Robotic Repair of Right Bochdalek Hernia [VIDEO]

The following video of a Right Bochdalek Hernia Repair by Dr. Mazen Iskandar contains scenes of medical surgery.

This is Mazen Iskandar, presenting a case of a robotic repair of a right Bochdalek hernia. The patient is a 63-year-old female with history of an open Roux-en-Y gastric bypass in 2009, and with significant weight loss, who presented initially with a fat containing Bochdalek hernia that was surveilled and over time, it started having bowel as you can see here in the scan. So, given the enlargement and now that it’s containing intestines, despite minimal symptoms, the decision was made to proceed with surgery. The patient was placed in a supine position with a bump on her right side and lysis of adhesions was initially done laparoscopically to remove some of the adhesions related to her previous open gastric bypass. And forearms was used with the tip up and arm number four to be used for dynamic retraction.

Here, we are retracting the liver and lysing some of the adhesions between the liver and the hernia sac. And the hernia sac was reducing pretty nicely. Very similar to reducing a direct hernia or a paraesophageal hernia. Then I was able to start reducing the small intestine. My access port was used as an assistant Yankauer for suctioning. So, as you can see there was a lot of small bowel that was herniated. The colon which you can also see on the left of the screen was incarcerated, but by reducing the small bowel first, it gave more room for reduction of the right colon. After reducing all of the small bowel, we were able to then reduce the colon much more easily than if we had tried to reduce that in the beginning.

And here is the defect in the posterior diaphragm. We then proceeded to completely mobilize and reduce the sac, dissecting the sac away from the pleura. The goal was to completely reduce and mobilize the sac.

The edge of the sac is now visible. And complete mobilization and reduction of the sac was now achieved. We then proceeded to mobilize the sac away from the posterior diaphragm and mobilized the liver. We identified the vena cava, the porta hepatis, and we ensured that we were away from them. And so now, we are mobilizing the posterior diaphragm and the superior pole of the kidney to be better able to close the defect and reinforce it with mesh. Once we mobilized enough retroperitoneum, we proceeded to close the defect, which measured 6 centimeters with 2-0 permanent V-Loc.

And the defect closed without much tension.

We then measured the space for mesh placement and I opted to use a 9-centimeter Symbotex mesh. The mesh was placed into the pocket between the kidney and the diaphragm, and was fixated to the diaphragm and to the peritoneum using 2-0 silk sutures.

Then the excess mesh was trimmed to ensure that there is no mesh in contact with viscera. So, the mesh was tailored. And once the liver was dropped, the mesh was completely excluded. Thank you for watching.

source https://iskandarcenter.com/hernia-surgery/robotic-repair-of-right-bochdalek-hernia-video/

Shingles vs Hernia: When Viral Nerve Damage Mimics Abdominal Wall Defects

It’s not uncommon for patients to experience symptoms that seem like a hernia—only to later learn that shingles is the true cause. At The Iskandar Complex Hernia Center, we occasionally evaluate individuals with abdominal pain, swelling, or bulging that turns out to be the result of nerve damage from the shingles virus rather than a true hernia. While these two conditions can feel similar, their causes and treatments are very different. In this article, we’ll explain how to tell the difference and when to seek expert care. If you’re dealing with unexplained abdominal wall symptoms, schedule a consultation with The Iskandar Complex Hernia Center for an accurate diagnosis and treatment plan.

How can shingles cause a bulge that looks like a hernia?

Shingles can cause a visible bulge in the abdomen by damaging motor nerves and weakening the abdominal wall muscles—a condition called postherpetic pseudohernia. This rare complication occurs when the herpes zoster virus (the same virus responsible for chickenpox) reactivates in the spinal cord and affects motor fibers traveling through the vertebral column. When motor branches are involved, particularly those serving the skeletal muscle of the abdominal wall, it leads to flaccid paralysis or even localized paralysis. As a result, the weakened wall may bulge outward, mimicking a hernia even though no fascial defect is present. While it may resemble a hernia from the outside, this condition does not involve a tear or structural opening and typically resolves over time without surgery.

What’s going on with the nerves when this happens?

When shingles (caused by the herpes zoster virus) flares up, it can do more than just cause a rash and pain. In rare cases, the virus affects not just the sensory nerves that cause burning or tingling but also the motor nerves that help your muscles move. This can result in something called segmental paresis—a fancy way of saying the nerves in a certain part of your abdomen stop working properly. That part of your muscle becomes too weak to hold firm, and the result is a bulge. This usually shows up on one side of the abdomen or flank and matches the area served by the affected nerve, also known as a dermatome.

