Novel Hernia Repair System Offers Faster Recovery

Kurt Keller was gearing up for the New York City Triathlon when an inguinal hernia threatened to put the brakes on his training.

At times, the protruding sac would get pinched during his exercise program, and it caused so much discomfort that Keller would have to take a break and lie down.

Even then, as he was flat on his back, Keller’s initial reaction was to train through the pain. His father had previously undergone surgery to repair a hernia, and it had taken six months for him to fully recover. Keller figured that if he wanted to participate in the race, he didn’t have that kind of time to recover from surgery.

Richard Andrassy, M.D., professor and chairman of surgery at The University of Texas Medical School at Houston, offered an innovative solution that got Keller back to running, swimming and biking almost immediately after his surgery.

Using a new, 3-D mesh repair called the PROLENE Hernia System, Andrassy can fix an inguinal, incisional or umbilical hernia under local anesthesia in less than 30 minutes.

The device, developed by ETHICON Inc., consists of an underlay patch that repairs the inside posterior of the abdominal wall. It also has a connector similar to a plug, but smaller and flatter, and another mesh patch that fits over the abdominal wall.

The device, which is secured with a minimal number of stitches, rests flat against the abdomen, and it eventually grows into the tissue to create a new wall.

After making the hernia repair, Andrassy covers the incision with a plastic patch, so patients can shower within hours of surgery. Patients leave the hospital the same day, and can immediately return to normal activities – even if those activities include weight lifting or other strenuous exercise.

This novel method for “battling the bulge” could benefit more than 1 million Americans who have hernia repairs each year. Andrassy said men are far more likely to suffer hernias, and it is one of the most common reasons men seek surgical evaluations.

“In the past, hernias have been repaired with sutures, which can cause a lot of pain and discomfort,” Andrassy said. “It could be six weeks before the patient was allowed to exercise or lift anything. The PROLENE Hernia System allows patients to get right back to work or exercise, and it’s tension-free, so there is very little pain.”

Best of all, the 3-D mesh device appears to have the lowest recurrence rate of all the hernia repair techniques available today.

A patient who has had a hernia repair with sutures has a 20 percent chance of developing another hernia in the area. With the mesh repair, an improvement on the plug and patch technique, the recurrence rate is less than 1 percent.

It provides the benefits of a strong posterior repair, much like a laparoscopic procedure, but is less costly and can be done without general anesthesia.

Andrassy said PROLENE Hernia System’s record of effectiveness is impressive, but it is the testimony from his patients that has convinced him this is the best device for his teen-aged and adult patients.

One of Andrassy’s patients, Roger Barber, Ph.D., associate professor in the department of integrative biology and pharmacology at UT-Houston, said he would recommend it to anyone facing surgery to repair a hernia.

Six years ago, Barber had a hernia repair “the conventional, old-fashioned way.” After the procedure, he was on painkillers for seven days and it was months before he could do any strenuous activity.

When the hernia recurred, Barber went to Andrassy, who recommended the PROLENE Hernia System. Barber had the surgery and within two days, no longer needed pills to dull the pain. Within a week, he was back to work, and within two weeks, was working out with weights.

“I can already put weight on my back and squat, and that is certainly not something I would have done two months, let alone two weeks, after the old-fashioned surgery,” Barber said.

Andrassy is the first surgeon in the Texas Medical Center to offer the PROLENE Hernia System, and is currently training other UT-Houstonphysicians to implant the device.

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©2006 Texas Medical Center

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