Hernia

[char_]

I have been diagnosed with a fat containing hernia in my abdomen near the site of a prior laproscopic incision. Non-emergency, working through being seen by whoever it is I need to be seen by.

Thoughts on avoiding a repeat occurrence? There appears to be some discussion around the effectiveness of mesh, more incisions just causing more hernias etc. This was likely triggered by a nasty cough I had a few weeks ago.

[old goat]

Whether or not it needs mesh depends on how big the defect is. Since it's from a laparoscopy incision probably doesn't need but that's up to the surgeon. Get it fixed--it will only get bigger with time and the bigger it is the more surgery it will take to fix it and the less likely the surgery will be effective. I would think they would do a simple open repair--make an incision over the hernia, sew up the hole in the muscle layer, close the skin incision. There wouldn't be any new incision made in the muscle layer that would be a potential site for another hernia.

[el hefe]

I have one in my belly button area, seems to be getting a bit larger. Been there for 2 years now, surgeon at the time said best to leave it.

It does worry me pulling stuck sleds out in the B/C though.

[Glen1978]

Ive got what was half assed diagnosed as a sports hernia in my right groin. Been there two years, I live through it. It does suck though.....need to get it fixed this next off season.

[cmcrawfo]

Evidence based best practice would suggest that all incisional hernias be repaired with a mesh. its extremely common to develop a hernia post laparoscopy. Depending on the structure of your health care system, you could see your family dr who would referee you to a general surgeon. Alternatively, if you can readily access the surgeon who performed the original laparoscopy, then just skip the GP, as they will (likely) be preforming the repair anyway.

Inguinal Hernias (described by el hefe and Glen1978) can be managed differently. Unless they are symptomatic, you can just watch them and wait. (symptomatic hernia is one that can not be reduced, causes pain, or interferes with your daily life). That said, something crazy like 80% of people who follow the watch and wait program, eventual have surgery with in 10 years. Some high stress employment scenarios list inguinal hernias a contraindication to being fit for employment (fire fighters as an example). Personally, I would elect to have a surgical intervention to repair an inguinal hernia, and would not watch and wait for a prolonged period of time. The rational being, that I am an active individual who doesn't need this becoming a complication at an inopportune time, and I currently have no comorbidites that would other wise complicate a simple procedure.

But all that said .... what ever your dr and you decide is right works too.

[el hefe]

Evidence based best practice would suggest that all incisional hernias be repaired with a mesh. its extremely common to develop a hernia post laparoscopy. Depending on the structure of your health care system, you could see your family dr who would referee you to a general surgeon. Alternatively, if you can readily access the surgeon who performed the original laparoscopy, then just skip the GP, as they will (likely) be preforming the repair anyway.

Inguinal Hernias (described by el hefe and Glen1978) can be managed differently. Unless they are symptomatic, you can just watch them and wait. (symptomatic hernia is one that can not be reduced, causes pain, or interferes with your daily life). That said, something crazy like 80% of people who follow the watch and wait program, eventual have surgery with in 10 years. Some high stress employment scenarios list inguinal hernias a contraindication to being fit for employment (fire fighters as an example). Personally, I would elect to have a surgical intervention to repair an inguinal hernia, and would not watch and wait for a prolonged period of time. The rational being, that I am an active individual who doesn't need this becoming a complication at an inopportune time, and I currently have no comorbidites that would other wise complicate a simple procedure.

But all that said .... what ever your dr and you decide is right works too.

comorbidites ???? I think I will just leave mine in so you have pull all the stuck sleds while I watch and drink beer

[cmcrawfo]

comorbidites ???? I think I will just leave mine in so you have pull all the stuck sleds while I watch and drink beer

Not only am I lazy ... but while I am quoting best practices .... you only want to expose one person to an avy hazard at a time ... so, to keep everyone safe I am just going to have to stay on the sidelines and watch you figure it out.

[old goat]

I would recommend relatively young, relatively healthy people to have inguinal and other hernias repaired, regardless of whether they are symptomatic or not. If they are not now they will be and repairing longstanding, large hernias is more morbid and somewhat less successful than fixing small, recent ones. The biggest concern is chronic pain from the surgery. The frequency of chronic pain has been said to be as high as 10%, although in my experience it is a lot less. (I practiced in a closed health care system where I would hear about any of my patients with complications whether they came back to me or to someone else.) Over the years I modified my technique with the intent to reduce the risk of chronic pain, perhaps at the risk of a higher recurrence rate although I have no follow up on my later cases.

[char_]

Thanks for the info!

[old goat]

I should qualify my last post--chronic pain is primarily a risk with inguinal hernias, shouldn't really be a factor to consider with repair of a port site or trocar site (post laparoscopy) hernia.

