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Sponsored: Laparoscopic Hernia Repair

Scott de Villeneuve, M.D.

What is a Hernia?
Hernias occur when the inside layers of the abdominal wall weaken, andultimately bulge or tear. The weakened area forms a protrusional sac that cancause severe pain and other potentially serious health problems. Men andwomen of all ages can have hernias. Hernias usually occur either becauseof a natural weakness in the abdominal wall or from excessive strain on theabdominal wall, such as from heavy lifting, substantial weight gain, and pregnancy,among other reasons.

What types of Hernias are there?
People can get several different types of hernias. The most common are inguinal/groin, umbilical, and incisional. Inguinal hernias develop as theresult of a weakness, tear, or opening in the muscle wall of the lower abdomenor groin causing the contents of the abdomen, namely the small intestine, to protrude through the opening. This can result in severe pain and in some cases become stuck or incarcerated, requiring emergency surgery.Umbilical hernias develop in and around the navel, typically caused by a weakness in the naval area that has existed since birth. The signs of an umbilical hernia include pain at or near the navel area as well as the developmentof an associated bulge or navel deformity. In infants, these hernias may gradually close by age 4, but if not, surgery is then recommended to correct it. Umbilical hernias do not typically heal in adults and tend to increase in size. They will often then become problematic and eventually require surgical intervention. Incisional hernias occur at the site of a previous surgical incision, typically presenting as a bulge at the incision site following surgery. They can occur at any time after surgery, even after several years. Patients can get an incisional hernia from any procedure that has an incision including major surgery such as a colon resection to something smaller such as an appendectomy. Like most other hernias, incisional hernias gradually increase in size and become progressively worse. They typically result when too much tension is placed on the sutures used when closing the abdominal incision creating poor healing,swelling, and wound separation. 

Surgical Associates of North Texas performed more than 400 hernia repairs laparosopically with the last year alone.

How can my Hernia be treated? 
There are two major categories when dealing with hernia surgery. Traditional open methods and more recently, less invasive laparoscopic techniques.The surgeons at Surgical Associates of North Texas try to treat hernias with the newer, less invasive laparoscopic techniques. The surgeons use laparoscopic surgery for a variety of surgeries including gallbladder, colon, and appendix removal, but the majority of the operations are hernia repairs. In fact, Surgical Associates of North texas performed more than 400 hernia repairs laparoscopically within the last year alone. With traditional hernia surgery, patients have a more lengthy recovery time and can experience significant pain post surgery. With laparoscopic surgery, significantly smaller incisions are made through which a small camera, or laparoscope, is inserted. This laparoscope is used to visualize the hernia defect, and small instruments are then used to return the contents of the hernia to their normal anatomic location. A thin, flexible piece of mesh is then placed into the area and used to patch or cover the actual hernia defect. This functionally closes the hernia, thus preventing any future “bulging” and eliminating the pain and other complications that hernias can cause. The incisions used for this are typically less than a half-inch long and are not visible six months after surgery. Using this less invasive approach cuts the recovery period in half, allowing patients to resume normal activity in a few days and usually return to work in less than a week. Once recovered, patients are able to resume all of their pre-operative activities including sports and exercise without limitation.

Dr. Scott deVilleneuve is currently the senior member of Surgical Associates of North Texas and works in the McKinney, Allen, and Frisco areas. A native Texan, he is a graduate of Texas A&M University and UT Southwestern Medical School. He completed his residency in general surgery at the University of Kansas Medical Center in Kansas City before returning to Texas to start private practice in 2004. During his residency and time in practice he has had extensive exposure to and experience using a variety of techniques for laparoscopic herniorraphy and performs more than 200 laparoscopic hernia repairs annually.

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