Epigastric Hernia Repair
Most epigastric hernias, including recurrent epigastric hernias, are safely performed as an outpatient ambulatory procedure. Our surgical technique requires only mild sedation and local anesthesia for the overwhelming majority of these repairs.
Most common epigastric hernias are addressed by our "Tension-Free" technique, using mild sedation and local anesthesia. Surgeons make a small incision (about two inches in most patients).
Once the hernia (bulge) is freed up by gentle dissection, it is returned through the hole or weakness into its proper position. Rather than just suturing the defect closed under tension or covering over the weakness at this point, a specially designed, sterile "mesh" system is gently placed through the defect. It is then carefully opened on the under-surface of the muscle to reinforce and repair the defect from the inside, by far the best place for mesh to be positioned. This underlying area of mesh extends well beyond the edges of the defect to reduce pressure on the hernia opening, and reinforces the entire weakened and hernia-prone area. The mesh is held in place without tension. There is no need to place painful, tight sutures, staples or tacks to pull muscle unnaturally together.
The mesh is held firmly in place and rapidly develops a bond between the mesh and the abdominal wall. Since there is no tension, and only a small surgical dissection, post-operative pain is minimal and patients quickly return to normal activity. This technique has been utilized for more than a decade, with recurrence rates lower than one-half percent.
Patients remain awake, yet calm and sedated and comfortably free of pain, and avoid the risks of general anesthesia. Patients begin walking shortly after surgery, and are discharged home within about one to two hours.
Tailoring to the Patient
Our surgeons choose from several mesh systems to best match patients’ unique needs. Hernias differ from patient to patient, often quite significantly. One single tension-free operative approach or single mesh product system may not be suitable for all patients or all hernias.
Tailoring the mesh or mesh product to the exact dimensions and needs of the patient is critically important for effective and safe hernia repair. Since some mesh products are not amenable to this type of tailoring, we choose only mesh products that permit us to provide exact, yet completely effective mesh coverage for hernia repair. This safe, effective product is utilized in the overwhelming majority of hernia repairs.
Surgeons at North Penn Surgical Associates perform various advanced Tension-Free repair techniques commonly in use today, and utilize many diverse mesh systems. We individually select the precise mesh product (selecting the precise size, shape, configuration and manufacturer) at the time of surgery that is best suited for each hernia. Our expertise in both routine and complex hernia surgery assures that all of our patients receive the most satisfactory, safest and importantly the most effective repair available.
Recovery is rapid, pain is minimal since muscles are not cut and are neither pulled together nor sewn under tension. Post-operative restrictions are few, if any, and our patients can actually return to their normal activity in a short period of time.
The advanced techniques we utilize are associated with a lower risk of recurrence when compared to most other older surgical techniques that place tension on the muscle and the repair by cutting and sewing muscle together. Our technique is equally safe and the fully effective for most recurrent hernias as well.
While the over-whelming majority of these hernias are both safely and effectively repaired using just local anesthesia and mild sedation, certain hernias (those that are large and/or complex, have recurred multiple times, or patients are extremely obese) or for certain patients, a safe, light form of mild general anesthesia under the supervision of a certified anesthesiologist may be required.
125 Medical Campus Drive
Lansdale, PA 19446