In Dr. Reinhorn started to focus on the care of hernia and pilonidal patients. In , Dr. Nora Fullington was recruited from her work as a general surgeon performing hundreds of laparoscopic hernia repairs to Boston Hernia. Together with their physician assistant team, they provide a focused practice designed to provide a superior clinical experience. The team performs approximately hernia surgeries every year and offers a tailored approach for each patient from anesthesia type to consideration of mesh and no mesh repairs, laparoscopic and open surgery.
We have published outcomes and continue to participate in hernia and surgery societies. Our research led to a reduction in opioid prescribing after hernia surgery.
Sometimes a general anaesthetic is used. This means you'll be asleep during the procedure and will not feel any pain. Once the anaesthetic has taken effect, the surgeon makes a single cut incision over the hernia. This incision is usually about 6 to 8cm long. The surgeon then places the lump of fatty tissue or loop of bowel back into your abdomen tummy.
A mesh is placed in the abdominal wall, at the weak spot where the hernia came through, to strengthen it. When the repair is complete, your skin will be sealed with stitches.
These usually dissolve on their own within a few days of the operation. If the hernia has become strangulated and part of the bowel is damaged, the affected segment may need to be removed and the 2 ends of healthy bowel rejoined. General anaesthetic is used for keyhole inguinal hernia repair, so you'll be asleep during the operation. During keyhole surgery, the surgeon usually makes 3 small incisions in your abdomen instead of a single larger incision.
A thin tube containing a light source and a camera laparoscope is inserted through one of these incisions so the surgeon can see inside your abdomen. Surgical instruments are inserted through the other incisions so the surgeon can pull the hernia back into place.
During transabdominal preperitoneal surgery, instruments are inserted through the muscle wall of your abdomen and the lining covering your organs the peritoneum. A flap of the peritoneum is peeled back over the hernia and a piece of mesh is stapled or glued to the weakened area in your abdomen wall to strengthen it. They are much less common than inguinal hernias and are far more likely to occur in women than in men.
They also present a higher risk of complications if they are not repaired. Ventral hernias occur though an opening in the muscles of the abdomen. There are three types of ventral hernias: Epigastric hernias occur above the bellybutton. Incisional hernias are caused by a weakening of the abdominal muscle resulting from an incision made during a previous abdominal surgery. Umbilical hernias , which occur near the bellybutton, are most common in newborns, especially those born prematurely.
These hernias usually close on their own by the time the child turns 4. Umbilical hernias can be more problematic when they occur in adults. Hiatal hernias occur when the upper part of the stomach bulges into the chest through a small opening the hiatus in the diaphragm.
The hiatus allows the esophagus, which carries food from the mouth to the stomach, to pass through the diaphragm. What are some hernia symptoms? What are the options for hernia surgery? There are two primary options: Open hernia surgery. The surgeon makes a cut in the groin to view and repair the hernia. After repairing the hernia, the surgeon uses stitches alone or stitches and a piece of mesh to close the abdominal wall. The mesh is designed to strengthen the weak area of the abdominal wall where the hernia occurred.
Laparoscopic hernia surgery. The surgeon makes several small cuts in the lower abdomen and inserts special tools to view and repair the hernia.
The surgeon typically uses a piece of mesh to close and strengthen the abdominal wall. There are some surgeons who opt for robotic repair, which means they sit at a console controlling robotic arms that perform the surgery. When might I need emergency surgery? Signs of this condition include: A hernia bulge that is suddenly larger than before A hernia bulge that used to go back inside the abdomen but no longer does Fever Redness in the area of the hernia Sudden or severe pain or tenderness in the area of the hernia Symptoms of intestinal obstruction, such as abdominal pain, bloating, nausea, and vomiting What type of anesthesia should I receive for surgery?
Several anesthesia options may be discussed with your physician anesthesiologist: Local anesthesia with sedation , also referred to as local with monitored anesthesia care , or MAC.
This is the most frequently used option. Local anesthesia is usually administered as a one-time injection of medicine that numbs a small area of the body. Sedation relaxes you and is usually administered and adjusted through an IV placed in your arm. Nerve block and sedation. This might be used for inguinal or femoral surgeries, especially if the patient has severe heart or lung disease that precludes the use of general anesthesia. Nerve blocks involve the injection of an anesthetic into specific nerves to block pain signals.
Spinal block and sedation. This less frequently used option numbs the body from the waist down.
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