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Thread: Hernia

  1. #1
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    Oct 2015
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    Hernia

    I have been diagnosed with a fat containing hernia in my abdomen near the site of a prior laproscopic incision. Non-emergency, working through being seen by whoever it is I need to be seen by.

    Thoughts on avoiding a repeat occurrence? There appears to be some discussion around the effectiveness of mesh, more incisions just causing more hernias etc. This was likely triggered by a nasty cough I had a few weeks ago.

  2. #2
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    truckee
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    Whether or not it needs mesh depends on how big the defect is. Since it's from a laparoscopy incision probably doesn't need but that's up to the surgeon. Get it fixed--it will only get bigger with time and the bigger it is the more surgery it will take to fix it and the less likely the surgery will be effective. I would think they would do a simple open repair--make an incision over the hernia, sew up the hole in the muscle layer, close the skin incision. There wouldn't be any new incision made in the muscle layer that would be a potential site for another hernia.

  3. #3
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    vernon
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    I have one in my belly button area, seems to be getting a bit larger. Been there for 2 years now, surgeon at the time said best to leave it.

    It does worry me pulling stuck sleds out in the B/C though.
    www.skevikskis.com Check em out!

  4. #4
    Join Date
    Dec 2017
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    Ive got what was half assed diagnosed as a sports hernia in my right groin. Been there two years, I live through it. It does suck though.....need to get it fixed this next off season.

  5. #5
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    Evidence based best practice would suggest that all incisional hernias be repaired with a mesh. its extremely common to develop a hernia post laparoscopy. Depending on the structure of your health care system, you could see your family dr who would referee you to a general surgeon. Alternatively, if you can readily access the surgeon who performed the original laparoscopy, then just skip the GP, as they will (likely) be preforming the repair anyway.

    Inguinal Hernias (described by el hefe and Glen1978) can be managed differently. Unless they are symptomatic, you can just watch them and wait. (symptomatic hernia is one that can not be reduced, causes pain, or interferes with your daily life). That said, something crazy like 80% of people who follow the watch and wait program, eventual have surgery with in 10 years. Some high stress employment scenarios list inguinal hernias a contraindication to being fit for employment (fire fighters as an example). Personally, I would elect to have a surgical intervention to repair an inguinal hernia, and would not watch and wait for a prolonged period of time. The rational being, that I am an active individual who doesn't need this becoming a complication at an inopportune time, and I currently have no comorbidites that would other wise complicate a simple procedure.

    But all that said .... what ever your dr and you decide is right works too.
    "Its not the arrow, its the Indian" - M.Pinto

  6. #6
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    Quote Originally Posted by cmcrawfo View Post
    Evidence based best practice would suggest that all incisional hernias be repaired with a mesh. its extremely common to develop a hernia post laparoscopy. Depending on the structure of your health care system, you could see your family dr who would referee you to a general surgeon. Alternatively, if you can readily access the surgeon who performed the original laparoscopy, then just skip the GP, as they will (likely) be preforming the repair anyway.

    Inguinal Hernias (described by el hefe and Glen1978) can be managed differently. Unless they are symptomatic, you can just watch them and wait. (symptomatic hernia is one that can not be reduced, causes pain, or interferes with your daily life). That said, something crazy like 80% of people who follow the watch and wait program, eventual have surgery with in 10 years. Some high stress employment scenarios list inguinal hernias a contraindication to being fit for employment (fire fighters as an example). Personally, I would elect to have a surgical intervention to repair an inguinal hernia, and would not watch and wait for a prolonged period of time. The rational being, that I am an active individual who doesn't need this becoming a complication at an inopportune time, and I currently have no comorbidites that would other wise complicate a simple procedure.

    But all that said .... what ever your dr and you decide is right works too.
    comorbidites ???? I think I will just leave mine in so you have pull all the stuck sleds while I watch and drink beer
    www.skevikskis.com Check em out!

  7. #7
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    Quote Originally Posted by el hefe View Post
    comorbidites ???? I think I will just leave mine in so you have pull all the stuck sleds while I watch and drink beer
    Not only am I lazy ... but while I am quoting best practices .... you only want to expose one person to an avy hazard at a time ... so, to keep everyone safe I am just going to have to stay on the sidelines and watch you figure it out.
    "Its not the arrow, its the Indian" - M.Pinto

  8. #8
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    I would recommend relatively young, relatively healthy people to have inguinal and other hernias repaired, regardless of whether they are symptomatic or not. If they are not now they will be and repairing longstanding, large hernias is more morbid and somewhat less successful than fixing small, recent ones. The biggest concern is chronic pain from the surgery. The frequency of chronic pain has been said to be as high as 10%, although in my experience it is a lot less. (I practiced in a closed health care system where I would hear about any of my patients with complications whether they came back to me or to someone else.) Over the years I modified my technique with the intent to reduce the risk of chronic pain, perhaps at the risk of a higher recurrence rate although I have no follow up on my later cases.

  9. #9
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    Thanks for the info!

  10. #10
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    I should qualify my last post--chronic pain is primarily a risk with inguinal hernias, shouldn't really be a factor to consider with repair of a port site or trocar site (post laparoscopy) hernia.

  11. #11
    Join Date
    Mar 2006
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    Quote Originally Posted by Glen1978 View Post
    Ive got what was half assed diagnosed as a sports hernia in my right groin. Been there two years, I live through it. It does suck though.....need to get it fixed this next off season.
    Mine lasted a couple years but eventually healed. Swimming light breastroke frog kick really helped me.
    Last edited by 4matic; 12-05-2018 at 03:04 PM.

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