The abdominal wall is a layer of strong muscles, which is found between your ribs and groin. It works as a normal corset that keeps all the intestinal organs positioned well. Occasionally, a weakness in the intestinal wall develops and creates a contained hole through which the internal organs can protrude. If this tissue loses its blood supply, it can become gangrenous and require emergency surgery.
Historically, hernia repair was performed by making an incision in the skin and identifying the hole in the muscle. We would then replace the protruding abdominal contents back into the abdominal cavity and use stitches to close the hole in the muscle. If there was too much tension on the stitches, we would use a mesh screen, (either dissolving or permanent), to add a layer of strength.
Unfortunately, larger hernias require larger skin incisions and the recovery was often quite dicult for patients and required hospitalization for several days following surgery. Though we still perform occasional open hernia repair surgery, for the most part, we repair most hernias laparoscopically using 3 small incisions, each about 8 mm in size. The majority of patients go home a few hours after surgery and experience considerably less pain.
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