World's first hernia repair through vagina conducted

Washington: Surgeons at UC San Diego Medical Center have conducted what is said to be the world's first hernia repair through vagina.As part of a clinical trial, Garth Jacobsen, M.D., and Santiago Horgan, M.D., were able to repair a painful weak spot in a patient's abdominal wall using the vagina as the path to the surgical site.
"This minimally invasive hernia repair is believed to be the first of its kind in the U.S. and abroad. If research proves that this 'natural orifice' technique is ideal for patients, more than 50,000 women in the U.S. may be eligible for this innovative hernia surgery," said Horgan, director of the UC San Diego Center for the Future of Surgery. A hernia is an abnormal bulging of organs or fatty tissue through a muscular wall.

The bulge is repaired by closing the hole with stitches and then placing a mesh over the repair for reinforcement.The mesh is made up of a biologic absorbable material and over time is incorporated into the body's tissue.

This repair itself was performed by entering the vagina and making a small incision behind the uterus through which the abdomen could be accessed with surgical tools. Only one small external incision was made to place a camera to safely view the surgery.

A traditional laparoscopic repair uses three incisions.The process of performing surgery through a natural opening means avoiding major incisions through the abdomen, and patients may experience a quicker recovery with less pain and scarring.

Surgeons at UC San Diego Medical Center have performed 38 of these natural orifice surgeries as part of a clinical trial comparing "scarless" to laparoscopic techniques. Patients recruited to the trial have had diseased gallbladders and appendix removed through either the mouth or vagina.

A gastrectomy, an obesity surgery that reduces the size of the stomach, and the hernia repair, are also part of the clinical trial.

Note: In general terms, we can say that a hernia occurs when the layers that make up the abdominal wall weaken. In other words, the fabric of muscle and other tissues which protect the gut, develops a defect, or weakness. Through that defect the peritoneum (PER-IT-TA-NEE-UM) - and perhaps other organs - push their way outward, forming a lump which can be felt - and sometimes seen - protruding from the abdomen.