What signs suggest the bulge might be caused by shingles and not a hernia?

There are a few key clues. If you’ve had shingles recently—or even just the nerve pain and rash associated with it—pay close attention to any new bulges. Shingles-related bulges usually show up in the same area as the rash and may be paired with changes in skin sensation, like numbness or burning. The bulge itself tends to be soft and painless and doesn’t have the “cough impulse” or firmness that abdominal hernia cases often do. You also might notice a loss of abdominal reflexes on that side. These are signs that the nerve, not the muscle or tissue itself, is the root of the problem.

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How do doctors determine whether it’s shingles-related or a true hernia?

A physical examination and your medical history are the first steps. Dr. Iskandar will ask about recent shingles outbreaks, pain patterns, and any changes in skin feeling. Imaging tests like a CT scan or ultrasound are especially helpful—they show whether there’s an actual tear or defect in the abdominal wall. If no defect is found, it’s more likely a pseudohernia. In some cases, a test called electromyography (EMG) can be used to check if the muscle is getting signals from the nerve. All of this helps build a clear picture so you get the right treatment.

What does treatment look like for a shingles-induced pseudohernia?

Because the problem comes from nerve damage—not a physical hole in the abdominal wall—surgery is usually not needed. Instead, treatment focuses on helping the nerve heal. This often includes antiviral medication which can help reduce the effects of the virus. Pain relief is another big part of care, especially since shingles can cause nerve pain long after the rash is gone. Some patients may benefit from physical therapy to help rebuild strength in the abdominal muscles. Most people see improvement within a few months, but full healing can take up to 18 months.

When should someone see a surgeon or be more concerned?

While most pseudohernias caused by shingles improve with time, there are red flags that mean you should see a surgeon. These include severe or worsening pain, changes in the skin over the bulge (like redness or dark patches), or symptoms of a bowel blockage—like nausea, vomiting, bloating, or not being able to pass gas or stool. Also, if the bulge becomes hard and doesn’t go back in, or if it continues for more than a year without getting better, it’s time for a closer look. These could be signs of a true hernia, an infection, or another abdominal disease that requires further evaluation.

What’s the long-term outlook for patients with this condition?

The good news is that most patients recover fully. Once the nerve heals, the muscle usually regains its strength and the bulge goes away. While rare, some patients may experience lingering symptoms like constipation, urinary issues, or even a longer-term change in how the muscles feel. However, these outcomes are uncommon. The prognosis is typically very good, especially when the condition is recognized early and managed properly. What’s most important is getting an accurate diagnosis so you can begin healing without delay or confusion.

Wondering What’s Really Causing Your Bulge? Let’s Find Out Together.

It’s easy to assume any abdominal bulge is a hernia, but as this condition shows, that’s not always the case. With expertise in complex abdominal wall issues and a commitment to getting to the root of the problem, Dr. Iskandar provides the answers patients need. Whether it’s nerve-related, structural, or something else entirely, we’re here to guide you through the diagnosis and healing process. If you’ve noticed a new bulge—especially after shingles, chickenpox, or unexplained nerve pain—schedule a consultation with The Iskandar Complex Hernia Center and get the clarity you deserve.

source https://iskandarcenter.com/hernia-surgery/shingles-vs-hernia-when-viral-nerve-damage-mimics-abdominal-wall-defects/

How to Prepare Hernia Surgery: Pre-Habilitation Tips

Preparing for hernia surgery involves more than just showing up on the day of the procedure. Taking steps in advance—known as pre-habilitation—can help improve recovery, reduce complications, and support better surgical outcomes. At The Iskandar Complex Hernia Center, we guide patients through this important process with personalized care and expert recommendations. Our goal is to help you enter surgery in the best possible health. Schedule a consultation with Dr. Iskandar at The Iskandar Complex Hernia Center to start preparing with confidence.

What are the key steps I should take to optimize my health before hernia surgery?

