Mini-open Hernia repair (MOHR)
Hernias can be repaired by a traditional open technique which is done by via 10-15cm. They can also be repaired by a laparoscopic approach. This has been published in the NICE guidelines. Recent studies have highlighted that laparoscopic repair (LR) are costly, but effective. There is a higher incidence of bowel injury with LR, and contrary to popular belief the incidence of pain and recurrence is similar to open repair (OR). However, patients often return to work earlier after LR. MOHR ideally combines the best of the two approaches using a small incision whilst minimising complications such as bowel and major blood vessel injury.
Mr Chaudhuri has devised the mini-open technique which has been widely published and presented internationally. This allows repair of inguinal hernias via a 3-4cm incision, and because of the results, allows almost all uncomplicated hernias to be dealt with as a day case. This allows complete repair of the weakness using a synthetic titanium-coated mesh (Timesh, pfm Medical) with or without a plug for the weakness.
Mr Chaudhuri now has the largest experience with Titanium-coated mesh in the United Kingdom.
What should I do?
- Have the hernia seen by a surgeon with expertise in the area.
- Avoid wearing a truss unless you absolutely have to (a truss is a device that compresses the groin to push the hernia back in)
- Lose weight- this reduces risk of recurrence.
- Stop smoking- this reduces other complications e.g. chest problems, infections.
What does the procedure entail?
- This procedure can be done under general, epidural anaesthesia (or even local anaesthesia in appropriate patients).
- Small cut in the groin
- Find the defect and reinforce it with synthetic mesh
- The wound is closed with dissolving sutures
- There is an element of pain in the first week that gradually diminishes
What are the complications of the procedure?
- Chronic groin pain
- Testicular shrinkage- very rarely.
- Foreign body reaction- not noted with Timesh as the titanium coating is designed to minimise the body’s reaction to the mesh.