General Information

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Umbilical Hernia Repair Techniques

I often get asked whether the Shouldice or the Bassini is the best method for repair of umbilical hernias. This represents a misunderstanding about hernia repairs. The Shouldice and the Bassini are methods to repair inguinal hernias but have no place in the repair of umbilical hernias.  For umbilical hernia repair, there are two basic methods. The first is a pure tissue repair and the second is the use of mesh.

Pure tissue repair uses sutures to close the hole.  This can be a primary closure or a layered closure such as pants over vest.  The pure tissue repair has the best results for small hernias (less than 3 to 5cm) and in patients with a normal BMI.

Unfortunately, for large umbilical hernias mesh has to be used to get the defect closed. The mesh can be placed to cover the hernia or placed on the peritoneal side of the…

Mesh and Autoimmune Disease

Sports Hernia Patients and Classic Hernia Patients and Hernia Mesh Removal

Autoimmune diseases occur when the body’s defense system mistakenly attacks the normal cells of the body. This can result in chronic fatigue, myalgias, joint pain, irritable bowel, rashes, and more. It has been suggested that the inflammation caused by the implantation of mesh causes the body’s white body cells and foreign body cells to become overly active and thereby causing autoimmune disease. There are several studies that followed patients after mesh hernia repair. These surgical patients did not develop autoimmune disease at a rate any higher than the general population. This would suggest that mesh is not a cause of autoimmune disease. But the studies did report that if a patient has multiple allergies before surgery they are at increased risk to suffer autoimmune disease after mesh hernia repair. If you already have an autoimmune disease, then you should…

Testosterone in Sports Hernia Athletes and in Patients with Classic Hernias.

To T or not to T?  That is a great question.

I care for many athletes with sports hernias and classic hernias. Athletes always want to take advantage of ways to improve their recovery and strength. So I often get questions about testosterone. Testosterone is a key hormone that helps maintain a healthy body in both men and women. We will only deal with the male half of the discussion today. Once a man hits 40 years old the production of testosterone slowly decreases. This can result in loss of muscle mass, weaker bones, less energy, loss of libido, erectile dysfunction, memory loss, depression, and more. Testosterone replacement can be a great help, and older men with symptoms should consider testosterone replacement therapy.

Before you start therapy you need to be evaluated by your doctor. He or she will perform a careful history and physical examination and blood tests. This…

Can You Shower After Surgery?

You had your hernia repaired and you are on your way home from the surgery center. You are hot and sweaty from the car ride. Your skin is itchy from the betadine skin prep, and you are starting to smell. You have a box of baby wet wipes, but you really want a shower. Is it safe to get naked and jump in the shower?

After your surgery, the body immediately starts the healing process. After 12 hours, the skin is healed enough to prevent bacteria from entering through the incision. So 12 hours after your hernia repair feel free to take off the gauze and the tape and take a shower. Soap will not hurt the incision.

Afterward, you can leave the incision open to the air. If there is some drainage, put a fresh bandage on overnight.

Only one person in the shower with you until you feel…

Not All Bodies Are The Same

It Would Be Nice everyone’s body was exactly the same on the inside. That way it a surgeon would always know where important structures were located and therefore during surgery, these vital structures could be quickly identified and protected. But the human body makes its own decisions and does not always follow the rules found in the anatomy books.

During hernia repairs, the nerves are the structure most commonly in the “wrong place”.
In the anatomy books, the genital nerve usually is on the posterior aspect of the cord, but it can be found on the floor of the inguinal canal or along the inguinal ligament. The Ilioinguinal nerve usually runs on the anterior aspect of the spermatic cord, but it can run along the internal oblique muscle. The iliohypogastric nerve usually runs along the anterior aspect of the internal oblique muscle, but it can be found traveling within the…

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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.

Location:
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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