Specialty Care for Hernia Repair by: About Hernia Surgery Hernia surgery today is much more advanced than even five years ago. The use of laparoscopic surgery techniques and the newest, lightweight meshes (if needed), often allow patients to heal faster, in less pain, and have a more cosmetic outcome. Healthcare providers who are deciding on where to refer hernia patients should make sure that their surgeon has all the tools available to offer the most state-of-the-art techniques and mesh to their patients. About Hernia Symptoms Hernia symptoms vary dramatically from one patient to the next. One of the most common symptoms of a hern ia is therapid onset of pain at the hernia site. When internal fat or internal organs press through a hole in the muscle, a hernia develops. These internal organs and fat cause the skin over the hernia to 'bulge' out. In rare cases, a piece of intestine can become trapped inside a hernia causing strangulation (see image). This is a rare, but serious concern. Open versus Laparoscopic Hernia Repair The two major types of hernia surgery are traditional open surgery, and laparoscopic surgery. No one approach is suitable for every patient. Patients with certain types of hernias may benefit from open hernia surgery while another similar patient may need laparoscopic hernia repair. The size of the hernia, the location, and whether it is unilateral or bilateral influences the best approach (see comparison chart). At California Hernia Specialists, we develop treatment plans for individual patients to suit their medical needs, their overall medical condition, and their preference when possible. Open Hernia Repair Laparoscopic Hernia Repair Most common technique used for hernia repair. Techniques vary widely from surgeon to surgeon Less common approach for hernia repair. Requires advanced training Can be done under local anesthesia with sedation Requires complete general anesthesia Hernia is fixed on the outside by opening the muscles over the weakness Hernia is fixed from the inside, behind the muscles where the weakness is located Requires standard surgical equipment. Requires advanced laparoscopic equipment Recurrence rates of 1-2% and infection rates of <1% Recurrence rates of 1-2% and infection rates of <1% Basic preoperative workup is required Occasionally requires more advanced workup because general anesthesia is used 4-5 cm incision in the groin or bikini area 1-2 cm incision next to belly button, and 2 small punctures below the belly button Mesh is placed behind the muscle and above the muscle. The mesh is sutured in place Mesh is placed only behind the muscle, and is secured in place with dissolvable sutures Tension Free Repair The term 'tension free' hernia repair is commonly used to describe hernia surgery. Hernias are caused by a weakening of the abdominal muscles. Some surgeons choose to sew the muscles back together, thus causing 'tension' on the muscles around the hernia. However, the muscles around a hernia are already weak, and over time those muscles tend to pull apart and the hernia can recur, or come back. Therefore, most hernia specialists today utilize a mesh to help strengthen the muscles. When using a mesh, the muscles themselves are not sewn together (see image). Instead, a mesh is placed over or under the hole in the muscle to prevent anything from pushing through the abdominal wall. For Referring Physicians Patients and providers can learn more by visiting our website at www.CaliforniaHerniaSpecialists.com . We work with a large number of primary care, internal medicine, and other physician specialties for hernia care. We take your referrals as the highest compliment we can receive. By choosing to have treatment at California Hernia Specialists, patients and their healthcare providers can ensure the most consistent and highest quality hernia care. Todd S. Harris, MD Dr. Todd S. Harris is board certified in general surgery as well as highly experienced in hernia surgery. Dr. Harris is a Fellow of the American College of Surgeons, one of the highest distinctions for a general surgeon. He is the medical director of California Hernia Specialists and coordinates all clinical functions of the office and surgical center for hernia patients. Dr. Harris was born and raised in South Carolina and is a graduate of The Medical University of South Carolina. He completed his general surgery training at St. Vincent's Hospital and Medical Center in New York City. After completing his surgical residency, Dr. Harris returned for a cardiovascular and interventional radiology (CVIR) fellowship at the University of Minnesota. After completing his fellowship in 2008, he relocated to Orange County to develop his hernia practice. Outside of work Dr. Harris enjoys a variety of recreational activities. He is an avid runner and swimmer. He has competed in several triathlons, including the 2012 Malibu International distance race. He balances cardiovascular activities with core and strength training. His interest in fitness allows him to appreciate getting patients back to what they enjoy as quickly and pain free as possible after their hernia surgery.