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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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No Mesh Put In Umbilical Hernia Repair, CT Showed Some Mass. Re-herniated, Got Abdominal Adhesion, Pain And Fever. Is This Normal ?

On 7/2 my husband had Umbilical Hernia repair. The surgeon did not use mesh, even though we asked him to use mesh because my husband has allergies that cause him to cough hard which has fractured ribs. Anyway, on 7/11 he went back to the ER and got a CT done and they saw what hey said was a "mass" of some kind. His surgeon re-admitted him to the hospital and did exploratory surgery to find what was wrong, he re-herniated and developed abdominal adhesions. So he "fixed it" again. Wait....it's not over. On 7/20, he was running a low grade fever and was having abdominal pain and swelling, they did another CT and said "everything looks good." The next day the surgeon called and said he was going to admit him again because he had re-herniated and needed to fix it this time with mesh (finally). He had surgery on 7/22. Here we are still in the hospital. Wondering if this 3rd one was done correctly. The doctor said this was a very unusual case. The incision runs through the center of his belly button about 6in in length. Just to the right he is having like a swelling bump and even clothes hurt when they touch it. Question 1: Is this all unusual for a hernia repair? In your opinion, did the doctor not do something he should have? Could the sensitivity be from abdominal nerve damage? He fears he will need another surgery because after the first 2 he always felt something was not right and his instinct was right, he is again feeling that way. Please Help? If you can give some advise that would be helpful.
Wed, 31 Jul 2013
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General Surgeon 's  Response
Hello!

Thank you for the query.

You need to know that many people have a tiny hole in the belly button. But only some part of them have a hernia in this area. Its because hernia needs some factors to be created. It is usually an inherited weakness of connective tissue all over in the body. This weakness in some area (like a groin or belly button) allows for the abdominal contents to get out of the abdominal cavity.
Sever coughing is another very strong factor witch leads to hernia creation.
Severely coughing patients with abdominal hernias are very hard to treat. Any abdominal wounds (including hernia repair wounds) are constantly stretched and teared by increased pressure in the abdominal cavity during coughing.

Umbilical hernia surgery is usually performed without a mesh (its called Mayo repair) and there is nothing wrong in it. So his doctor has done anything correctly in my opinion. Just a risk of reherniation is much higher than regular.

Bump and pain around the wound can be present. This pain is numbness due to skin nerves cut. This will go away however it can take up to a year or so.

Hope this will help.
Regards.
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No Mesh Put In Umbilical Hernia Repair, CT Showed Some Mass. Re-herniated, Got Abdominal Adhesion, Pain And Fever. Is This Normal ?

Hello! Thank you for the query. You need to know that many people have a tiny hole in the belly button. But only some part of them have a hernia in this area. Its because hernia needs some factors to be created. It is usually an inherited weakness of connective tissue all over in the body. This weakness in some area (like a groin or belly button) allows for the abdominal contents to get out of the abdominal cavity. Sever coughing is another very strong factor witch leads to hernia creation. Severely coughing patients with abdominal hernias are very hard to treat. Any abdominal wounds (including hernia repair wounds) are constantly stretched and teared by increased pressure in the abdominal cavity during coughing. Umbilical hernia surgery is usually performed without a mesh (its called Mayo repair) and there is nothing wrong in it. So his doctor has done anything correctly in my opinion. Just a risk of reherniation is much higher than regular. Bump and pain around the wound can be present. This pain is numbness due to skin nerves cut. This will go away however it can take up to a year or so. Hope this will help. Regards.