Improved Recovery Through Prehabiliation Before Hernia Repair
Rehabilitation is widely recognized for its critical role in successful recovery from many surgical procedures. However, many don’t realize the importance of prehabilitation in recovering from certain procedures, such as surgical hernia repair. Prehabilitation is the process of ensuring optimal physical functionality before surgery.
A hernia is a hole or defect in the abdominal muscular wall which allows internal tissue to protrude or stick out, usually creating a bulge. Hernias may or may not cause pain but they do pose the risk of having intestinal or fatty tissue become trapped. Hernias do not go away without treatment and surgery is the only treatment.
“Though hernias are often repaired through minimally-invasive options, there is always a risk of complications,” says Bryan Ellis, DO, assistant program director and a surgeon with the Comprehensive Hernia Program at the TriHealth Surgical Institute. “Fortunately, the risk factors commonly associated with hernia repair can be mitigated through a prehabilitation program customized for each patient.”
Possible complications of surgical hernia repair include surgical site infection, surgical site occurrences such as bruising, cellulitis, and hemorrhaging, hernia recurrence and readmissions due to these and other complications following surgery.
Knowing and minimizing risks
According to Dr. Ellis, the common risk factors for hernia repair are:
- Lack of strength in core muscles
The physicians with TriHealth’s Comprehensive Hernia Program see patients at their location at the TriHealth Fitness & Health Pavilion where patients have access to services such as diabetic counseling, smoking cessation counseling, medical and surgical weight loss and outpatient physical therapy all under the same roof.
“This is an important aspect of the program,” Dr. Ellis says. “By making it as convenient as possible for patients to access these services we increase the chances for compliance with their prescribed prehabilitation, especially when they are able to combine visits.”
According to Dr. Ellis, TriHealth’s convenient and comprehensive approach to hernia prehabilitation, focus on minimally-invasive procedures when possible, individualized care and timely follow-up have helped them outpace national readmission rates following surgical hernia repair.
According to data from the Americas Hernia Society Quality Collaborative, the national readmission rate for 2016 was five percent. For patients with TriHealth’s Comprehensive Hernia Program, it was about two percent.
TriHealth’s rate for surgical site infection was also two percent, compared to the national rate of three percent. According to Dr. Ellis, the approximation of this data compared to readmission rates further illustrates the importance of limiting risk factors through prehabilitation.
“Of course it means that we are able to catch and treat infections earlier,” he says. “But we also know that limiting the risk factors lessens the chance for an infection to lead to further complications and readmissions.”
June is National Hernia Awareness Month, but it’s always important to consult a doctor as soon as possible if you suspect you may have a hernia or notice symptoms such as a bulge in the groin or abdominal area – even if there is no associated pain.
“The sooner a patient calls the better the chances for a successful long-term recovery,” says Dr. Ellis. “Especially those who exhibit any of the risk factors and who would benefit from a customized prehabilitation program before surgery. Lowering the risk of complications and recurrences could save them a lot of time, a lot of pain and a lot of money.”