Hernias

Dr. Rafael Lugo is  a hernia surgeon in the the woodlands

What is a hernia?

A hernia is an abnormal opening or defect in the abdominal wall that could be acquired or genetically predisposed.  

Why hernias have different names?

The name given to a hernia is dependent on the location. Although there are many different types of hernias, the principle used to repair them is the same. As you can see in the picture below, these are the most common hernias seen and their approximate locations.

How is a hernia reapired?

The principles of hernia repair are basically the repair of the opening in a tension-free fashion. In the past, the only means to do this was by stitching the opening with sutures primarily. For the last 50+ years, hernia repair has been enhanced by the use of mesh. Mesh has been one of the most important developments in hernia repair and has made it possible to repair defects that were virtually impossible to fix in the past without undue tension.  Although in recent years the use of mesh ah been attacked by some, the mesh is still a necessary tool used in the repair of virtually all hernias. when used appropriately the risks as minimal.

What role does tension play in hernia repair?

Tension is avoided since it will be a big determining factor when predicting the recurrence of the hernia. The use of mesh is responsible for the low recurrence rates we see today in most hernia repairs. It is important that surgery is tailored to the specific patient needs and type of hernia as well as the type of mesh used. There are many choices of meshes as one might imagine. At Lugo surgical, we always try to limit our choices to proven methods and products that yield the best results possible. We are not swayed by the marketing tools used by large companies unless there is scientific evidence to prove them.

How is mesh selection made and procedure selection made?

As there are many meshes, there are also a variety of procures and ways to repair a hernia and the choice will be dependent on the location and mechanism of the hernia. Minimally invasive surgery is utilized as long as we do not compromise the results and recurrence rates. Again, this is discussed with each patient in a one on one fashion and very personal way. Everyone's needs are personalized and customized to your best solution. 

Hernia Types (see picture above fora.  visual reference)

Ventral -Generic name for a hernia in at the abdominal wall 

Inguinal - Hernia located in the groin

Incisional - Hernia located in a location where a previous surgery was done

Umbilical - Hernia located around o at the umbilicus

What are some of the possible complications of hernia surgery?

Hernia surgery is not exempt from complications, but we are able to minimize these with the newer techniques and equipment we have at our disposal.

Some of the most common risks are, bleeding, infection, recurrence, bowel injury, need for more surgery, numbness, pain, need for more surgery and surrounding organ or structure injury. Also, mesh as a foreign body can cause some unforeseen and personal problems that are specific to a particular patient. We can discuss all in more detail during your visit.

What is general post-operative care after hernia surgery?

In general, the procedure is done as an outpatient procedure and same-day surgery. You are allowed to shower in 24 h\ours and to be active from day one. you can go upstairs and downstairs and lift anything that you can lift without the use of your abdominal muscles. Most people are back to work within a week and I release you for any lifting after the second week. 

Every person has different needs and for that reason, the post-operative care will be customized to each person specifically. 

 Wha Meshes are Used?

Ventral Hernia - Bard ECHO

Inguinal hernia - ETHICON PHS

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