[4matic]

Ive got what was half assed diagnosed as a sports hernia in my right groin. Been there two years, I live through it. It does suck though.....need to get it fixed this next off season.

Mine lasted a couple years but eventually healed. Swimming light breastroke frog kick really helped me.

[el hefe]

So mine gave me a really strange feeling the other day pulling my boots off. Felt like squished out and then pain radiated out from my belly button across my stomach. Since then I have had dull pain under the stomach muscles.

[cmcrawfo]

So mine gave me a really strange feeling the other day pulling my boots off. Felt like squished out and then pain radiated out from my belly button across my stomach. Since then I have had dull pain under the stomach muscles.

It’s a shame no one in this thread gave you advise to fix it before it became problematic...

[el hefe]

Its been there for 3 yrs and s surgeon said to leave it

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[cmcrawfo]

Its been there for 3 yrs and s surgeon said to leave it

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But you are asking medical advise on TGR, so what do you really care about a surgeons opinions . I know how to ski, that should be sufficient credentials.

[old goat]

So mine gave me a really strange feeling the other day pulling my boots off. Felt like squished out and then pain radiated out from my belly button across my stomach. Since then I have had dull pain under the stomach muscles.

If it's been there a couple of days it's probably just fat in there and things will eventually calm down although the hernia will still be there and the same thing can happen again.

Can you feel the lump and if so how big is it?

You might want to try and push it back in which will help relieve the pain and if you can push it in you know it's nothing immediately serious. If it's bowel in there you'll know because you'll start throwing up and shit will come out of your navel. Get it checked tomorrow to be on the safe side.

[Shredly von Whiplash]

Orchialgia is probably the biggest risk - the one that gives men pause when contemplating these procedures.
It is a real bear....I have had 2 surgeries to correct the problem and am considering a third. Should anyone have
this very serious issue spend a bit of time on the pur clinic website to get up to speed if nothing else. I am shocked that I am posting this on tgr but I think given my experience I should. 53 and struggling to get back up to speed but will get there and be in the alps for 6 weeks this year. Just get back out there asap.

You learn to handle the pain pretty quickly...but it intrudes on general level of fitness from time to time. The mountains and swimming are the best things in my case.

[Robik]

Do a repair and forget about it. I had hernia for over a year and came to the point where it affected my daily routine, not talking about active life. Went for surgery and after 1 month I feel like it was never there. It's not going to heal by itself.

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[el hefe]

Spoke with my surgeon yesterday. he said I can keep on keeping on - skiing, gym etc.... it might be getting stretched a bit (taking my boot off) which will cause some pain.

Said we should take it out after ski season. I have had 2 surgeries already this year, I don't think they want me back at the hospital for a while.

[cmcrawfo]

Spoke with my surgeon yesterday. he said I can keep on keeping on - skiing, gym etc.... it might be getting stretched a bit (taking my boot off) which will cause some pain.

Said we should take it out after ski season. I have had 2 surgeries already this year, I don't think they want me back at the hospital for a while.

They are just blowing off low dollar surgical procedures.

[el hefe]

I also don't want to take a month off of skiing. It's ok, I only ski B/C with medical professionals.

[el hefe]

They are just blowing off low dollar surgical procedures.

Yes I am hearing the same. I was very lucky to get in to get my ankle hardware removed. Pays off knowing the Dr's in town.

[old goat]

They are just blowing off low dollar surgical procedures.

Nah. sounds like the surgeon knows it's a very small one that would only have fat in it, not bowel, so fine to wait as long as not too much pain.

[schwerty]

FWIW I’ve had an inguinal hernia for 3.5 years. Used to think about it all the time but that passed. The damn thing really only bugs me when I stand for extended periods of time. Concerts suck after a few hours without a seat. Surprisingly, I have no problems skiing for a day, hiking...being active. It just hurts when standing.

I got the same advice from two surgeons and my GP. Wait until it sticks. Might man up and have it done next fall despite my adversity to getting cut open.

Old Goat gives great advice on these things!

[thefortrees]

FWIW I’ve had an inguinal hernia for 3.5 years. Used to think about it all the time but that passed. The damn thing really only bugs me when I stand for extended periods of time. Concerts suck after a few hours without a seat. Surprisingly, I have no problems skiing for a day, hiking...being active. It just hurts when standing.

I got the same advice from two surgeons and my GP. Wait until it sticks. Might man up and have it done next fall despite my adversity to getting cut open.

Old Goat gives great advice on these things!

I'd say man up and get it done. I had a large mesh repair last September and was close to 100% and skiing by mid-December. 6 weeks of no activity other than walking sucked (my surgeon's recommendation), but it was actually a good time for a mental and physical reset. Eased back into activity and was back into my normal activities with no problems.