Hernias Do Not Have to Be Long-term Problems

Article

Although there are 2 types of abdominal wall reconstruction procedures, both use the same approach to repair the damage from a hernia.

The simplest way to describe a hernia is an opening in the abdominal wall that allows deep tissue or organs to push through. As these tears create massive discomfort and lead to more serious organ or tissue damage, life with a hernia can be incredibly painful.

The cause of an abdominal hernia can range from birth defects, to heavy lifting, to being overweight. Regardless of the cause, a hernia can become worse over time without proper treatment, making basic duties in life unbearable.

Therefore, it is our job to educate patients with an abdominal hernia about their surgical options. Fortunately, there are treatments available that can correct the damage done to the abdominal wall and help patients resume their normal lives.

During an initial consultation with a hernia patient, I always discuss the available surgical approaches and highlight the benefits of each procedure. However, the recommended course of treatment will depend on the patient’s particular needs, current situation, and health in order to achieve optimal results.

Although there are 2 types of abdominal wall reconstruction procedures, both use the same approach to repair the damage. However, they incorporate different materials, as one approach uses synthetic materials to close a hernia, while the other uses natural materials to achieve the same end result.

I find the most commonly used practice to reconstruct the abdominal wall is the synthetic approach. This procedure uses a strong mesh material to effectively hold the wound closed, which prevents the deep tissue and organs from pushing through.

While the mesh works well and allows the wound to remain closed without any additional tension, there is potential for some complications. Using synthetic materials has the small possibility of resulting in infection, rejection by the body, and fistula formation. While these complications are rare, they do occur in some cases and are factors that have led to research in natural materials — a fact that patients should know when considering their options.

On the other hand, the use of natural materials in abdominal wall reconstruction is relatively new. In this procedure, xenogenic and allogenic materials are used in place of synthetic materials to ensure a smooth introduction to the body. I always tell my patients the upside to using natural materials is that the complications associated with synthetic materials are significantly reduced, as the body is more likely to recognize the materials as belonging there, rather than treating them as foreign entities.

That said, I have found both approaches are effective in alleviating the pain and discomfort associated with abdominal wall problems, including hernias. The bottom line is there are options available for those who have been suffering with abdominal hernias, and it is our job to educate and work with them to help improve their overall quality of life.

Robert T. Grant, MD, MSc, FACS, is Chief of the combined Divisions of Plastic Surgery at New York-Presbyterian Hospital-Columbia University Medical Center and New York-Presbyterian Hospital-Weill Cornell Medical Center. He is also Associate Clinical Professor of Surgery in the College of Physicians and Surgeons at Columbia University and Adjunct Associate Professor of Clinical Surgery at Weill Cornell Medical College. For more information about Dr. Grant or to contact him, visit his website at www.robertgrantmd.com.

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