Gros ventre ? C'est peut être un Diastasis ? : la Méthode DREAMDécouvrir
The Hernia InstituteParis provides the most effective tailored approach. At the Hernia InstituteParis, surgery is carried out by specialized and skilled surgeons. The methods used at the Hernia InstituteParis are based on the reinforcement of the abdominal wall by a prosthetic patch, placed by laparoscopic approach in ambulatory (day-case) setting.
Advantages of the laparoscopic hernia repair
The most commonly used procedure of hernia repair (the Lichtenstein technique) consists of fixing the patch on the outer surface of the muscular wall. In this location the patch tends to be separated from the abdominal wall by the intra-abdominal pressure. Therefore, the patch must be fixed by sutures or staples, which can trap and damage the small sensory nerves running in the inguinal canal and provoke long lasting pain. Chronic pain can also be induced by the chronic irritation due to the contact between the patch and the nerves. Consequently, this technique results in chronic pain in 10 to 12% of the cases.
On the contrary, when the patch is placed at the inner surface of the muscular wall, it does not contact the sensory nerves of the inguinal canal, which are separated from the patch by the muscle. Therefore, no or minimal fixation is required, since in this location the intra-abdominal pressure tends to apply the patch onto the abdominal wall. Thus, there is no risk of nerve injury and the incidence of chronic pain is minimal.
At the Hernia InstituteParis we use laparoscopy to place the patch in the inner (preperitoneal) location. Laparoscopy consists of performing surgery through three small (5 to 10 mm) holes, which results in minimal damage to the abdominal wall, and only three small scars that will soon become invisible.
Advantages of ambulatory surgery
Ambulatory surgery (day-case setting) offers the dual benefice of enjoying the comfort of going back home the day of operation and minimizing the risk of nosocomial infection.
In our practice the patient is admitted to the clinic on the morning, surgery is carried out after a short preparation, and the patient is discharged a few hours later, after the surgeon and anesthetist control visit.
Patients coming from abroad can either stay overnight in-hospital or go back to their hotel in the afternoon. They are seen again by the surgeon on the morning after operation. Afterwards they may either go back home or spend a few days in Paris for fun.
We have a huge experience in ambulatory surgery. We have led the way in France 1, 2 .
1 Johanet H, Marichez P, Gaux F. Organisation et résultats de la cure de hernie de l'aine par laparoscopie en chirurgie ambulatoire : Résultats immédiats. Ann Chir. 1996 ; 50 : 814-9.
2 Ngo P, Pélissier E, Levard H et al. Ambulatory groin and ventral hernia repair. J Visc Surg. 2010 ; 147 : e325-8.