Hernia Surgery

Our Commitment to Patients

After graduating from surgical residency in 2002, James deCaestecker, DO, FACS, learned early that hernia surgery was a very individualized procedure depending on the surgeon performing the surgery. There is no standardized approach to the management of hernias and there is no governing body offering guidelines on how to best manage them. 

Dr. deCaestecker, along with and Michelle DeGroat, MD, and Laszlo Toth, MD, took a strong interest in this evolving field of surgery because it’s one part of the practice where patients rely on the experience, knowledge, and dedication of their surgeon. Patients expect the best hernia repair with the lowest rate of recurrence and the fastest recovery possible in order to get back to their normal daily lifestyle without any complications. Everything from choosing the mesh, advising the patient about the ideal surgical approach, and optimizing the surgical environment both pre-operatively and post-operatively are all extremely important in order to ensure a successful outcome.

The goal of hernia surgery is to return the patient’s abdomen back to their normal anatomical and physiological state while also focusing on a low recurrence rate. At Gem City Surgeons, we are able to offer this specialized care by staying current on advances in hernia surgery. Everything from mesh development, minimally invasive laparoscopic and open techniques, and review of recent surgical literature allows us to better serve our patients. Gem City Surgeons opened the first hernia center of excellence in Dayton.

Gem City Surgeons strives to provide patients with updated approaches to hernia repair. Our hernia center offers a comprehensive approach that individualizes the repair based on the patient’s history, exam, and common goal to return to their normal lifestyle. Too often a hernia can really detract and prevent patients from taking full advantage of what life has to offer. Everyone wants to be able to participate in and enjoy the special moments that make life worth living, but a hernia can interfere with these special times and hold patients back. Although hernia surgery may seem like a straightforward surgical disease to the patient, hernia surgery is a complex field that is still evolving today. Gem City Surgeons will always strive to provide our patients with quality care and focus on the goal of helping our patients getting back to a worry-free lifestyle. 

History of Hernias

The surgical description and treatment of hernias dates back to ancient Egypt, according to the National Institutes of Health (NIH). Although there is written proof of patients suffering from inguinal hernias as early as 1550 B.C., hernias were likely a surgical disease long before that.

By the 19th century, medical breakthroughs were aiding surgeons as they struggled to understand more about the surgical repair of hernias. Advances in human anatomical descriptions of the abdomen, advances in anesthesia and the understanding of microorganisms allowed surgeons to develop and publish their results on success and recurrences of hernia repairs.

By the 20th century, further advances were made when synthetic polymers were invented. This breakthrough in mesh development lead to the introduction of the concept of a tension-free repair to avoid recurrences after hernia repair, according to the NIH. Dr. Irving Lichtenstein published a paper in 1989 describing his tension-free hernia repair using synthetic mesh on 1,000 patients that is still a procedure other techniques are compared to regarding recurrence rates.

Other surgical pioneers like Dr. Rene Stoppa thought of other ways of placing mesh in different anatomic spaces to create a tension-free repair, according to the NIH. These procedures revolutionized the way hernias are approached and managed. By the end of the 20th century, surgeons began to better understand the science surrounding the management of hernias, although herniatology is still in its infancy.

The 21st century now brings with it many new advances in mesh development and surgical techniques. Many discussions now are fixated on how to best return the abdomen back to its normal physiological state when determining the best hernia repair for a particular patient. There are surgical conferences held annually which are dedicated to the education and development of the surgical treatment of hernias. The term herniatology has been coined, and the technical expertise and dedication to this surgical disease has led to the development of hernia centers of excellence.