Grand River Surgery, PLLC

General Surgery

• Breast
• Colon
• Endoscopy
• Gall Bladder
• Hemorrhoids
• Hernias
• Laparoscopy
• Lipomas
• Skin Cysts
• Stomach for Reflux (Nissen, Hiatal Hernia)

Pain Management

• Pain Pump & Nerve Pain

Bariatric Services

• Lap Band

Vascular Services

• Abdominal Aortic Aneurysm
• Endovenous Ablation
• Peripheral Bypass Surgery
• Sclerotherapy
• Venous Closure Procedure

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Services

Hernia Surgery

We use a variety of techniques to repair hernias, including advanced laparoscopic surgeries for inguinal hernias, ventral and incisional hernias.  Laparoscopic techniques may allow for an earlier return to work/activities and are generally associated with a decreased level of post-operative pain.

There are a variety of hernias and a variety of ways to repair them.  The common theme between all of them is that there is a weakness in the belly wall that has allowed fat or bowel to pass through the hole.  (Think of a tire inner tube bulging through the side wall of tire.)  This is a potentially severe problem -- if the bowel looses it's blood supply, it dies and that is a significantly complicated issue.  That's why it's preferred to fix hernias before they turn into a real problem

Another thing hernias share is the possibility of a recurrence, or that the hernia may come back after a repair.  Recurrences happen, but fortunately they are very rare for most patients.  To decrease your risk of a recurrence, you should have stopped smoking by at least a couple of weeks prior to surgery.  Some hernia repairs will not be performed if you are smoking at the time of surgery -- the risk of infection and poor wound healing is too high.  Smoking represents a major risk factor for complications from surgery and if you smoke, you should choose to decrease your operative risks.  One more risk for recurrence is weight, if you are considered obese (BMI >30, use the calculator), you are at a higher risk.  If you gain weight after your hernia repair, you also jeopardize the repair.  Please review these wellness options to help you achieve and maintain a more healthy body weight.

Different types of hernias that we repair:

• Inguinal or groin hernias
• Femoral hernias
• Umbilical or "belly button" hernias
• Ventral (midline) hernias
• Incisional hernias (hernias that occur at sites of prior abdominal wall incisions)
• Hiatal hernias

Inguinal Hernias

An Excisional Breast Biopsy is also done to achieve a diagnosis.  This is usually done to evaluate abnormalities on a mammogram.  Generally a "wire" will be needed to guide the surgeon to the area of interest.  On the day of your surgery, the radiologist will place the guide wire in the area of interest using a special mammogram machine.  Then, you'll return to the preop area until surgery.  Surgery is generally done with moderate sedation administered by an anesthesiologist and takes about 45 minutes.  We always confirm removal of the abnormal tissue before you wake up, just in case more tissue needs to be removed.  Most women go back to the pre-op area, where your family can be with you.  Most women sleep comfortably through surgery and don't remember the experience.  This is also a diagnostic procedure.  Occasionally, if a cancer is discovered, it is completely removed and no further breast surgery is indicated, although lymph node sampling may be indicated.  You should wear a bra day and night for a week after surgery.  Most women will take 3-5 days off from work and may use narcotic pain pills for a few days.  You will be seen approximately five days after the procedure to discuss the results and decide upon a treatment or surveillance plan.  Most women will not appreciate a cosmetic change after this procedure, but the breast tissue will feel different. 

If no cancer is detected with the above options, a repeat mammogram will be ordered for three month's time to establish a new baseline for future comparisons.  On occasion, if a cancer is detected, it may not be all removed and a lumpectomy will be required as described below.  Lumpectomy with sentinel node biopsy is demonstrated to have excellent results in terms of survival and low recurrence, in comparison to mastectomy.  Lumpectomy does usually require radiation therapy to the breast to achieve success.  If radiation therapy is not an option due to distance or prior radiation therapy, then mastectomy is generally indicated.  The use of chemotherapy and hormone medications to decrease the risk of future cancers is variable and will be discussed after lymph node status (cancer or not) is known.

Femoral Hernias

Femoral hernias are a rare type of hernia that occurs when there is a weakness near the large blood vessels that travel to the legs.  Bowel and fat can sometimes go into this area and get trapped.  This type of hernia has special repair options and is typically approached like an inguinal hernia and has similar risks and recovery.

Ventral or Incisional Hernias

These hernias occur in the abdominal wall or at sites of prior surgeries.  Generally these are fixed with laparoscopic (small holes) technique and with the placement of mesh, usually done as an outpatient surgery.