I made a few posts recently about a suspected insicional hernia. Spent over a month going back and forth with various surgeons, GIs, tests, etc to try to determine between the pain being scar tissue or a hernia.
We finally got to see one of the original CR surgeons from Mt Sinai that did my Jpouch surgeries.
He confirmed that there is a large defect in the abdominal wall along the midline insicion and it requires repair.
He is planning to do an open repair with a disolvable mesh attached inside the abdominal wall, closing the muscle wall and then a permenant mesh over the muscle wall. He plans to cover a very large area, going over the stoma site and well above and below the defect to prevent any future hernias.
He's estimating a 3 hour procedure with 4-5 days in the hospital and a drain. The recovery will be 6 weeks of no lifting and 6 weeks of light activity before I can return to work.

Anyone have experience with this type of repair?

He also suggested doing pain control via an epidural rather then a PCA morphine drip. From some of the things I've read, I think I'm going to opt for the PCA since I used that with my previous 3 surgeries.
Original Post
Hi CLeLong,
Just curious why he is going through all of that for a hernia repair? I have had a few and the best and most successful have all been through laporoscopy using a mesh repair...I just felt that I have had enough open surgery for a lifetime and the less playing around in my guts the better...been 2yrs since the last one and it is holding.
Sharon
Ok, he is the doctor but you may want to ask him what incidence of complication there is if you ever have to be opened up again...I guess that it all depends on what condition your abs are in now, were before and how much he fears another hernia. My surgeon refused to put a full mesh over the whole abdomen...fear that if they ever have to go back in, it could make it more difficult.
Different doctors, different techniques.
Good luck
Sharon
I don't yet have experience with hernia repair, although that will probably need to be done in the next several months.
Regarding pain control, the epidural that I had during and after my pouch construction surgery was an absolute godsend! With the exception of some easily-controlled itching, I had essentially zero discomfort during my entire hospital stay. I'd have one again in a second!
Good luck!
I had a hernia repair similar to what you describe, but I didn't have mesh over the entire abdomen, just local to the hernia. It was a really large hernia and the two surgeons I interviewed prior to picking the one I went with both had the same opinion, that there was no doubt that it would be an open surgery. Everything went fine and the repair held up. Of note, I had a later surgery above my colectomy/j-pouch midline scar (unrelated to UC) and I ended up with a huge hernia from that as well. I haven't gotten it fixed yet and it sticks out, but I figure there may be more surgery in my future, and if that is the case, I'll have it fixed then.

Good luck!
The surgeon wanted to make sure no additional hernias develop along the incisions. He felt doing this was the best route to prevent any future problems. He was confident that it will go well with little risk of bowel complications.

I'm usually more comfortable with familiar things. Since I've has PCA several times, I'm more comfortable with it than the epidural. From other people's experiences that I've read, including here, it seems like there is a chance of the epi not working well or at all. I'd hate to wake up from surgery and find out the epi isn't working right. I was also concerned about how it would effect feeling / controlling the pouch.

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