At the University of Maryland Medical Center (UMMC) in Baltimore, general surgeons from the Minimally Invasive Therapy Center (MITC) specialize in using the most advanced laparoscopic techniques to treat all types of hernias. On Sept. 14, 2005, at 4:30 p.m. (20:30 UTC), watch as Dr. Adrian Park, chief of general surgery at UMMC and professor of surgery at the University of Maryland School of Medicine, and his colleague, Dr. Scott Roth, director of surgical endoscopy at UMMC and assistant professor of surgery at the University of Maryland School of Medicine, perform a laparoscopic incisional/ventral hernia repair – a procedure that Dr. Park helped pioneer.
Incisional/ventral hernias are defects that appear at the site of a prior surgical incision. Seen as a bulge or tear, this type of hernia occurs in the abdominal wall and results from the protrusion of an organ, such as the intestine. With time, the hernia can increase in size.
At the University of Maryland, most hernias are repaired laparoscopically rather than as an open procedure – the standard treatment at many other institutions. During a laparoscopic repair, surgeons mend the tear in the abdominal wall using special instruments, small incisions, and a mesh patch. They begin by making a small incision in the abdominal wall in a location chosen to minimize the risk of running into organs or scar tissue from previous operations. Then a laparoscope (a tiny telescope with a television camera attached) is inserted through a small hollow tube, allowing the surgeon to view the inside of the hernia on a television monitor.
Other small incisions will be made for placement of other instruments to remove any scar tissue, and to insert a surgical mesh into the abdomen. This mesh is fixed under the hernia defect to the strong tissues of the abdominal wall to prevent the hernia from recurring.
Previously the challenge with ventral hernia repairs stemmed from high recurrence rates. When compared to conventional open surgery, the rate of recurrence is much less with the laparascopic approach (less than 10 percent ) as compared to the 20 percent to 40 percent recurrence rate with the open procedure.
There are many clear advantages to the laparoscopic approach, including quicker recovery and shorter hospital stays, as well as a significantly reduced risk of infection and recurrence. Patients typically go home within 24 hours after laparoscopic repair, as opposed to a longer hospital stay after open repair. Patients also report less pain and a quicker return to normal activity.
UMMC will host an internative forum where individuals may submit their questions surrounding this procedure. The forum will be active for one week following the broadcast.
