The objective of surgery is to help the patient. The surgeon wants to repair the injury but at the same time To Do No Harm. To help me achieve these goals I follow the following rules during hernia surgery.
- Handle the tissues delicately and with care.
- Minimize the use of the cautery. The heat and current can damage remote tissues.
- Minimize the dissection of the spermatic cord.
- Use absorbable sutures as much as possible.
- Do not place sutures in the region of the pubic tubercle or near the medial
attachment of the inguinal ligament. - When repairing the inguinal floor, avoid placing sutures in the internal oblique
muscle. The iliohypogastric nerve sometimes courses through this muscle. Use
the transversalis for the repair. - Handle the nerves little as possible.
- Know where the nerves are.
- If neurectomy is required, excise the nerve distally and bury the nerve proximally.
- Homeostasis
- Have plans to do with any unforeseen problems.
- Be sure the patient understands the procedure and has reasonable expectations
Does the length of time of the injury matter on the outcome of the surgery? ive had a groin disruption for 6 years.
Long standing pain can become centralized. This means that the pain originates in the spinal cord and not at the site of the injury. In that case, even if the muscles are repaired, the pain may not resolve. It is best to repair the damage earlier than later. Even so, if the pain is not centralized a repair years after the injury can yield increased strength and relief of pain. Nerve blocks and trigger point injections can be used to differentiate peripheral from central pain. Do not hesitate to contact me.
I am a 28 year old former hockey player. For the last two to three years I have had a inguinal hernia that has progressively gotten worse. It is now in my groin and is out most of the day but retreats at night. I have a lot of anxiety about the procedure with the mesh. Is it possible to have this repair done in an alternative way without the mesh? I am not enjoying my life anymore as I am in a good amount of pain daily. I would love to get out and skate again.
-Doug Chance
Dr.Brown does your surgery include Deep muscle repair besides the oblique muscle. I feel like my groin disruption is in the deepest part of my groin,it feels like my muscles and tendons have been detached from thier original position. Thank you