Flank hernias develop on the sides or back of the abdominal wall, as opposed to the midline. They can result after surgery through the lateral abdominal wall, including surgeries on the liver, kidneys and gallbladder, as well as spine surgery. Most flank hernias develop in older males, between the ages of 50 and 70, and are more common in men than women.
Flank hernias don’t heal on their own; they require surgical intervention with an experienced surgeon like Dr. Gregory Dumanian. If left untreated, flank hernias can cause serious pain and other complications.
Dr. Dumanian has extensive experience and training with flank hernia repair. He specializes in the open repair of hernias, which involves repairing the abdominal wall muscles directly with strips of mesh used as sutures. Sheets of mesh are often avoided. As a leading hernia specialist, Dr. Dumanian believes that there is a lot of misinformation and controversy about the condition and its repair. In this post, he clears up some of the commonly believed misconceptions about flank hernia repair.
Misconception #1: Most Flank Defects Are Denervation Injuries
Some experts believe the cause of most flank bulges after surgery are not hernias, but rather denervation injuries (i.e., loss of nerve supply). In Dr. Dumanian’s experience, most of the time this is not true, and he believes that denervation injuries are being misdiagnosed. Although Kocher-type incisions do indeed sever some of the abdominal muscle nerves, the majority of surgical incisions are parallel and do not cut the nerves. These defects are confusing, because they represent hernias of the internal oblique and transversus abdominis muscles, with the external oblique muscle still intact. In the doctor’s opinion, the majority of flank defects are true hernias of the inner two layers of muscle.
Misconception #2: Flank Hernia Repair Is Complex
When performed by a qualified surgeon, Dr. Dumanian believes flank hernia repair can be repaired simply and directly with mesh sutures. He has incorporated several key principles into hernia repair. For example, he believes that many hernia repairs fail because of sutures pulling through tissue. He focuses on evenly distributing forces with mesh sutures to avoid this surgical complication.
Dr. Dumanian completed a review of 31 flank hernia repair cases and found an overall success rate of 90 percent without significant complications. Twenty-eight of the patients healed well and did not experience a recurrence of their hernias. Two patients had bulges but no hernias. The third had a small hernia recurrence.
For more information about flank hernia repair and some of the related misconceptions, please read the paper Dr. Dumanian published on the subject. You can also call (312) 695-6022 or email our office with questions.