Recurrent hernias and patient selection
All too often, Dr. Linville sees patients who have had multiple attempts at hernia repair, but which have failed and now the hernia has come back, potentially worse than it was originally.
A herniologist, or hernia surgeon, knows the most important aspect of a successful surgery is the optimization process prior to surgery, which in some cases can take months to years and may even require weight-loss surgery beforehand.
Most importantly, any type of tobacco use must be stopped at least a month before and a month after surgery, as the complication rate, and thus recurrence risk has been shown to be too high.
Weight must be stable, with a body mass index (BMI) of around 30. If a patient’s weight is too high, the mechanical forces pushing out on the delicate hernia repair are strained which can (and often does) lead to a recurrence.
Of course, other medical conditions such as Diabetes, heart issues, rheumatologic disease, etc, must be well controlled prior to undergoing this type of complex surgery.