Hernia Repair Types
There are many different kinds of hernia repair, but the three major categories are:
- Tension repair
- Open tension-free repair
- Laparoscopic tension-free repair
Tension Repair
For a long time, tension repair was the only repair option available to people with hernias. In this procedure, the surgeon makes an incision in the abdomen over the hernia site, pushes any protruding tissue back into the correct position within the abdominal cavity, and then stitches it closed. This type of repair is called a tension repair because the stitches or sutures put tension on either side of the defect in order to keep it closed. For many reasons, including pain and patient discomfort, a long recovery period, and high recurrence rates, physicians began moving to tension-free repair techniques.
Tension-free Repair
Tension-free repair techniques utilize a piece of mesh to bridge the hernia defect, and are the most common today. They are considered the gold standard of hernia repair by the American College of Surgeons. Today's mesh products are state-of-the-art in their ability to be strong yet lightweight.
Flat Mesh Repair
After making an incision over your hernia, your surgeon will use a patch made out of flat plastic - like (polypropylene) mesh and stitch it to the tissue surrounding your hernia.
Advantages:
- Hernias recur in only 3% of flat mesh repair patients
- Quick recovery
- Only minor discomfort following procedure
- Can be done under local anesthesia
Disadvantages:
- If the hernia is large, more stitches may be required to fasten the mesh, increasing the risk of nerve damage, which could result in pain
- Procedure can take between 40 and 60 minutes
Today's mesh products are state-of-the-art in their ability to be strong yet lightweight.
Three-Dimensional Mesh Repair
Three-dimensional mesh devices such as PROLENE* polypropylene Hernia System and PROLENE* 3D Patch polypropylene Mesh ( both manufactured by ETHICON Products Worldwide, a Johnson & Johnson company ) - have revolutionized the repair of hernias by building upon the advantages of the earlier tension-free techniques and making them even more effective.
PROLENE hernia system a "3-in-1" design (meaning that it incorporates three of the most widely used and accepted repair techniques into one single device) consist of three components integrated into one device:
- An underlay patch that provides an effective posterior repair on the inside of the abdominal wall, much like laparoscopic repair.
- An onlay patch that lays over the abdominal wall, much like a flat mesh repair
- A low-profile connector that connects the underlay patch on the onlay patch. This connector virtually eliminates the possibility of the device from moving, or migrating, thus significantly reducing the potential for recurrence.
The system sandwiches tissue between two layers of mesh, which supplements potentially weak areas of the abdominal wall and minimizes the chances of getting another hernia in the same area. The patch helps the body heal by acting as a matrix for tissue ingrowth.
Advantages:
- Patient Comfort
- Virtually zero chance of migration
- Little suturing, reducing the risk of nerve damage that could lead to pain
- Can be done under local or regional anesthesia
- Takes typically about 20-40 minutes
- Quick recovery and return to normal activities
- Extremely low recurrence rates
Another breakthrough device, the PROLENE 3D Patch mesh, is a one-piece mesh device that affords surgeons secure, low profile repairs. It is typically used for or small hernias. The device consists of an overlay patch with a three-dimensional diamond-shaped underlay. The underlay is inserted into the hernia "hole" or defect, and then the surgeon pulls a string attached to the bottom of the diamond to "deploy" it. When deployed, the underlay becomes flat and forms a secure layer of mesh on the underside of the muscle wall.
General Surgery
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