This has only been going on for three days. Is it possible to have a recurring umbilical hernia?
Unfortunately, umbilical hernias may recur. You should contact your physician to have this evaluated soon. It likely will need to be repaired again. I would recommend a laparoscopic approach with mesh.
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Q
: 7
03/09/2008 |
I'm fairly certain I have a sports hernia. If these are even hard to see on scans, how is the diagnosis
confirmed? What is typical recovery time after
surgery? I have a golf trip planned for April 9th and am wondering if surgery between now and then would put golf
off limits?
Sports hernias are generally a diagnosis of exclusion. Scans are generally negative. They are confirmed at the time of an operation. Adequate rest of a minimum of two months is required prior to considering surgery. MRI is generally performed to identify other potential causes of pelvic pain. Postoperative rest is 4 to 6 weeks.
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Q
: 8
12/05/2007 |
I am currently 22 weeks pregnant and had a strangulated hernia repaired last February that was done with mesh. I am having extreme pain and my surgeon keeps sending me home and telling me I am fine. I have been to the emergency room at my local hospital and they send me home too. Could the mesh in my stomach be giving me this pain and is there anything I can do about it? I am trying to schedule an appointment with you, but don't know what to do in the meantime.
Surgery during pregnancy is only an option if it is emergent. The hernia mesh will not stretch. I try to avoid mesh in women that plan to become pregnant as the enlarging uterus may cause the mesh to tear from the abdominal wall and result in pain or hernia recurrence as a result of the mesh not stretching along with the abdomen. If you have developed a recurrent hernia, it should be managed with a binder unless it incarcerates or strangulates. If your problem is only pain without a hernia recurrence, then you will likely need to do your best to manage your pain until after delivery. If the pain persists after delivery, you may need to have further diagnostics tests or procedures to determine the etiology of your symptoms and hopefully resolve them without surgery. Many patients with pain from hernia repair without a recurrent hernia can be treated with nerve blocking injections.
This is a difficult problem without an easy answer. Surgery during pregnancy puts both you and the baby at increased risk and is not appropriate except for emergency conditions.
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Q
: 9
11/30/2007 |
I have complex ventral hernia that is very large. I look six months pregnant. I am obese, weighing 350 pounds. No doctor I have contacted so far will do surgery until I lose 100 pounds. Would you?
The risk of hernia recurrence will be much higher if you do not lose weight preoperatively. Ideally, some weight loss preoperatively would help to minimize the risk of having to have another operation in the future. However, if the hernia is extremely symptomatic, occasionally I will repair hernias prior to weight loss recognizing the higher risk of recurrence and need for further surgery.
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Q
: 10
11/27/2007 |
I have had two inguinal hernia repairs within the last six months. I have a hard ridge under the skin where incision done. I have had pain prior to and after surgery, and it worsens with abdominal exercise, or certain movements. I have been going to get steroid/nerve blocks to help, but it still hurts so badly that I sometimes cry because of it. The surgeon says he may have to go in and remove all the mesh and sew it all up. Any ideas why it would still hurt so badly? I can bear down and nothing "pokes" out, but straining with a bowel movement makes my inguinal area hurt too. There is an area that both the doctor and myself can feel a "hole" in between muscles in my abdomen. All of this pain started about a year and a half ago when had exploratory laporoscopy for endometriosis (which a doctor botched). Thank you for any light you can shed on this. I am desperate for answers.
This sounds suspicious for nerve related pain following your hernia surgery. If pain management and physical therapy have not been helpful, you may need an exploration with division of the nerves and removal of any contracted mesh. After performing this, the hernia will then need to be re-repaired. Without a new mesh, the hernia is likely to recur. I would favor placing a new mesh inside the abdomen (Propertoneal) at the time of the mesh removal.
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Q
: 11
11/16/2007 |
My wife has a ventral hernia but might want to get pregnant. What are the risks of not treating the hernia and getting pregnant? Is there something surgical that could be done that would help the hernia during pregnancy without using a mesh? Could she use some type of external device to support the muscles?
We're at a crossroads because she would like to treat the hernia, but might also like to get pregnant.
This needs to be carefully considered on an individual basis. If left untreated, the hernia could incarcerate and require emergency surgery. However, the hernia could recur during pregnancy. If the hernia is manageable, I would favor delaying repair until after she has completed childbirth. A binder may minimize symptoms.
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Q
: 12
11/13/2007 |
I have extreme pain just above my groin on the left side. There is no swelling. It is really painful when I sneeze or cough now. The pain does go down into the groin at times. I'm an extremely active soccer player and weight lifter. The onset of pain occurred after a game three or so weeks ago. I'm assuming this is a sports hernia as I am used to typical groin injuries and this seems nothing like that. I'm really not good at resting so I believe a diagnosis and surgery would be the step I should take. Does this sound like a sports hernia?
Sports hernias are a diagnosis of exclusion. A trial of rest for six weeks is mandatory. Most groin injuries will resolve with rest. MRI is performed to exclude muscle injuries or stress fractures of the pubis. Occasonally, sports hernias will be seen on MRI, but usually not. If your exam is consistent with a sports hernia following these measures, then exploration is an option.
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Q
: 13
10/25/2007 |
Can you die from hernia surgery? My mother is worried that she is not going to make it if she has this surgery thank you for you time concerned son.
In general, death following elective hernia repair is unusual. However, complex hernias or multiply recurrent hernias or patients with multiple medical problems will have higher risks than those with straightforward conditions.
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Q
: 14
02/17/2007 |
I'm 16 weeks pregnant and my doctor just confirmed that I have an umbilical hernia. I started to notice it a month ago and it has gotten bigger and more painful, especially after certain activities. I have to call a specialist but am interested in your opionion on surgery. Should I have it now or wait until after delivery?
I would wait until after delivery. The hernia will certainly reoccur if repaired during pregnancy.
You need to make sure that the hernia remains reducible. Once the uterus is above the umbilicus (20-22 weeks), the likelihood of a strangulated hernia will likely decrease as the uterus will be blocking the hernia defect preventing bowel from becoming trapped.
You should have this repaired 6-12 weeks after delivery.
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Q
: 15
01/25/2007 |
I am 12 weeks pregnant and have been sent to a surgeon to have my umbilical hernia repair done at 18 weeks due to the fact it has omentum tissue in it. How dangerous is this for me during pregnancy to have the surgery?
Surgery during the second trimester is the safest although it still carries increased risk to you and the baby. In general, I do not recommend hernia repair during pregnancy as the enlarging uterus will strain the repair and will likely cause a hernia recurrence. I typically recommend hernia repair one year prior to conception.
In your situation, the risk of an incarcerated hernia requiring emergency surgery has to be weighed against the risk of complications to you or your baby with an elective operation during pregnancy.
this can only be determined with a thorough history and physical examination.
You have time to get another opinion. The second trimester begins at 14 weeks. If you need the repair now, I would favor a repair at 14 weeks. This would give the repair longer to heal prior to the uterus enlarging significantly and stretching the new hernia repair.
As you can see, there is no clear answer to your question and this relies on sound judgement and decision making based on the available information.
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