Pre-Operative Preparation

For the best results from surgery, it only makes sense to start with a healthy patient. Keep the following in mind prior to hernia repair surgery for a smoother recovery.

Cigarette smoking is the most significant risk factor for failure of hernia repair. Smokers have weak collagen.  Collagen is one of the key structures in wound healing, and so smokers have repairs that are weak.  And the smoker’s cough puts great strain on the repair and can tear out sutures.  Dr. Brown advises patients to stop smoking for three months prior to surgery.

Obesity is also a significant risk factor for perioperative problems.  The tissue planes are difficult to find.  The nerves are harder to identify, and thus are at more risk for injury.  Sites of bleeding are harder to find and stop.  The operation takes significantly longer.  Surgery should be delayed until the patient has had a chance to get the BMI back down to normal levels.

Every time a patient coughs, the muscles pull on the sutures and could possibly tear apart the repair.  Therefore, it is important that all pulmonary problems should be treated prior to surgery.   

Patients with chronic constipation have to strain to have a bowel movement. This pulls on the sutures and can disrupt the repair.  Problems with constipation need to be corrected before surgery.  The same is true for men with a large prostate.  Having to strain to empty the bladder pulls on the sutures and increases the risk of tearing the hernia repair apart.  Do not hesitate to have your patient see the urologist prior to surgery.

A malnourished patient is not going to heal. Evaluate nutritional stasis and correct prior to surgery.

Medications that thin the blood should be stopped prior to surgery to decrease the risk of bleeding.  If you take medications that thin the blood, then talk with your primary doctor or Dr. Brown about when and how to stop those medications.  Occasionally, the blood thinners should not be stopped because of the risk of a stroke or a heart attack. The operation can still be performed, but the chance for hemorrhage is increased. Medications that hinder healing (such as prednisone) should also be stopped prior to surgery.

Diabetes should be controlled prior to surgery.

Weight loss medications should be stopped prior to surgery (blood pressure can fall during anesthesia).

Dr. Brown also strongly believes that homeopathic therapy helps with inflammation and healing. 

Learn more about Dr. Brown’s approach to hernia repair without mesh. Contact Dr. Brown today.

William Brown, MD
Hernia Specialist

Dr. Brown has been repairing inguinal hernias for over 30 years, taking care of Athletes with Sports Hernia injuries since 1999.  Dr. Brown has been taking care of patients with complications from mesh for so long that his hair is gray. Luckily he still has some hair.

His patients include players from the San Jose Sharks and the San Jose Earthquakes as well as athletes from the NFL, AFL, NBA, and the local college teams. As well as Athletes from 15 foreign countries.

Fremont Office
William H. Brown, M.D.
39470 Paseo Padre Pkwy
Fremont, CA 94538
(510) 793-2404
Fax: (510) 793-1320

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