Monday, December 18, 2017

OCMA Blog

OCMA Specialty Spotlight: Specialty Care for Hernia Repair

Specialty Care for Hernia Repair

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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 hernia 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.


OCMA Specialty Spotlight: Humanitarian Healing


Arpan Global Charities (AGC) is a non-profit organization established in 2005 by Dr. Sudeep Kukreja.  The goal of AGC is to bring health and hope to medically underserved populations around the world while providing humanitarian assistance and medical education to those who need it the most.

Arpan Global Charities' 13th international medical volunteer mission took place in the city of Latacunga, Ecuador and a team of 52 dedicated medical and non-medical volunteers participated. Team  members had diverse backgrounds and many years of experience in their respective fields and among them were: 5 nurses, 5 pediatric residents from CHOC Children's Hospital of Orange County, an echo tech, 3 anesthesiologists, 7 pediatricians, 1 cardiologist, 1 dentist, 1 geneticist, 1 gynecologist, 1 CT surgeon, 1 ENT surgeon, 1 ophthalmologist, 1 plastic surgeon, 2 general pediatric surgeons, 1 pediatric orthopedic surgeon, 1 orthopedic surgeon for adults, 1 radiologist, 1 pharmacist, and 10 non-medical volunteers.

Volunteers arrived from the US to Quito in waves and landed in Quito's new airport, located approximately an hour and half away from Latacunga. Although team members faced multiple challenges due to delayed airport pick-ups, lost luggage, and a late arrival to the hotel in Quito at 2:30 AM, the volunteers were eager to start working so they rushed to their rooms to get some rest. The team members were ready at 6 AM for the bus ride to their final destination, the small town of Latacunga.  After a 2-hour trip, the team arrived at a government clinic named Patronato where they immediately examined hundreds of patients and pre-screened them for treatments and/or surgery. Arpan Global Charities rented two facilities with operating rooms in Latacunga for surgeries: Clinica Continental and Instituto de la Mujer. Some surgeries were also performed by the pediatric orthopedic surgeon and the geneticist at Baca Ortiz Children's Hospital in Quito. Furthermore, Arpan's genetics doctor took the initiative to collaborate with local physicians to organize a genetics conference scheduled to take place at the Sheraton Hotel in Quito for the "Rare Diseases Day."  While reaching out and collaborating with local physicians, our medical team established a promising relationship with Quito's medical faculty to discuss the development of a partnership between CHOC Children's Hospital of Orange County and Baca Ortiz Children's Hospital in Quito to promote international collaboration and exchange programs.



Volunteers of Arpan Global Charities also visited 4 different orphanages in Latacunga and Quito where they examined every orphan residing in those centers and facilitated treatment, distributed clothes, and donated toys. Mission volunteers had the opportunity to visit two schools located in very poor areas of their town where they examined every student and discovered some children who had undiagnosed serious medical conditions for which treatment was facilitated. The team of anesthesiologists and nursing staff provided supportive services to patients in the recovery room which allowed skilled surgeons to perform more than one hundred major surgical procedures. With the help of the echo technician, the cardiologist volunteer was able to examine and treat hundreds of patients. Even the dentist surgeon was kept extremely busy from 8 AM to 6 PM everyday with long lines of patients eagerly waiting to see him. 


The help and support of the nursing members, pediatric residents, pharmacist, non-medical volunteers, Ecuadorian volunteers and Ecuadorian medical students was phenomenal. This mission would have not been possible without them.  Besides providing free medical care to the most underserved population in Ecuador, Arpan Global team members were also involved in the education of local nurses, medical students, and doctors in both Latacunga and Quito.

Considering that team members had limited equipment and very scarce medical supplies, it is important to acknowledge their caring attitude and sense of commitment for these qualities enabled them to work long hours on a daily basis to provide humanitarian healing to all their patients.  Indeed, the team's dedication and hard work enabled Arpan Global Charities to touch the lives of more than 1,500 Ecuadorian children and adults. A lot was accomplished during this missionary trip which makes it one of the most exciting and successful medical volunteer missions of Arpan Global Charities.




