HERNIA INSTITUTE OF PENNSYLVANIA
North Penn Hernia Institute
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EPIGASTRIC HERNIAS

EPIGASTRIC HERNIAS {photo} develop in the upper mid-abdomen, usually along the line between the sternum (breast bone) and the umbilicus (navel). Either a congenital weakness (meaning present since birth) or an acquired defect in the abdominal wall exists in this area allowing abdominal contents to protrude through creating a bulge. In addition to the deformity and an associated bulge, the signs and symptoms include pain at or near the area.

Epigastric Hernias can also occur at any time during later life. They cannot "heal" without surgery. These hernias gradually increase in size, often becoming progressively problematic as they enlarge. Incarceration or Strangulation are rare, but may occur on the occasion of large and neglected Epigastric Hernias.

Optimally, Epigastric hernias should be repaired using a 'TENSION-FREE TECHNIQUE.

Epigastric hernias often occur in adulthood because of progressive and significant tension on the area of weakness along the mid-line of the upper abdominal wall. This develops through the normal stresses and strains of daily activity. Standard techniques still widely utilized today attempt to repair these hernias by simply closing the muscle defect with sutures placing the muscle tissue under significant tension. Often in these older method repair techniques, muscle layers are overlapped. Such suturing not only recreates the muscle layer tension that originally created the hernia defect, but too often this process also weakens adjacent tissue layers as well. Moreover, this leads to unnecessary pulling of the tissues at the hernia area. We know that any tension on sutured muscles inhibits normal healing and causes swelling, pain and prolonged recuperation. These older suture-only techniques have been shown to be less effective than Tension Free mesh repairs with a significantly higher recurrent hernia rate later on.



THE RESULT OF HERNIAS REPAIRED WITH TENSION
Excessively prolonged recovery, and more importantly, a high risk of recurrence. This need not be the case any longer!


At The NORTH PENN HERNIA INSTITUTE, our Surgical Staff is now fully trained to repair these hernias effectively in a TENSION FREE fashion, most often as a "Same Day" procedure. This contemporary surgical technique is usually performed with mild sedation and local anesthesia, thus avoiding the risks of General Anesthesia. In Epigastric Hernias in adults, especially large and recurrent Epigastric Hernias, a Mesh is utilized to created a 'Tension Free' repair. The mesh is carefully opened "BELOW" (never over) the defect, extending somewhat beyond the under edges of the hernia 'hole' or defect itself. This immediately, safely and securely repairs the hernia. In addition, the mesh acts as a bridge or scaffolding for in-growth of new tissue to broadly support the abdominal wall muscle. In the process, the mesh safely becomes incorporated into the muscle layer. No muscle is cut, nor is it ever sutured together to create unnecessary or unwanted TENSION. The surgical mesh utilized for hernia repair is extremely thin and very flexible. Therefore it is undetectable to the patient both during normal day to day activity as well as during more aggressive physical and recreational activity. However, it is strong enough to fully and effectively repair the hernia such that our patients are fully able to resume NORMAL ACTIVITY without undue concern for recurrence. Plastic Surgery skin closure techniques are always utilized on Epigastric Hernias as it is in all of our hernia incisions.

Patients are discharged on the same day as surgery.

Return to NORMAL ACTIVITY in Days!!


215-368-1122
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Surgery is performed at
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Outpatient Surgery Department

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FROM: James A. Goodyear,M.D., F.A.C.S.

NORTH PENN HERNIA INSTITUTE
125 Medical Campus Drive, Suite 310
Lansdale, PA 19446-7205
215-368-1122

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