I am a 33 year old woman with two children. After the birth of my second child, I developed an umbilical hernia that I had repaired but in the past six months I have experienced a lot of GI issues I recently did a CT scan that showed a hernia stricture. I would like to know if this stricture can be repaired while doing a Tummy Tuck but by a General Surgeon?
Hernia Stricture Repair with Tummy Tuck
Doctor Answers 4
Umbilical hernia stricture and tummy tuck
There are two issues here: 1) should the hernia stricutre be repaired at the same time and 2) will insurance cover a portion of the procedure. If the hernia is a true umbilical hernia, repairing at the same time as a full tummy tuck may result in compromise of the circulation of the umbilicus. Furthermore, these defects are increasingly being repaired laparascopically or with the use of mesh. In some instances, hospitals do not grant these privileges to plastic surgeons and a general surgeon may be the one who performs the repair and the one who bills for reimbrusement. In regards to reimbursement, most facilities have separate fees and will bill for these individually with pre-payment for the cosmetic portion. Furhtermore performing both at the same time may compormise the circulation of the umbilicus.
Performing tummy tucks with hernia repairs.
It is common to perform a tummy tuck in combination with other abdominal surgeries. In our practice, we commonly work with general surgeons, urologists, and gynecologists. When we do this, we typically begin the surgery and elevate the skin and tissue. At that time the other surgeon enters and corrects the hernia or performs their necessary procedure. Once they have completed, the plastic surgeon then closes the incision in a cosmetically pleasing way. This is an excellent combination for it these patients as they will experience one recovery. And will have a scar and cosmetic appearance much better than if their surgeons have not worked with the plastic surgeon.
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Hernia repairs are commonly performed during tummy tuck
In most cases hernia repairs can be performed at the same time as abdominoplasty procedures. They are most commonly performed by general surgeons, however they are often found incidentally during surgery(abdominoplasty) and may then be repaired by the plastic surgeon. Most are however treated by general surgeons who work with plastic surgeons when the hernia is recognized preoperatively.
Depending on the size of the hernia and its location ,some general surgeons suggest that by working together with a plastic surgeon, a better repair is possible. This is related to the exposure that the abdominoplasty procedure creates for the general surgeon which may allow better visualization of the anatomic defect.
There are few instances when hernias cannot be repaired at the same time as the abdominoplasty procedures. These are usually very rare and complicated situations that maybe addressed by either surgeon.
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Combination herniorrhaphy and tummy tuck
In general, yes, these can be technically combined although you must be sure that your general surgeon and your plastic surgeon are both agreeable and in sync with each other. Obviously you need to consider your hernia repair a priority and have an understanding that if something goes awry at this procedure, such as bowel leakage or perforation or excessive bleeding, that the tummy tuck may be postponed. Always leave an "out" and be sure that the general surgeon and plastic surgeon agree on and coordinate the incisional access for the hernia repair.