(Traditional) Hernia Repair
There are many different techniques of open hernia surgery.
Under local or general anaesthesia, a small (7-10cm) incision is made over the site of the hernia. The peritoneal bulge is returned to where it belongs, but the repair is achieved by placing a piece of fine (inert and sterile) mesh at the defect in the tissue. This is firmly held in place with sutures and tacks and the outer incision closed. The whole operation takes 45 minutes to perform. Unlike other techniques, even those now using mesh, our approach does not require any stitching together of the muscle tissue at all, thus eliminating the tension induced by some other methods.
The healing process starts to take place immediately whereby, (sensing the presence of the fine mesh) the muscle and tendon send out fibrous tissue which grows around and through the mesh, incorporating it in a way similar to the placing of the steelwork inside reinforced concrete. It is not a “patch” stuck on the outside, (as is relatively common with mesh repairs) but a total, tension-free reinforcement inside the layers of the abdominal wall itself. The results are also similar to the concrete analogy, in that the mechanical load is spread over the whole area, precisely at the area of weakness, rather than on high pressure points of stitching through the deep, sensitive tissue with older methods.
When performed correctly, this technique requires no bed-rest, even after the operation. The patient is able to walk away from the hospital after surgery. The mesh itself is made of the same material as surgical sutures (stitches), inert and sterile.
The technique was originally devised as a much-needed alternative to restitching failed hernia operations (i.e. recurrences) done the old (non-mesh) way. It was then realised that, as the technique was so very successful with recurrent hernias, it should be used for first-time repairs and thus avoid recurrences altogether.
There are several different types of mesh in use, mesh will vary in material and in construction, your surgeon will pick the best mesh for you, based on your hernia and his/her technique.