OCMA Specialty Spotlight: First-of-its-Kind Room Provides a Special Space Where Parents Can Bond with Their Child After Surrogate Delivery

Laguna Hills, CA - Thanks to the generosity of Dr. Jane Frederick, a co-medical director at HRC Fertility, The Women's Hospital at Saddleback Memorial now has a Bonding Room designated specifically for intended parents (parents utilizing a surrogate). The room allows intended parents to bond with their child after delivery by the surrogate. Saddleback Memorial and Dr. Frederick believe it's the first room of its kind in the U.S. 

 

The room was made possible through philanthropic support from Dr. Frederick, one of the longest practicing female reproductive endocrinologists in the Orange County area who has worked with intended parents for over 20 years.  

 

"In the past, Saddleback Memorial would find a place for intended parents to bond with their newborn, but this is the first time a room has been specifically designated for, and designed with, these parents in mind," says Dr. Frederick. "Surrogacy continues to be a viable option for many families and often these families don't have a place to go in a hospital delivery situation.  Parents really need a special place that is theirs and The Women's Hospital at Saddleback Memorial has come through with a beautiful area that is really unique."

 

The Women's Hospital at Saddleback Memorial remains the only women's hospital in South Orange County and is the birthplace of more than 50,000 babies. The Women's Hospital at Saddleback Memorial offers a team of highly trained obstetricians, pediatricians and other specialists who are sensitive to the needs of new mothers and their babies, and are committed to providing the highest level of service. They deliver nearly 3,000 babies a year, and of these, approximately 10 percent are high-risk births and high-risk multiples referred from throughout Orange County and the surrounding area.

 

"This is a beautiful room for our intended parents to celebrate the birth of their child and is complementary to our facility and specialized programs we currently offer," says Dr. Michael Haydon, medical director of The Women's Hospital at Saddleback Memorial.

About Saddleback Memorial Medical Center  

With campuses in Laguna Hills and San Clemente, Saddleback Memorial provides exceptional medical expertise across a range of treatment areas including cancer, stroke, and cardiac care. Innovations such as robotic surgery, low dose CT, and dedicated breast MRI set us apart. In addition, The Women's Hospital at Saddleback Memorial - Laguna Hills offers special comfort and care to new mothers and their babies. A proud member of the MemorialCare Health System and named Best Regional Hospital by U.S. News & World Report for three consecutive years, Saddleback Memorial continues to provide comprehensive care for patients at every stage of their lives.  For more information, go to memorialcare.org/Saddleback.


About MemorialCare Health System


MemorialCare Health System is a not-for-profit, integrated delivery system that includes six top hospitals - Long Beach Memorial, Miller Children's Hospital Long Beach, Community Hospital Long Beach, Orange Coast Memorial, and Saddleback Memorial's 2 campuses; two medical groups - MemorialCare Medical Group, Memorial Prompt Care; an Independent Practice Association (IPA) - Greater Newport Physicians; MemorialCare HealthExpress retail clinics; and numerous outpatient health centers throughout the southland. For more information, go to memorialcare.org.


Jane Frederick, MD 

Dr. Jane Frederick (Second from right in photo) is a co-medical director of HRC Fertility in Orange County. Practicing in California since 1990, Dr. Frederick is an internationally noted specialist in Reproductive Endocrinology and Infertility. She has developed a diverse clinical practice in reproductive surgery, IVF, and the genetic screening of embryos. Dr. Frederick is board certified in Reproductive Endocrinology/Infertility and Obstetrics/Gynecology from the University of Southern California.  She has recently been honored as the top 10% of specialists in the nation by US News and World Report.

 

Orange County Fertility's Facebook

Dr. Jane Frederick's Facebook

Orange County Fertility's Website


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