My name is Dr. John P. Fischer.
I'm a plastic surgeon here at the University of Pennsylvania.
An example of a patient that was recently treated here
at the Penn Hernia center was a patient of mine.
Who's a forty-five year old gentleman.
He had a previous hernia repair following a colectomy
in which he had his colon removed and he an recurrance
of his hernia so he came to my office with a fairly large
lower abdominal hernia.
So when he first came in to see me,
we spent significant time going through his history
and also obtaining all of his previous operable reports
to get a better understanding of his unique condition
and we also talked in a lot of detail
about how the hernia bothered him and how it affected him
and the activities that really meant the most to him.
And we also learned a lot about what types of approaches
we could offer this patient based on his unique conditions
including his recurring hernia, the fact that is was below the
umbilicus or belly button and the fact that
the patient was obese.
So we offered several different interventions including
placing the mesh on the inside of the abdomen verses
placing the mesh beneath the muscles.
Placing the mesh beneath the muscles leads to a lower chance
of the hernia comes back and really that's our goal,
we try to fix these more complex hernia's
is try not to have it come back.
Because of the different types of techniques
that we're able to offer, we're able to use a state-of-the-art
type of flap called the "TAR" flap,
which is transversus abdominis where we release one of the
inner muscles of the abdominal wall without having to raise
any skin flaps up which means the patient has a lower chance
of developing a post operative wound complication.
This patient did great following his surgery.
He left the hospital after day two and recovered quite well.
He's able to go back to doing the things
that he really cared about which included playing sports
and really being involved with his two children at home.
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