Hernia disease is as old as mankind.
Ever since Homo sapiens started an erect posture, Hernia as a disease came into existence. The primitive men considered it as a projection of some growth outside the body & resorted to castration or cauterization, of course with horrendous results.
With the knowledge of anatomy, Hernia surgery has evolved to present as a repair of the defect, initially with sutures & then with a prosthesis (Mesh).
With the revolution of Minimal Access surgery, treatment of hernia became less painful. However, the concept still remains of patching the hole to prevent protrusion of contents.
The incidence of hernia has been rising. We see older populations as life expectancy has improved. More patients are surviving from advanced cancers as a result of improved onco-care, more Polytrauma with abdominal intervention are surviving because of improved trauma care & more abdominal catastrophes are successful with improved surgical & ICU care. All these patients eventually develop a large hernia. The repair with patching these large “Holes” as done by general surgeons was often unsuccessful with high failure rates. As a result, General surgeons were reluctant to treat them. These unfortunate patients who survived major challenges, otherwise, had to suffer from large protrusions with poor quality of life.
There is a “Sea Change”, in the last decade, in concepts as well as the repairs of hernia. It is no longer considered as “HOLE” in the muscle, but how it affects the body as a “WHOLE”. A structural defect is now seen as a functional loss of the abdominal wall & hence the repair is not filling the gap but reconstructing the area, i.e Abdominal Wall Reconstruction (AWR).
A modern hernia surgeon or Herniologist (a better name) will reconstruct the whole weakened area to recreate structure, restore the function & reinforce it with a large prosthesis to give a durable repair.
The necessity to have a herniologist, well trained in abdominal wall reconstruction has been realized the world over & it has been echoed in the leading hernia journals recently.
• The time now seems to be ripe for hospitals/ clinics/universities, too, to address the need for ad hoc centers and formal and institutional specializations for surgeons wishing to devote themselves to AWR. – Campanelli, HERNIA 2021
• Hernia repair be better done by surgeons having a passion for hernia surgery & who are well trained in AWR. Patients should be referred to such dedicated Hernia Centers for better results. -F. Kokerling, HERNIA 2019.
I have joined ACI Cumbala Hill Hospital, with an aim to do Hernia repair & abdominal Wall Reconstruction for your hernia patients.