Hernia Repair: More Gains, Less Pain
Innovations in several areas are making major discomfort a thing of the past.
Jim Burger, Associate Editor
When it comes to reducing the pain of hernia repairs, plenty of gains have been made in recent years. Laparoscopic refinements, innovations in mesh and fixation devices, and a new drug-delivery system can all minimize discomfort and increase patient satisfaction. Here are 4 factors to consider in the quest to minimize, or virtually eliminate, the pain that traditionally accompanies hernia surgery.
1. Open or laparoscopic?
There's no question that laparoscopic procedures offer several advantages with inguinal hernias, but there are several variables to consider, one of the biggest being who's doing the surgery. "You have to look at the ability of the surgeon," says Guy Voeller, MD, FACS, professor of surgery at the University of Tennessee Health Science Center in Memphis and past president of the American Hernia Association. "Laps are more technically demanding. If you're not well-versed, you should probably stick with open."
But if you are, one of the benefits is likely to be less discomfort for patients.
"There's less acute pain, a quicker recovery and, when done properly, less chronic pain," says Dr. Voeller. "Of course you also have to consider the patient. If you're dealing with someone with a lot of other illnesses, or if the patient has comorbidities that make him high-risk with general anesthesia, you probably want to do open."
It depends on the type of hernia, too, says laparoscopic surgeon Sharona B. Ross, MD, of Tampa, Fla. "For large ventral hernias, I almost exclusively use an open approach, which results in a nice, flat abdominal wall. However, since laparoscopic surgeries do produce less pain and discomfort, there's less peritoneal trauma. Virtually all my inguinal and hiatal hernias I repair laparoscopically. The only time I use an open approach (with hiatal hernia) is when there's an especially hostile abdomen due to previous operations."
Dr. Voeller agrees. "With inguinal hernias, if there have been previous surgeries in the area, or if there's a lot of scarring, it probably should be an open surgery unless the surgeon is very experienced at laparoscopy," he says.
hernia surgery, hernia repair, innovations... show all keywords
hernia surgery, hernia repair, innovations
© Copyright Herrin Publishing Partners LP. REPRODUCTION OF THIS COPYRIGHTED CONTENT IS STRICTLY PROHIBITED. We encourage LINKING to this content; view our linking policy here.