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Ask The Expert Archive

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Hernia Archive Questions

Below are Dr. Kavic’s answers to Hernia questions
received through the Ask the Expert feature.

This content is provided for informational purposes only, and is not intended
to be a substitute for individual medical advice in diagnosing or treating a
health problem. Please consult with your physician about your specific health
care concerns.

Questions about this topic have been organized into several categories.
Click on a category name below or select "View All" to read all the Q&As in this archive.

. Inguinal hernia
. Hiatal hernia
. Pregnancy and Hernia
. Spiegelian hernia
. Sports hernia
. Umbilical
. Ventral hernia
. View all Questions
. All Questions

Now displaying records 1 to 15 of 15.


Q : 1

Do you do abdominal wall reconstruction using biologic mesh?

Hello, yes we do routinely. Biologic mesh is not always the best mesh, but in selected circumstances it has been shown to be quite useful.

Q : 2

I have three children. After my last child's birth I had a ventral hernia repair done with mesh, thinking we would not have any more children. I just found out I am 5 weeks pregnant. What are the risks involved with pregnancy now with a large mesh in my abdomen? Am I able to carry this pregnancy? Any advice is appreciated!

There is no cause for alarm. There is no concern over the pregnancy when a mesh is in place. If anything, you are at risk for developing another hernia, but that's about it.

Q : 3

What can I do to ease the pain of my hiatal hernia?

Hello, our first maneuvers are usually lifestyle - weight loss, loose fitting clothing, elevating the head of the bed at night. If the hernia is painful, a thorough evaluation by a gastroenterologist or general surgeon may help direct you toward surgery.

Q : 4

Do you perform hernia surgery without mesh?

Hernia surgery can be performed without mesh, but here in the U.S., the results are uniformly better when it is used. In other words, if I had a hernia, I would seek a mesh repair. If you are interested in avoiding mesh, look for a surgeon who performs the Shouldice repair.

Q : 5

My husband had umbilical hernia repair one week ago. After surgery he looked like he had a normal belly button but today we noticed his belly button is pushed out like it looked before the surgery. He had a repair with mesh. Is this normal?

Hello, he likely has a fluid collection above the mesh, called a seroma. Most seromas will re-absorb, with time (usually months). There is no medical problem that this will cause, but it can cause a lot of anxiety.

Q : 6

I have had an appendix surgery performed (leaked then 1 week of infection wound left open) about 10 years ago. About a year latter I experienced an incisional hernia and had it repaired. Now I have another incisional hernia and have likely had it for a couple of years. My question is there any way to fix this and if so where/who would you recommend me go see? Note previous hernia did use a screen to aid in prevention of reoccurrence. How many hernia surgeries do you perform annually?

It is fairly common for a wound that is infected to lead to a hernia. I'm not sure why a repair didn't work, but a laparoscopic or minimally invasive repair should do the trick. We do a lot of hernia repairs at the University of Maryland, and there isn't a week that goes by that I don't fix at least one or two. Please feel free to call our office for a consultation at 410-328-7592.

Q : 7

Is exercise is bad for Inguinal Hernia? Also, is there any activity that is beneficial?

in general, aerobic exercise is okay - walking, bicycling, treadmill, should not produce significant strain on the hernia. On the other hand, heavy lifting and exercise that makes the veins in your neck pop out is probably a bad idea. Swimming is particularly good.

Q : 8

Are there any tests (aside from a physical exam) that can be done to diagnose an inguinial hernia?

The best test is the physical examination. Sometimes, an ultrasound can be useful as well.

Q : 9

I have a large ventral incisional hernia that is about10-15 cm and contraction of the rectus muscles. My question is if you have ever done a laparoscopic surgery for a hernia this large? Also, with the rectus muscles so contracted, would you use a regular mesh to close the gap?

Hello, thank you for your question. The larger the hernia, the less satisfying it is to have repaired laparoscopically. In the end, you may be better served by an open repair with "separation of components" technique. I would consult a surgeon experienced in both open and laparoscopic reapirs for a more definitive answer.

Q : 10

What is the usual time it takes to perform a hernia surgery?

It depends on the location and the size. For groin hernias, most can be repaired in about an hour. For those at the belly button, anywhere between 20 minutes for a small one and 2 hours for a large one. Hernias around an old incision are the most variable due to the potential presence of scar tissue on the inside.

Q : 11

Are their any studies on how a women is affected by having an inginual hernia: how she will heal and how it will affect her return to work outside of lifting?

Inguinal hernias are about 7 times more common in men, so there is relatively little data about long-term results. In the short term, we expect good initial healing and a very high success rate of repair. Most people are back at work at full speed in about a month. Over the longer term (5-10) years, we anticipate good results with a low risk of recurrence.

Q : 12

What type of visible scar is to be expected after laparoscopic sport hernia surgery?

There are typically three puncture wounds - one at the belly button, which is largely hidden, and two to the sides, each 5 millimeters across.

Q : 13

If you are having surgery for the third time to repair a hernia what is the sucess rate of it not opening again?

This is an excellent question. There are no guarantees. The more scar tissue that builds up, the greater the chance of hernia recurrence. However, a lot depends on the type of initial repair. A laparoscopic, or minimally invasive repair, done with a generous piece of mesh, may have minimal risk of recurrence if the the first were done with stitches only or had some technical problems such as a wound infection.

Q : 14

Is hernia repair done on an outpatient basis?

In general, hernia repair is same day surgery: that is, you are repaired and discharged on the same day. For more complex hernias of the abdominal wall, or internal hernias, expect a short inpatient stay.

Q : 15

If a sports hernia goes undetected or untreated, what can the consequences be?

In general, the consequence is ongoing pain.


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