You know you have a hernia. What next?
What do you do before the surgery?
You may have been recommended to a surgeon by your general practitioner or physician. You may have obtained the name of a surgeon from others, such as relative or friend who has had a similar procedure.
However as shown by you visiting this site you are looking for more information and possibly wish to choose a surgeon based on that surgeon’s experience and specialisation in a technique that you particularly wish to have carried out on yourself.
There are many choices of technique. There are 2 broad methods mainly used today.
The open technique
Here a small cut is made directly over the hernia and the hernia is repaired under direct vision. A non – absorable Mesh which stays permanently in place is frequently used.
The other technique, which has developed over the last 10 years, is a laparoscopic or “keyhole” surgery technique where the operation is performed from within, under general anaesthesia using instruments remote from the site of the operation. This technique always requires the use of a Mesh after distension of the abdomen, or the abdominal wall with a gas.
I recommend the open repair using local anaesthetic infiltration with light intravenous sedation and mesh reinforcement.
This is called “tension free repair”. It was popularised by Lichtenstein of California and has increased in popularity for many reasons as will be elaborated later.
Another major advocate of the “tension free technique” is Mr Martin Kurzer of the British Hernia Centre in London.
More recently there has been increasing tendency to use what are called Mesh plugs which can be inserted between the muscles or deep to the muscles. This also avoids tension and can be used in particular circumtances.
When you are seen by a surgeon, he will confirm your diagnoses and advise you as to whether surgery is necessary. He will advise you regarding the technique to be used and the possible risks and complications.
Most hernia surgery is trouble free. At the Melbourne Hernia Clinic, we believe the best and safest technique is the tension free open technique carried out under local anaesthesia and sedation. Where another technique is desirable this will be discussed and used.