New Surgical Treatment Options for Hernias

Hernia repair is one of the most commonly performed surgical procedures worldwide. In fact, there are over 600,000 hernia repair surgeries performed each year in the U.S. alone. A hernia is a weakness or defect in the abdominal muscles which can result in the protrusion of tissue through an opening in the outer layers of the abdominal wall. Hernias can develop at any part of the abdominal wall, but generally occur in areas that have a natural tendency to be weak. These areas include the groin , umbilicus , hiatus and incisions from previous surgeries . While hernias generally do not pose serious long-term health problems, they can cause severe pain and discomfort for those suffering from this condition.

Hernias are typically repaired through a surgical procedure called herniorrhaphy, in which the surgeon repairs the hole in the abdominal wall by sewing surrounding muscle together or by placing a patch called "mesh" over the defect. Most surgeons make an incision at the site of the hernia in order to gain access to the defect, although some surgeons prefer to do these procedures laparoscopically.

During a laparoscopic hernia repair, the surgeon makes very small incisions to pass through specialized instruments and an endoscope, a device that allows the surgeon to see the abdominal area without opening the patient up. Laparoscopic hernia repair generally results in less postoperative pain and recovery time than open surgery. There is still a great deal of controversy over the long-term benefits of laparoscopic hernia repair, however, and it is by no means an option for every patient.

The use of surgical mesh to repair hernias is gaining in popularity with surgeons. Most meshes currently on the market are made from synthetic materials such as polypropylene, polyester, silicone or polytetrafluoroethylene (PTFE), commonly known by the DuPont brand name Teflon®. While these meshes have good strength characteristics, they remain in the body as permanent implants and sometimes can cause adverse reactions when the surrounding tissue identifies these materials as foreign bodies.

An alternative to synthetic and absorbable mesh is human tissue. There are a handful of companies that are now marketing processed, freeze-dried human dermis for soft tissue repair and augmentation. This material is implanted using the same technique as other meshes and provides for revascularization, cellular ingrowth and "remodeling" into the patients tissue. While this option generally provides a permanent repair with few adverse reactions, the processing and distribution of human tissue is not regulated by the Food and Drug Administration (FDA) as are most other products that are implanted in the human body. In fact, there have been a number of recent cases of serious infections and even deaths resulting from the implantation of human cadaveric tissue during surgical procedures.

Only physicians can properly diagnose and appropriately treat hernias. However, patients have the right to actively participate in decisions that affect their health or quality of life