Beltline Bariatric and Surgical Group
Specializing in the care of complex abdominal hernias
Welcome to the BBSG center for complex hernia repair. We are honored that you have entrusted us with your surgical care. Our mission is to restore the injured body as near as possible to its original form. We are surgeons and surgical educators with a keen interest in the area of hernia repair and research. Our program’s approach is multidisciplinary and we recognize that optimal outcomes occur when the patient and surgeon are among a much larger team that endeavors to reach the best possible outcome.
Included in this packet, you will find information that will help you on your way through this difficult journey. We recognize that hernia patients are, first and foremost, SURVIVORS and FIGHTERS. Most have braved previous surgery, trauma, and medical conditions to get where you are. We respect and admire what you have been through and our utmost concern is to see you through the final few miles of this difficult marathon. Please read through this information carefully. It should be used as a how-to guide as well as a springboard for questions for your surgical team.
What is a hernia?
A hernia occurs when there is a tear or opening in the muscles of the abdominal wall. A sac containing fat or intra-abdominal contents such as intestines protrudes through that opening. A hernia that develops at an incision is called an incisional hernia. A ventral hernia can occur anywhere in the abdominal wall where there is a weakness. The repair of a hernia is called a herniorrhaphy. There are acquired hernias which are caused by straining over the years and congenital hernias which have resulted from a weakness in the abdominal wall present since birth. A hernia that cannot be reduced is incarcerated. If the blood supply of the hernia contents is compromised this is called a strangulated hernia. A hernia that develops at the belly button is called an umbilical hernia. Inguinal hernias develop in the groin.
Why Have I been referred to a hernia center?
Most general and plastic surgeons can and do take care of simple hernias that are either acquired (incisional, inguinal) or congenital (umbilical, hiatal hernias). However some hernias, because of their size or location, or because they have recurred multiple times, or may be complicated by infection, should be managed by a hernia specialist. A hernia specialist is a surgeon with specific knowledge and expertise in dealing with these types of issues. We work closely with our medical colleagues as well as our clinical support team in the hospital to ensure that you have the best possible outcome. Hernia repair doesn’t begin and end with a trip to the operating room. It begins with you, the patient working with your specialist to prepare you for success. It ends, months after your surgery when you have been cleared to resume all of the things you have been missing because of your hernia problem.
What can I expect on my first visit?
When you first meet one of our hernia specialists, you can expect that we will “get to know each other”. This is a relationship that, like any other, will require that we know everything about you (in a medical sense). In this case, we will want to know all about your medical and surgical history. It would be very helpful if you could obtain and bring with you any previous operative reports and CT scans. Operative reports should be available from your surgeon’s office and can be faxed to us at your request (877-708-5261). If you have had a recent CT scan of your abdomen, we would very much like to see that as well. Copies of your CT scan can be loaded onto a compact disk, but you usually have to request a copy. If you have not yet had a CT scan, let our scheduler know when you call for an appointment. Very often we can schedule you to have one here at Piedmont Hospital on the same day as your appointment. That way we can look at it with you and talk about your treatment options. We will often (with your permission of course) take before and after pictures to document your journey and to use as teaching aids when we train other surgeons on advanced hernia repair techniques.
What kind of things can I do to prepare for my surgery?
If you are like many patients, you have had prior attempts at having your hernia repaired. Our aim is to repair your hernia once-and-for-all. While there is no guarantee that any hernia repair will last forever, our goal is to give you every opportunity to have a successful, long-lasting repair. For your part, there are few things that you can do to help ensure that you get the best possible outcome:
- If you are diabetic, talk to your doctor about maximizing your therapy. Studies have shown that, even if you have diabetes, if you can get your hemoglobin A-1c below 7.2 prior to surgery, your risk of complications, including recurrence, will decrease.
- If you are a smoker, STOP SMOKING. The risk of complications with smokers is SO HIGH that we will not operate on you until you have been nicotine free for at least 3 months. All former smokers will undergo a urine nicotine test just prior to you scheduled surgery date to ensure that you are safe to undergo surgery.
- Weight loss. If your body mass index (BMI) is greater than 35, we will need to discuss options for either medical or surgical weight loss prior to surgery. Every one point drop in your BMI will lead to a significant decrease in your chance for having a complication.
- Be healthy! That sounds like a simple request but hernia surgery is a BIG DEAL. Treat it as if you are preparing for a marathon. That means:
- Start taking a multi vitamin daily
- Start doing a little exercise every day to help build your cardiovascular stamina.
- Drink a protein shake every day. Your body will need building blocks (protein) to help you heal after your surgery. Start building your stores now.
- Plan ahead. Most incisional hernia surgeries will require a 5 day hospital stay (average). After that, you will need to take it easy for a few weeks. Plan to stay out of work for 3 to 4 weeks. If you live more than an hour from Atlanta, ask your doctor if he/she is comfortable seeing you between your visits here if needed.
How much pain will I be in after surgery?
All surgery hurts. Our aim is to make your experience as comfortable as possible. We consult our anesthesiology pain team on all hernia cases. Most patients will receive a specialized “nerve block” by our anesthesia team which will minimize you discomfort for days after your surgery. When you go home, you will be on prescription pain medication that should very adequately cover any discomfort you may have.
Why Do Hernias Come Back?
All hernia repairs (even in the best hands) have a recurrence rate. Stated differently, there is always a chance that your hernia can come back in the future. Our goal is to minimize this possibility as much as possible. There are several risk factors that are well known to cause hernia recurrence. The most significant of these are:
- Obesity (BMI >35)
- Prior hernia surgery
- Non-mesh repairs
- Pulmonary disease
While not all of these risk factors can be changed, many can and we will work with you to optimize your chances of a long-lasting repair prior to surgery. So it is important to be patient! Sometimes waiting a little longer to make sure your body is ready for surgery can save a lot of problems down the road.