In today’s “Unique Challenges during Hernia Surgery” Panel Session (2:30 pm in Room Skyline/W-375c), speakers will present strategies for navigating specialized operative complexities in hernia repair, with a focus on how underlying conditions, such as cirrhosis and cancer, can affect the surgical approach.
Carlos V. Brown, MD, FACS, a trauma and acute care surgeon, and Shirin Towfigh, MD, FACS, a hernia specialist, will comoderate the session.
“We chose the true expert in each field to give you their insightful tips and tricks on how to manage challenging situations in hernia repair. Every general surgeon and every surgeon who take emergency surgery calls will want to learn from our expert surgeons so that they can immediately apply what they learn onto their next call night,” said Dr. Towfigh.
Addressing hernias in patients with chronic disease, in both elective and emergent cases, requires critical patient care considerations.
“Patients with cancer or organ failure, such as cirrhosis, are a very special group,” Dr. Towfigh said. “Coordination of care with their medical specialist is very important. Also, understanding perioperative management tricks, dealing with various chemo- and immunotherapies, and modifying your surgical techniques will allow you to optimize their hernia care without significantly worsening their underlying chronic illness. In this session, the details of how to do that will be shared with the audience.”
The session also will include presentations on the following topics: tissue repair options and techniques for umbilical and inguinal hernias, approaches for managing hernias in unusual locations, strategies for mesh use in contaminated fields, and identifying differences between early and late management of traumatic abdominal wall hernias.
“One of the takeaways of our session is life over hernia—and that means it is important to first address the life-threatening problem and leave the hernia for when it would be more appropriate to repair it, resulting in better outcomes for the hernia repair and the patient as well,” said Dr. Towfigh. “For traumatic hernias, they often present at the time of the major trauma. In general, the early focus on the patient should be to address the life-threatening, trauma-related injuries, such as internal hemorrhage, intestinal injury, or any pulmonary or cardiac injury. The traumatic hernia will often scar down and reduce in size later during the patient’s recovery, allowing time for the surgeon to address it when the tissue is no longer friable and the soft tissue injury and bleeding has resolved.”
Hernia surgery, while generally a safe procedure, can present unique challenges when patients present with a comorbidity or other underlying factors, requiring the surgeon to acquire additional skills and an enhanced knowledge base.
“Every surgeon needs some tricks and tools to handle challenging situations,” Dr. Towfigh said. “Our goal is to share knowledge from this panel of experts in order to improve hernia care throughout all types of practices. I highly encourage any surgeon who sees hernias, both electively and acutely, to attend this session. I am confident you will learn more than one tip and trick that you can use in your practice.”
