Like Patching a Tire: How to Fix a Hernia

Sometimes in medicine, analogies work great. Here’s one for your consideration. Imagine a tire with an inner tube inside. Now think of the outer tire as your abdominal wall, and the inner tube as your intestine underneath. If the outer tire develops an opening, then the inner (intestinal) tube can peek through that hole. That’s what having an inguinal hernia is like, and you’ll know you have one if you experience groin pain and can feel the lump of an “inner tube” poking through your “tire.”

If that sounds like what’s happening to you, then step one is to get an exam for a proper diagnosis.

Your doctor might tell you that your hernia is mild enough to be left alone, with some home care tips and general health awareness. However, if it requires some operational intervention, your physician will explain various strategies ideal for your situation.

The Boston Hernia Perspective

At our clinic, 90 percent of the patients who come to our practice receive the same recommendation, and that’s for Advanced Open Pre-peritoneal Inguinal Hernia Repair. That’s quite a mouthful, so I just call it Fast Recovery Inguinal Hernia Surgery. As someone who has performed thousands of hernia procedures using every method, I can tell you that it’s the most proven approach for an easy recovery and the diminished likelihood of hernia recurrence.

How It’s Done

After administering local anesthesia and sedation (or in some specific cases general anesthesia), I make a small incision just above the hernia location and gently push the protruding tissue back into the abdomen where it belongs. Then, I clear the weakened abdominal area and reinforce it with a synthetic mesh (hernioplasty). The mesh sits under the muscles, away from dangerous nerves, avoiding mesh-related complications. After that, I close the entry incision with dissolvable, or melting stitches. Patients are up-and-about an hour later, and our team explains their recovery program before sending them home.

The Alternative

There are several reasons why I recommend Fast Recovery Inguinal Hernia Surgery vs. Laparoscopy – which involves three small incisions, inflation of the abdomen using gas, and sometimes usage of expensive robotics to perform the procedure. What we are saying here is counter-intuitive. Why would open surgery be better than laparoscopic? Below are a couple of reasons.

Laparoscopic repair can increase the risk of complications and the recurrence of another hernia. Laparoscopy requires general anesthesia, something many patients like to avoid when they safely can. The biggest benefit of Laparoscopy is a smaller scar. But I don’t feel like that’s a bonus at all, given the advantages of the Fast Recovery Inguinal Hernia Surgery performed successfully at Boston Hernia. To tie back to the tire analogy, Fast Recovery Inguinal Hernia Surgery is like having your busted tire fixed by a professional at a reputable shop, intended for long-term, good-as-new use.

 


Dr. Michael Reinhorn is a specialist in inguinal hernia and umbilical hernia. He started his practice as a general surgeon in 2001, and in 2012 he transitioned to focus on the care of hernia patients. In 2018, he co-founded Boston Hernia, an ambulatory surgery practice focused exclusively on hernia surgery. In 2020, Dr. Nora Fullington was recruited from her work as a general surgeon, where she performed hundreds of laparoscopic hernia repairs, to Boston Hernia where she was intensively trained by Dr. Reinhorn in the open preperitoneal and Shouldice techniques. Together with their physician assistant team, they perform approximately 800 hernia surgeries every year. Both surgeons offer a tailored approach for each patient, taking into account individual patient factors to decide if surgery is recommended or not, what type of repair (open, laparoscopic, mesh, non-mesh) is best, and what type of anesthesia is safest. At Boston Hernia, our focus is on each individual patient and continuously improving our own surgical techniques and outcomes. We do this by participating in various hernia societies, studying our own outcomes through a national database, and publishing our data to influence the care of hernia patients nationally and internationally. Boston Hernia is an affiliate practice of the Mass General Brigham system. In addition to operating at Newton-Wellesley Hospital, a Mass General Brigham Hospital, we offer care at ambulatory surgery centers in Waltham, MA and Derry, NH.