Treatment of Sports Hernias

The Healing Ridge After Hernia Repair

Published February 20, 2019 By William Brown, MD

After any operation the body goes through three stages healing.

Inflammatory Stage: During this stage the white blood cells move into the incision to remove injured cells, bacteria, and debris. This stage can be minimized by the surgeon with gentle handling of the tissues and careful hemostasis.

Proliferation Stage: During this stage fibroblasts move into the area to lay down collagen and fibronectin. The strands of collagen provides the strength of the repair. The fibronectin binds the collagen strands together. Because of the collagen deposition, on about day 5 you will feel what is called the “Healing Ridge” under the incision. This will be firm and mildly painful ridge of tissue. It will extend beyond the incision for about 2cm. Myofibroblasts will then move into the area. These cells contain muscle fibers and will contract to pull everything together. This will make the operative area will feel very tight. The…

Sports Hernia and Inguinal Hernia Surgery

Published January 28, 2019 By William Brown, MD

Post Operative Pain Control

You have decided to your inguinal hernia or your sports hernia repaired, but you are worried about having pain after surgery. Luckily by understanding the innervation of the region, pain control after surgery has vastly improved. The ilioinguinal and the iliohypogastric nerves provide sensation to the inguinal region. These nerves start at L1 and L2 and then travel to the inguinal region between oblique muscles. Local anesthetics can be used to block the nerves and thereby minimize postoperative pain.

Types of Nerve Blocks

TAP Block (transversus abdominis plane). Using an ultrasound machine the ilioinguinal and the iliohypogastric nerves are visualized between the transversalis muscle and the internal oblique muscle. Then a needle is used to inject local anesthetic around the nerves.
The ilioinguinal and an iliohypogastric nerves can also be blocked at the anterior superior iliac spine. At this site the nerves travel between oblique muscles.…

Potential Complications During and After Hernia Repair Surgery

Published October 23, 2018 By William Brown, MD

It is Important To Be Informed

Even though hernia repair surgery is one of the most common surgical procedures, it does not come without potential complications. There are two steps you can take to lower your risk. One, choose an expert and experienced surgeon who has done the operation thousands of times, like Dr. William Brown. Two, understand what the complications are so you can identify them and let your doctor know immediately should you experience one or more of them.

Complications Associated with General Anesthesia

Repairing an inguinal hernia without mesh is an outpatient surgery, yet it does require anesthesia. Any time anesthesia is involved, there are risks for complications. Your doctor will discuss your medical history with you and assess any risks or complications based on your history. To accurately assess potential complications, your doctor must know about any past surgeries, existing medical conditions and allergies.

The…

Options For Your Hernia Repair

Published February 25, 2018 By William Brown, MD

Do All Hernias Have to be Repaired?

Once you’re diagnosed with a hernia – be it an indirect inguinal hernia, direct inguinal hernia and/or femoral hernia – the next question is does it have to be repaired, and if so, how soon? If you’ve been living with a hernia for long, then you may have increased your pain tolerance to a point where the hernia doesn’t appear to have a negative effect on your life. Some hernias simply don’t cause much discomfort. And, there’s the recovery period post-hernia repair to consider and plan for, which can make you want to put off repairing your hernia.

Relieving significant pain that stops you from living daily life as usual is the top reason to repair a hernia, but there are several other reasons that cause people with hernias to have them repaired sooner versus later. If you’re on your feet for long…

Shouldice Hernia Repair Technique

Published February 22, 2018 By William Brown, MD

Four Things You Should Know About the Shouldice Hernia Repair Technique

Shouldice Repair for Hernias

If you are researching hernia repair techniques, chances are that you’ve come across the Shouldice technique. No wonder since it’s considered an excellent hernia repair method due to it putting minimal tension on the repair, which leads to less post-operative pain and easier recovery, it has a low hernia recurrence rate, it has a low infection rate, and its results are equal to or better than using mesh.

That just scratches the surface of this popular hernia repair method. Here are four more things you should know about the Shouldice hernia repair technique.

1. How it’s performed.
The Shouldice hernia repair involves using a running permanent suture to first plicate and strengthen the inguinal floor. Then a second running suture is used to plicate the oblique muscles, creating a four-layer hernia repair.

2. Who invented it.
Dr. Edward Shouldice,…

Hernia Repair Technique Needs To Match Type of Hernia

Published February 22, 2018 By William Brown, MD

The Bassini Technique: A Classic Non-Mesh Way to Repair Inguinal Hernias

Dr. William Brown, the renowned inguinal hernia repair surgeon, has never wavered from his stance against repairing hernias with mesh. He performs non-mesh hernia repair to avoid the poor results and complications that come with using mesh. When mesh binds to nerve endings, which is common post procedure, chronic pain results. When mesh becomes stiff, fibrosis occurs causing more damage to the herniated area. When mesh affects nearby blood vessels or organs, problems arise that could mean another surgical procedure, or worse, nothing can be done to correct the situation. Considering the risks, Dr. Brown strongly recommends non-mesh hernia repair, like the Bassini, Shouldice, or Desarda technique.

Of all the ways to repair an inguinal hernia with the local soft tissue, the Bassini method is a classic inguinal hernia repair technique that has been used by surgeons for over…