AMERICAN

'CENTER OF EXCELLENCE'
and
NATIONAL LEADER IN ADVANCED HERNIA SURGERY

North Penn
Hernia Institute

125 Medical Campus Dr.
Suite #310
Lansdale, PA 19446

215-368-1122
Fax:215-368-3569

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FREQUENTLY ASKED QUESTIONS, and ANSWERS!

INCISIONAL HERNIAS

and VENTRAL HERNIAS

INCISIONAL or Ventral Hernias may occur in the area of any prior surgical incision, and can vary in size from very small, to very large and complex. They develop as the result of disruption along or adjacent to the area of abdominal wall suturing, often subsequent TENSION placed on the tissue or other inhibition to adequate healing (infection, poor nutrition, obesity, or metabolic diseases).

These hernias present as a bulge or protrusion at or near the area of the prior incision scar. Virtually any prior abdominal operation can subsequently develop an Incisional Hernia at the scar area, including those from large abdominal procedures (intestinal surgery, vascular surgery), to small incisions (Appendectomy, or Laparoscopy). These hernias can occur at any incision, but tend to occur more commonly along a straight line from the breastbone straight down to the pubis, and are more complex in these regions. Hernias in this area have a high rate of recurrence if repaired via a simple suture technique under tension and it is especially advised that these be repaired via a TENSION FREE repair method using mesh.

These hernias may develop soon after the original surgery, or at any time thereafter. Incisional Hernias gradually increase in size once they develop and become progressively symptomatic. A bulge may not be evident at the hernia site initially, and pain may be the only early hernia symptom. These hernias develop in many cases as a result of too much tension placed when closing the abdominal incision, as stated above. Tension creates poor healing, swelling, wound separation and eventual Incisional Hernia formation.

Effective repair of Incisional Hernias must include a TENSION FREE approach. By eliminating tissue tension, we are able to significantly reduce the risk of subsequent recurrent hernias. This fact is not well understood by many surgeons who repair these difficult hernias utilizing a simple, tissue-to-tissue, suture-only technique.

Examination by a trained Hernia Specialist may be necessary to detect these hernias early on in their development, as well as to repair them properly to avoid recurrence and complications later on.

At The NORTH PENN HERNIA INSTITUTE, our Surgical Staff is able to repair many of these hernias effectively using our TENSION FREE METHOD. Here, mesh is placed broadly, under the defect in the muscle layer of the abdominal wall. The mesh extends well beyond the under edges of the hole or defect, and is not merely sewn to the hernia edges. Organs within the abdomen are protected from injury from the mesh by a naturally occurring membrane called "peritoneum", which is neither cut nor entered in this repair under most circumstances. Adhesions to intestine are thereby avoided. This approach assures an EFFECTIVE repair without tension, and without the need for tight and painful tension suture placement. The result is a more effective repair with a lower recurrence rate and a more rapid and less uncomfortable recovery.

In smaller and uncomplicated incisional hernias however, discharge on the "Same Day" as surgery is anticipated.

While this technique can in many cases be a "One Day" procedure, performed under local anesthesia and sedation, Large and/or more Complex Incisional Hernia repairs often do require General Anesthesia as well as a potential for an overnight hospital stay.

Patients with Recurrent Incisional Hernias, previously repaired using surgically-placed mesh, are quite often not acceptible candidates for repair using this method. While we are most happy to see such patients in consultation, it is strongly advised that a preliminary Telephone Consultation or E-mail Consultation be scheduled with one of our surgeons to determine your suitability and candidacy, so as to avoid unnecessary long-distance travel to the North Penn Hernia Institute. Importantly, the patient must be at or very near Ideal Body Weight or with a Body Mass Index (BMI) not over 28 and generally healthy medically to be considered an acceptible candidate for an INCISIONAL HERNIA repair procedure here at NPHI.

Full examination and evaluation are necessary to fully outline the operative approach in these large and complex cases. Importantly, this technique is quite effective and well tolerated even in these circumstances.

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Surgery performed at
ABINGTON HEALTH, LANSDALE HOSPITAL
in Lansdale, Pennsylvania

.

LARGE or COMPLEX
"INCISIONAL" and "VENTRAL" HERNIAS

Very large and/or complex Incisional Hernias often require General Anesthesia as well the potential for hospital admission.
PLEASE CALL
North Penn Hernia Institute
215-368-1122
to discuss your particular INCISIONAL HERNIA with our surgeons prior to your consultation or surgery.

IMPORTANT PATIENT CANDIDATE CRITERIAINCISIONAL HERNIA REPAIRS-

The patient should be at or near Ideal Body Weight or with a Body Mass Index (BMI) not over 28 and generally healthy medically to be considered a good candidate for this safe and effective INCISIONAL HERNIA repair procedure. Again, it is strongly advised that a preliminary Telephone Consultation or E-mail Consultation be scheduled with one of our surgeons to determine you suitability and candidacy, so as to avoid unnecessary long-distance travel to the North Penn Hernia Institute.
.
RECURRENT INCISIONAL HERNIAS, previously repaired elsewhere using mesh, especially in those individuals exceeding Ideal Body Weight, may not be able to be repaired with this method. Patients with current abdominal wall infections, drainage or open wounds may not be ideal candidates for this technique. Consultation and comprehensive examination beforehand is necessary in patients with a Recurrent Incisional Hernia previously repaired using mesh. Again, it is strongly advised that a preliminary Telephone Consultation or E-mail Consultation be scheduled with one of our surgeons to determine you suitability and candidacy, so as to avoid unnecessary long-distance travel to the North Penn Hernia Institute.
Please feel free to call our office to speak to one of our surgeons about your INCISIONAL HERNIA to find out if you are a candidate for this advanced, effective method of Incisional Hernia repair prior to long-distance travel for a consultation. (215-368-1122)

These weight requirements are mandatory only for Incisional Hernias, and are NOT mandatory for Inguinal (primary or recurrent), Umbilical or Femoral hernia repair techniques.

215-368-1122
PLEASE CONTACT US with QUESTIONS or COMMENTS

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