Welcome to the MedSoup Podcast, where we talk about trending healthcare topics. I’m your host Laura Schumacher, let’s dig in.
Today we are talking with Dr. Brian Schmidt. We’re going to discuss hernias which are actually a very common condition in the United States. Apparently, there are more than one million hernia repairs that are performed in the US. And, I know that this is something that is a big part of your practice.
Dr. Brian Schmidt 0:36
Correct, hernia repairs are a big part of my practice and a very common problem.
What exactly is a hernia?
Dr. Brian Schmidt 0:44
Hernias are essentially a hole in the muscle where there is not supposed to be a hole. Common sights are in the groin region and any previous incension has a risk factor for having a hernia. And there are also certain types of hernias, call Hiatal hernias where the stomach moves from where it is supposed to be, such as the abdomen to the chest.
So, this is not to be confused with a sports hernia that you hear people talk about?
Dr. Brian Schmidt 1:12
A sports hernia is a different entity and they are typically tears in the muscles or the groin that sometimes require surgery sometimes can be treated nonsurgically.
So are there always symptoms for the types of hernias you’re treating?
Dr. Brian Schmidt 1:29
In most cases, there are symptoms of hernias. It’s either a bump or a bulge that the patient notices or they have pain with activity in the area where the hernia is.
So that’s how it would be diagnosed initially, they would see a primary care physician and have that place examined that is causing pain or creating some sort of bulge?
Dr. Brian Schmidt 1:52
Correct and some patients present directly to us and some patients directly to the emergency room. Some patients have these diagnosed while getting a scan for something completely different and just found incidentally.
Are there differences between in types of hernia that men and women get?
Dr. Brian Schmidt 2:08
Not really, most hernias are the same and in the same region, they’re treated pretty similarly.
Is it more common in men?
Dr. Brian Schmidt 2:18
Groin hernias are more common in men.
If someone has been diagnosed with a hernia and they come to you, what is the next step?
Dr. Brian Schmidt 2:26
Next, step is to examine the patient and what exactly what kind of hernia they have and then discuss the treatment options which is most cases with hernias involve surgery.
And how does that surgery help repair? You talked about a mesh or is it tacked? How do you treat a hernia?
Dr. Brian Schmidt 2:48
Some hernias are treated with mesh, some are just closed with sutures. Hernias can be treated with traditional open procedures, with laparoscopic procedures, or robotic procedures nowadays.
Are there any particular risks to the surgical treatment, or is it more of a risk not to have it treated?
Dr. Brian Schmidt 3:08
There’s risk to both. There’s always risk with surgery with bleeding and infection and hernia recurrence. But without fixing hernias as well there’s a risk of incarcerations, blockages, so forth.
Are there any options for nonsurgical treatment?
Dr. Brian Schmidt 3:25
Some people that have hernias that aren’t candidates for surgery or anesthesia, we sometimes recommend hernia trusses or belts, which can help with some symptomatic relief. They obviously don’t fix the hernia problem but they can help with symptoms.
Are there particular risk factors for hernias or someone’s type of lifestyle or something they may do that makes them more susceptible to this condition?
Dr. Brian Schmidt 3:51
There are some risk factors for hernias. Previous surgeries are definitely a risk factor for developing a hernia at the sight of the incision. Obesity is another risk factor for hernias. The more intra-abdominal pressure that a patient has from their weight, the more at risk they are for getting hernias. Some people are just more predisposed for getting hernias in certain areas such as the groin.
If someone has been diagnosed with hernias and has had surgery, is there a chance that it is going to come back?
Dr. Brian Schmidt 4:22
There are recurrence rates with hernias and the recurrence rate is all dependent on the type of hernia and the location. Risk factors are too much activity too soon. Types of hernia repairs, typically mesh hernia repairs, have a lower recurrence rate than a suture hernia repair. Obviously keeping off weight and having an optimized BMI, or body mass index helps prevent recurring hernias.
Well, that seems to be a key factor in just about everything is weight management.
Dr. Brian Schmidt 4:56
Would there ever be a case where a patient would come directly to you or are they always referred by a physician?
Dr. Brian Schmidt 5:04
There are some patients that end up directly in our office for hernias. There are a lot of patients that don’t have a primary care doctor or notice a lump and just refer themselves directly or have a family member that has been treated before and sometimes they’ll come directly to us.
You did mention, in terms of surgical options for hernia repair, include open surgery but also robotic surgery. Can you discuss robotic surgery a little bit more?
Dr. Brian Schmidt 5:30
Sure, robotic surgery has been in play now for about ten years now. It’s another option for hernia repair and it’s a very good option for people who have bilateral hernias, Hiatal hernias, who have recurring hernias, it’s a very good option to repair these hernias.
And that’s something that has a fairly good recovery rate?
Dr. Brian Schmidt 6:01
Correct, yeah robotic surgery tends to have very quick recovery rates. It’s very similar to laparoscopic surgery where small incisions, a little bit shorter healing time, and less pain associated with the surgery.
Okay, well thank you very much. If anyone wants to learn more hernias and surgical treatment options, they can call the office at (704) 786-1108 or they can visit https://paragonsurg.com/. Thank you so much