News Feed Discussions Having second thoughts! Input please. Having second thoughts! Input please.

  • DrEarle

    May 22, 2016 at 2:27 pm

    Having second thoughts! Input please.

    gretarae – The proper way to decide if/how to repair your hernia is to follow a process that takes in to account your individuality, the surgeon’s perspective and ability, and available technology. 1) Identify your goal. Why do you want it fixed? Normalize abdominal wall contour, relief of symptoms, prevention of it getting worse, scar revision, etc. May be a combination of things. 2) Look at you own medical and surgical history, particularly as it relates to complications, especially infection. 3) Look at the details of the hernia – location and size of defect, and sac. 4) Choose a technique that will most likely obtain your goals (which your surgeon should align with) with the least possible risk. 5) Choose a mesh (or not) that best fits with the technique, and your goals. If you follow this, you will make the best decision you can. Will it be right? Only time will tell.
    A couple more thoughts:
    – There are many types of “component separation” techniques. Make sure you are having one that spares the blood supply coming from the peri-umbilical blood vessels (perforator-sparing). Sparing these blood vessels drastically reduces the risk of skin problems in most studies.
    – If recurrence is your biggest goal, go for a permanent prosthetic that is specifically designed for the technique being used, and strong enough to bridge a gap if needed. There are some mesh products that are simply not strong enough to bridge large gaps, such as Physiomesh. While there is no cut-off number, a basic understanding of what features each mesh has will enable the surgeon to use the most appropriate mesh for a given patient’s hernia repair. Many surgeons don’t have a solid understanding of the mesh products available.

    Hope this helps!