Abdominal Wall Hernias and How Telemedicine is Streamlining the Path to Hernia Repair

Despite the prevalence of hernias and hernia repair, there often is a lag time between hernia diagnosis and surgical repair, which remains the only way to fix the condition. The Baylor Medicine Hernia Center aims to close that gap by providing screening telemedicine visits.

A hernia is a hole in the tissues that compose the abdominal wall and can occur at many different locations across the belly. Some individuals are born with hernias, while others can be caused by heavy lifting, persistent coughing, strenuous physical activity, or they can develop after previous surgeries. Because of this hole, tissues that normally reside in the abdomen may protrude or bulge out of the abdominal wall.

A patient sitting at their kitchen table in front of a laptop. On the laptop, a doctor discusses hernia and hernia repair via a webcam telehealth appointment.The only way to fix hernias is with surgery. Individuals may seek hernia treatment because of pain or because of distortion of the body’s normal contour, making some people self-conscious about their appearance. We also worry that tissues can become trapped in the hernia which can necessitate emergency surgical repair.

It is estimated that 20 million hernia repairs are performed worldwide each year. Despite the prevalence of hernias and hernia repair, there can still be a delay between hernia diagnosis and surgical repair.

Factors that can contribute to this delay include:

  • Lack of available information for patients on the necessity of hernia repair
  • Fear of surgery or surgical recovery
  • Patients being seen in an inappropriate surgery clinic (not every surgeon repairs every type of hernia)
  • Poorly optimized general health of patients preventing surgical repair

Screening telemedicine visits by telephone or video are designed to decrease time between diagnosis and repair, provide patient education and support patients every step of the way.

When a patient calls to schedule an appointment for hernia evaluation, they will be scheduled for a virtual visit with a physician assistant who will gather information about their health history and the hernia, provide general information regarding hernias and different approaches to hernia repair, and address any generalized concerns. The physician assistant, in collaboration with Dr. Michele Loor, Hernia Center director and associate professor of surgery, will discuss each individual case to determine a treatment management plan and which surgeon is most appropriate for that type of repair. Patients will be scheduled to see the designated surgeon to further discuss surgery and get answers to any questions they may have.

At any point in this process, patients also may be referred to other providers or clinics within Baylor to ensure they receive comprehensive care.   These providers may include cardiology,  weight loss specialists, pain management, plastic surgery, urology or physical therapy. Along the way patients always will have a point of contact to help guide and support them through this process!

-By Heather West, PA-C, Specialty Abdominal Wall Surgery, Division of Trauma and Acute Care Surgery

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