Hernias

Laparoscopic hernia repair surgery in Santa Barbara

A hernia develops when a portion of the abdominal wall weakens and creates a defect that allows the intestine and other abdominal organs to push through the compromised areas. A loop of intestine or abdominal tissue may slip into the sac, causing severe pain or other potentially serious health problems. Although most hernias require surgical repair, these repairs can usually be performed using minimally invasive techniques. Dr. David Thoman specializes in minimally invasive laparoscopic gastrointestinal surgery, including hernia repair surgery in his Santa Barbara, California practice.

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  • What causes a hernia?

    Men, women, and children of all ages can develop a hernia. Hernias usually result from a natural weakness in the abdominal wall (congenital), or from excessive strain on the abdominal wall, including strain from heavy lifting, substantial weight gain, persistent coughing, or difficulty with bowel movements or urination (an acquired hernia). This defect is permanent unless surgically repaired. A hernia may be associated with mild discomfort or severe pain.

    Sometimes a hernia can cause serious problems. An incarcerated hernia is one in which the abdominal contents remain under the skin (as a lump) when the patient lies down and relaxes. It often is accompanied by pain. If the hernia cannot be reduced by gentle pressure, the blood supply to these organs can be compromised, resulting in gangrene (lack of blood supply to a structure) requiring major surgery. This is a potentially life threatening situation. Eighty percent of all hernias are located near the groin. Hernias may also develop below the groin (femoral), through the navel (umbilical), or along a previous surgical incision (incisional).

    How is laparoscopic hernia repair surgery performed?

    Laparoscopic surgery uses a thin, telescope-like instrument called a laparoscope, which is inserted through a small incision at the umbilicus (belly button). The laparoscope is connected to a tiny video camera, smaller than a dime, which projects a view of the operative site onto video monitors located in the operating room. Dr. Thoman inflates the abdomen to give him a clear view of the operative area.

    With the traditional laparoscopic technique, two additional small incisions are made near the laparoscope through which Dr. Thoman inserts specialized surgical instruments. He uses these instruments to expose the weakened area of the abdominal wall. A mesh patch is affixed with titanium staples or sutures to repair the weakness. Following hernia repair surgery, the small incisions are closed with absorbable sutures and covered with special glue that allows the patient to shower soon after surgery. After a few months, the tiny scars are barely visible.

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  • What is the single-incision technique?

    Dr. Thoman was the first surgeon on the Central Coast to perform the single-incision approach to minimally invasive hernia repair surgery. Instead of using three small incisions on the abdomen, the instruments and camera are all placed through an incision in the belly button. When the incision has healed there is no remaining visible scar. This is truly scarless surgery and a good choice for anyone concerned with the cosmetic aspect of surgery. There may also be slightly less pain with this approach, although this has been difficult to prove so far.

    In addition to performing single-incisional hernia surgery, Dr. Thoman has performed gallbladder surgery, appendectomy, and LAP-BAND® surgery in California using this technique, all with excellent results. When you visit him for your consultation, he will determine whether this technique is appropriate for you.

    “Scarless” Surgery Is Here
    Dr. Thoman offers the single incision laparoscopic surgery (SILS) technique for this procedure. For more information, don’t hesitate to call our office.

    What are the benefits of laparoscopic hernia surgery?

    The benefits of laparoscopic stomach surgery for our patients include:

    • Surgery requires only 3 or 4 tiny scars instead of 1 large abdominal scar.
    • Decreased hospital stays — many patients leave the day after surgery.
    • Reduced postoperative pain.
    • Shorter recovery time — days, instead of weeks — and quicker return to normal daily activities, including work.
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  • What can I expect after hernia repair surgery in California?

    It is important to follow your doctor’s instructions after surgery. Although many of our hernia surgery patients feel better in just a few days, recovery may take longer in other cases.

    How safe is laparoscopic hernia repair surgery?

    If performed by a specialist like Dr. Thoman, laparoscopic hernia repair surgery is as safe and effective as traditional “open” hernia surgery. It has also been shown that less experienced surgeons (who have performed less than 250 operations) produce worse results. Dr. Thoman has performed over 1,000 laparoscopic hernia procedures, more than any surgeon on the Central Coast.