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Surgical Repair Technique

at the
North Penn Hernia Institute
Surgical Repair of EPIGASTRIC HERNIAS can be SAFELY and EFFECTIVELY performed as a "Same Day", out-patient ambulatory procedure. This includes most "RECURRENT" Epigastric hernias as well. For the most common Epigastric Hernias, we utilize a "Tension Free" repair, increasingly recognized by Hernia Specialists as the most superior method for hernia surgery. We are now convinced that this technique is truly the "STATE OF THE ART" in hernia surgery, providing the safest, most effective repair with the least post-operative pain.

We utilize a Mini-Incision "Open" Technique, using mild sedation and local anesthesia (i.e., Novocaine-like medication) for the overwhelming majority of all hernia repairs, including Epigastric Hernias. The repair of these hernias is performed through a small incision (about 1-2 inches or less in most average patients). With the patient awake, yet calm, sedated and comfortably free of pain, the risks of General Anesthesia are avoided. Our patients are walking shortly after surgery, and are discharged home within about 1-2 hours with minimum restrictions.

Once the hernia (bulge) is freed up by gentle dissection, it is returned through the hole or weakness into its proper position. Rather than just suturing the defect closed under tension or covering over the weakness at this point, a specially designed, sterile "Mesh" system is gently placed through the defect. It is then carefully opened on the under-surface of the muscle to efficiently reinforce and effectively repair the defect from the inside, by far the best place for mesh to be positioned. This "under-lay" mesh extends well beyond the under-edges of the defect to reduce pressure on the hernia defect opening, and at the same time reinforce the entire weakened and hernia-prone area. The mesh is held in place without tension. No painfully tight sutures are placed under tension to pull muscle unnaturally together, nor are staples or tacks utilized in this method. The mesh placed in a completely tension free fashion, being held firmly in place by a "VELCRO-Like" effect which rapidly develops between the mesh the abdominal wall itself. Since there is no tension, and only a minimal amount of surgical dissection, there is little post operative pain. Patients return to NORMAL ACTIVITY in DAYS. This technique has been essentially utilized for over 10 years, with recurrence rates of Less than 1/2 %, lower than any other technique including the conventional suture repairs, (TENSION REPAIR), or the Laparoscopic "Keyhole"Approach. WE FIRMLY BELIEVE THE TENSION FREE APPROACH IS THE MOST EFFECTIVE METHOD AVAILABLE.


Several Mesh Systems" are available. We feel that no two patients are alike and therefore no two hernias are alike either. All hernias differ from patient to patient, often quite significantly. We therefore feel that no one single TENSION FREE operative approach nor single mesh product system is suitable for all patients or all hernias.

Surgery at NORTH PENN HERNIA INSTITUTE is tailored specifically to the individual needs of each and every patient. We are expertly familiar with the various advanced Tension Free repair techniques commonly in use today, and all of these mesh system methods and diverse products are fully available to us. Rather than utilizing the same mesh product for all hernias, we individually select the precise mesh product (selecting the precise size, shape, configuration and manufacturer) at the time of surgery that is best suited for each hernia. This selection process, which is the foundation for what we call the "Benchmark" approach, is based on our extensive experience, developed by performing nearly one thousand various hernia repairs annually and "specializing" in hernia repairs for over 20 years. This expertise in both routine and complex hernia surgery assures that all of our patients receive the most satisfactory, safest and importantly the most effective repair available.

Recovery is therefore more rapid! Pain is minimal, since muscles not cut and are neither pulled together nor sewn under tension. Post-operative restrictions are few, if any, and our patients can actually return to NORMAL activity in DAYS! This includes resumption of work and recreational activity when desired.

This fully effective contemporary repair technique allows for your comfortably rapid recovery. The advanced techniques we utilize are associated with the Lowest Risk of Recurrence when compared to most other older surgical techniques which place extreme tension on the muscle and the repair by simply cutting and sewing muscle together. Our BENCHMARK technique is equally safe and the fully effective for "Recurrent" Hernias as well.

In addition, and equally important, Hernia repair with this advanced "Benchmark" approach is:

For Specific Questions on Inguinal or other Hernia Repairs


or Call 215-368-1122

Thank You,
James A. Goodyear, M.D., F.A.C.S.
Surgeon and Director