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How is the thorax involved in hernia repair?

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Posted on Fri, 17 Apr 2015
Question: In many discussions about hernia repair, did you mention thoracic? It is unfortunate, but, finally, I have answers. The surgeon who did my hernia repair; cut into muscle wall and "repaired" was sued and "Trauma Doctor" at esteemed hospital is taking patients and fixing the awful mess made by this doctor. After repair, I had very big issues with bowel movement; up to two weeks w/o. Unfortunately, colon and intestines are under repair. I'm reading about fascia in abdomen; confusing, of course, but somebody on your site mentioned to look at thorasic (I don't think this is to be confused with the part of spine) After all this searching, finally, I have reason to believe that the surgeon did mess up and not only with me. I understand mistakes, but, he had too many. I'm trying to understand the fascia/abdominal wall and how far down the fascia go and this why I'm asking about the thoracic? Not sure I'm writing the right word.
doctor
Answered by Dr. Ajit Naniksingh Kukreja (7 hours later)
Brief Answer:
Hiatus Hernia

Detailed Answer:
Hi

Thanks for writing in

There is an entity called hiatus hernia, where the abdominal contents herniated through the diaphragm in to the thorax, this is what is commonly known as hiatus hernia and we use a thoracoabdominal approach during open surgery to repair it

Fascia is a layer of the abdominal wall and it's role in anatomical repair of hernia is documented, when we were students the mesh quality and availability was an issue and we had done a series of anatomical repair for abdominal hernia using fascia dissected properly with very good results and low recurrence

It is sad a doctor has to face this huge number of complications, at a stage it needs introspection to revive the surgical skills

Hope I have cleared your doubts
Regards
Above answer was peer-reviewed by : Dr. Shanthi.E
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Follow up: Dr. Ajit Naniksingh Kukreja (3 days later)
I don't think I asked the right question. All I know is the surgeon was sued; no longer there but asked me to send tests to him (after he had already left) and was going to choose doctors - I don't think he wanted anyone to see results because the Trauma Doctor who is cleaning surgeon's mess (more than one_) has an appointment for me quicker than norm once he heard my surgery was done by this particular doctor. Sad, yes. I'm not angry; I think the doctor, according to communication with him, might have practiced too long. He cut my abdominal wall to repair the surgery and it was after this surgery that the colon seemed restriction and major problems came about; I called him many times; he said I"m fine. Then I read the law suit, his emails, and it all seems to come together - you said one doctor would eventually find a solution. You may be right as the Trauma Doctor at this esteemed hospital apparently knows what damage could have been done and how to help repair. I will know more once tests are done - I could never get the tests here because I have chronic pain and it appears it's out of the box and far too complicated. Unfortunately the sigmoid colon resection was done; unnecessarily then the infection then the repair. Colon/intestines affected after hernia repair - I do know that it is documented that bm going through ascending, transverse, and descending is very painful and I will go up to 2 weeks w/o movement. So, perhaps I didn't ask you the right question in right area. Bless your heart. I couldn't get any answers here; I've inundated you with them; you have been wonderful.
doctor
Answered by Dr. Ajit Naniksingh Kukreja (11 hours later)
Brief Answer:
Thanks for the kind words

Detailed Answer:
Hi

Thanks for the kind words
It is good you have found someone who is ready to look in to your issues

I have a feeling positive attitude works wonders and patients have recovered after having lost all hopes, may seem absurd to a lot of my colleagues but it is a fact

Would wait for the day when you write back to me about your well being

DO keep me posted once the tests are done
Regards
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Answered by
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Dr. Ajit Naniksingh Kukreja

Gastroenterologist, Surgical

Practicing since :1984

Answered : 923 Questions

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How is the thorax involved in hernia repair?

Brief Answer: Hiatus Hernia Detailed Answer: Hi Thanks for writing in There is an entity called hiatus hernia, where the abdominal contents herniated through the diaphragm in to the thorax, this is what is commonly known as hiatus hernia and we use a thoracoabdominal approach during open surgery to repair it Fascia is a layer of the abdominal wall and it's role in anatomical repair of hernia is documented, when we were students the mesh quality and availability was an issue and we had done a series of anatomical repair for abdominal hernia using fascia dissected properly with very good results and low recurrence It is sad a doctor has to face this huge number of complications, at a stage it needs introspection to revive the surgical skills Hope I have cleared your doubts Regards