Melbourne Hernia Clinic
The Melbourne Hernia Clinic, operated by General Surgeon Mr Maurice Brygel
at Sir John Monash Private Hospital is a clinic that has had a special interest in hernia
and related inguino-scrotal problems. Mr Brygel has been specialising in hernia
repairs for nearly 20 years.
Twenty years ago it was usual for the hernia patient to be in hospitable
for 4 -5 days. Local anaesthetic techniques and mesh reinforcement were infrequently
used.
Open Hernia Repair
It is possible to perform the majority of hernia repairs under local
anaesthetic and the patient to be treated as a day surgery case. Sir John Monash
Private Hospital has overnight stay facilities for those that are unable to be discharged
on the same day for various reasons.
The local anaesthetic technique together with amnesic medication, ensure
minimal anaesthetic side effects with reduced post operative pain, this allows for the
early mobilisation of the patient.
Where mesh is used in the repair, there is a reduction in the need for
tight suturing of the muscles - thus the term "tension free repair". The
mesh provides early strength to the repair and fewer recurrences.
Laparoscopic Hernia Repairs
Laparoscopic hernia repairs can be performed by the balloon
extra-peritoneal technique. This is used by the Melbourne Hernia Clinic only for
specific reasons such as multiple recurrences or by special request. General
anaesthesia is required. The mesh is stapled into position between the peritoneum
and the posterior wall of the inguinal canal. Generally this is a more expensive
technique due to the additional instrumentation and anaesthetic required. There is
still debate as to the benefits and long term results of the laparoscopic repair
technique.
