Considerations of Repairing a Hernia When Pregnant

January 24, 2024

Woman with watch covering pregnant stomach with both hands

We know the risk of developing a hernia is greater when abnormal pressure is placed on the abdominal wall. And rarely is more pressure placed on the abdomen than during pregnancy. Indeed, there is a risk of a midline or umbilical hernia developing during this time. It may be harder to notice a hernia when you’re pregnant, but a telltale sign is when a lump near the umbilicus or belly button protrudes more when you cough or sneeze. You may also feel added pressure, a burning sensation, or pain/tenderness in the area.

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Mesh Removal After Hernia Surgery

January 10, 2024

Doctor and an assistant in the operating room for surgical venous vascular surgery clinic in hospital

Well over 90% of all hernias are repaired with mesh. This is because mesh offers a level of strength that dramatically reduces the incidence of recurrence. Mesh repairs have been performed for decades and have proven highly effective and well-tolerated. Indeed, newer, lighter, and more customized meshes have made this stellar record even better of late.

However, there are rare risks associated with mesh implantation:

  • The patient may have a significant foreign body reaction that can lead to infection, which ultimately may cause the primary hernia repair to fail
  • Over time, the mesh may migrate from its original position or curl, causing pain in the surrounding area
  • The mesh may erode into a nearby organ, causing significant discomfort or pain and requiring reoperation
  • Finally, if the mesh is placed improperly, it can entrap nerves and cause significant chronic pain and possibly a recurrence.

Risk factors include:

  • Smoking, which makes abdominal tissue weaker
  • Having a hernia repaired over a decade ago when mesh technology was not as advanced
  • Not following post-operative instructions

In some cases, mesh removal may be indicated when conservative treatment options have been exhausted. However, removing the mesh is a complex and intricate procedure with additional risks.

Mesh removal will usually require the rebuilding of the abdominal wall. A plastic surgeon will typically work with one of our general surgeons to ensure the best outcomes. When employing experienced surgical providers, surgery to rebuild the abdominal wall is generally very successful and further strengthens the hernia repair against recurrence. Of course, this procedure has some inherent risks, which will be explained during consultation.

Patients experiencing discomfort because of a past hernia repair with mesh should know that there are several treatment options available that are more conservative than mesh removal. These options can be discussed with a general surgeon, such as those at MIIS, who have experience with complications after hernia repair.

Most importantly, we encourage you to visit one of our providers to see your options for correcting the previous repair.

Can Supplements Improve Your Recovery After Surgery?

October 24, 2023

Supplements scattered on table

With thousands of self-proclaimed biohackers on the Internet making seemingly incessant YouTube videos about supplements and their potential benefits, deciding whether to take one can be daunting. For one, supplements are not regulated by the FDA, and therefore, the quality and purity of the item may be questionable. Second, supplements often aren’t researched as part of well-made and controlled studies, so their benefit can be anecdotal rather than based on solid science and data.

On the other hand, supplements can be essential, especially if you have a deficiency. This is not only the case for bariatric patients whose supplement regimen can be the difference between good results and ending up in the hospital, but it goes for just about anyone.

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Top Five Tips for a Successful Surgery

October 10, 2023

Man smiling in nature scene

Surgery can be daunting, but with refined techniques and minimally invasive technology, it has never been safer to go under the knife. With that said, patients must follow certain directions before their surgical procedure to ensure that it is as safe as possible and successful as it can be afterward. These tips are meant to help patients improve their health before surgery or give the surgeon the information they need to best perform the procedure.

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To Shave or Not to Shave Before Surgery

September 19, 2023

Depending on the area being treated, patients may believe they are helping their surgeon by shaving any hair that exists there. On the surface, this is an excellent idea as he would think hair could be a contaminating factor, leading to the possibility of infections or other complications. The medical community thought that shaving the surgical area was appropriate until, relatively recently, we began to understand that shaving the surgical site may be counterproductive. To clarify, you must read your pre-surgical instructions, which may include trimming your hair, but we rarely suggest that a close shave with a razor be performed before surgery. Doing so increases the chances of folliculitis or infection of the hair follicles, which can cause a superficial but ultimately problematic infection.

Instead, we will often shave the area in the pre-op area or operating room before performing the procedure. If the patient has a significant amount of hair in the area, we may ask them to use clippers to trim it, but not down to the skin.

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Do All Hernias Hurt?

September 5, 2023

Man holding stomach in hernia pain

The very idea of a hernia sounds pretty painful. After all, it is a hole or defect in the strong lining of the abdomen known as the fascia. How could it not hurt? It may be interesting to know that while most patients believe the defect is painful, this is not the case. Usually, the entrapment of fat or intestinal tissue within the hernia defect causes the pain and discomfort people complain about.

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Concerns Over Wegovy and Gastroparesis

August 22, 2023

Black injectable lying on pink backdrop

With all the attention that weight loss medications like Wegovy are getting, we must show both sides of the story. In this case, for some patients, Wegovy, which consists of 2.4 mg of Semaglutide, a GLP-1 receptor agonist, has shown genuinely remarkable results, with some patients losing as much as 15% of their body weight. For patients on the lower end of the obesity scale, this is exceptional and may improve or eliminate some of their excess weight-related problems. A recent study showed that the risk for a major cardiovascular event drops significantly with patients taking Wegovy for weight loss. Again, these weight loss drugs can be a lifesaver for the right patient.

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Parsing the Trend of Increasing Laxative Use

August 8, 2023

white pills in clear bottle in front of orange backdrop

According to a recent Wall Street Journal article, there has been a significant trend in using laxatives among the aging population and even younger people. The movement originated during the worst COVID pandemic when virtually every part of our lives was thrown off kilter. However, there are also easily explained causes for this increase in demand, like a population that is also steadily aging – laxatives tend to become more necessary as we age. However, this phenomenon still doesn’t fully explain why younger people buy and consume laxatives more than ever. Let’s discuss some reasons and what we can do about it.

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How Do I Know I’m Having a Gallbladder Attack?

April 25, 2023

Man grabbing abdomen in pain from gallbladder attack

When it comes to abdominal pain, safe is always better than sorry. Like most aches and pains around our bodies, abdominal pain is usually not much to worry about. However, many vital organs are contained in the abdomen, and if they become diseased or unhealthy, they can begin to cause us pain. This can manifest as dull, deep aches or sharp, stabbing pains. They could last for just a few seconds or several hours. While many abdominal pains require significant diagnostic testing, a few have a very predictable profile and are often readily diagnosed, sometimes even without advanced imaging.

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Do We Check for Other Problems While in the Abdomen?

April 11, 2023

If you are having a general surgical procedure in the abdomen, you might be interested to know that we insufflate or expand the abdominal cavity by pumping in carbon dioxide (CO2). This is essential for better visibility within the abdomen and for giving our instruments room to move and perform the surgery. But with that excellent visibility, do we poke around to see if anything else is wrong with the structures within the abdomen?

Typically, when performing surgery in a particular area, we tend to remain in that space because we are uniquely set up for that surgery. There are times when we can perform combination procedures. For example, if a bariatric procedure is being performed, it is possible to remove the gallbladder should it be symptomatic from gallstones or other gallbladder diseases. We do not remove the gallbladder prophylactically (if you have no symptoms of gallbladder disease). Similarly, most obese patients also have a hiatal hernia, which can be repaired simultaneously as the primary bariatric procedure.

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