To optimize your health before hernia surgery and reduce the risk of complications, focus on boosting physical fitness, improving nutrition, and managing chronic conditions. Dr. Iskandar and the team at The Iskandar Complex Hernia Center recommend low-impact exercise such as walking or stretching to improve heart and lung function. Eating high-protein food and staying hydrated help strengthen tissue and support healing. Smoking cessation is critical, as tobacco use impairs blood flow and increases the risk of infection. Managing diabetes, obesity, or high blood pressure prior to your hernia repair can improve how your body responds to surgery and anesthesia. Your surgeon may also advise adjusting medications like anticoagulants or over-the-counter drugs such as aspirin, ibuprofen, or Vitamin E to lower bleeding risk. These prehabilitation strategies help prepare your entire human body for a successful result and smoother recovery. These interventions are especially critical when dealing with larger and recurrent hernias.

How can I safely increase my physical activity without risking my hernia worsening?

You can safely increase your physical activity by choosing exercises that avoid placing pressure on the abdominal wall. At The Iskandar Complex Hernia Center, patients are encouraged to walk daily or try low-impact activities like swimming or gentle stretching. These options strengthen the human body without worsening an inguinal hernia or other hernia type. Avoid heavy lifting or movements that strain the groin, cough forcefully, or create high intra-abdominal pressure. If any exercise leads to pain, stop immediately and consult Dr. Iskandar. Using proper technique and building up gradually are key. Physical therapy may be recommended in some cases for additional guidance. Safe movement before surgery supports cardiovascular health and improves how your body tolerates anesthesia in the operating theater.

Why is maintaining a healthy weight important for a successful hernia recovery?

Maintaining a healthy weight lowers the risk of surgical complications and supports faster healing after hernia repair. Excess weight increases pressure on the abdominal wall and can lead to recurrence of the hernia. Excess weight can also increase the rate of wound complications and blood clots. At The Iskandar Complex Hernia Center, we help patients address obesity and reduce body mass index as part of a broader risk management strategy. Achieving a healthy weight reduces inflammation, improves blood flow, and strengthens tissue surrounding the hernia. It also helps regulate blood sugar in patients with diabetes and decreases the likelihood of respiratory issues affecting the lung or gastrointestinal tract after surgery. A healthier body improves how you respond to anesthesia and reduces recovery time in the hospital.

What role does pre-habilitation play in reducing post-surgery complications for me?

Pre-habilitation reduces your risk of post-surgery complications by improving physical fitness, nutrition, and mental readiness before your hernia procedure. Dr. Iskandar uses evidence-based research to design customized pre-habilitation plans that address modifiable risk factors like smoking, poor diet, and unmanaged chronic conditions. Exercise helps reduce lung complications and blood clots (thrombus), while nutrition supports healing and immune function. Managing diabetes and stopping smoking improves tissue strength and reduces the chance of infection. Pre-habilitation also includes learning breathing exercises and preparing your home environment to support safe recovery. Patients who follow this approach tend to experience less pain, shorter hospital stays, and better long-term outcomes.

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What medications and supplements should I stop before hernia surgery?

Before hernia surgery, you should stop certain medications and supplements that may interfere with blood clotting or healing. Dr. Iskandar will review all your prescriptions and over-the-counter drugs. Medications like aspirin, ibuprofen, and anticoagulants can increase bleeding risk and are typically stopped one week before your surgical incision. Certain diabetes medications need to be held before surgery. Herbal products such as St. John’s Wort or Vitamin E may also interfere with clotting. Only continue prescription drugs that have been cleared by your surgeon, often with a small sip of water the morning of surgery. Proper drug and supplement management is a key part of risk reduction and safety planning before any minimally invasive procedure or laparoscopy.

What hygiene steps should I take before surgery to reduce infection risk?

To reduce infection risk, patients should shower or bathe with soap and water the night before or morning of their hernia repair. Chlorhexidine soap is one of the best soaps to use. Dr. Iskandar recommends avoiding lotions, perfumes, or shaving the surgical site, as these actions can introduce bacteria or irritate the skin. Clean skin lowers the risk of introducing infection into the surgical incision. This simple step, combined with proper use of antibiotics and antiseptic protocols in the operating theater, supports your body’s healing process and protects you from unnecessary complications. Your pre-surgery instructions will outline exactly how to prepare.

What should I know about fasting and bowel preparation before surgery?

Before hernia surgery, you will need to stop eating and drinking after midnight unless otherwise instructed by your surgical team. Fasting reduces the risk of aspiration during anesthesia and is essential for your safety. If you have constipation or issues with the gastrointestinal tract, Dr. Iskandar may recommend a fiber supplement or mild laxative in the days before your operation. Never take any medication or laxative without approval. Proper bowel preparation reduces the risk of complications during and after hernia repair, especially for surgeries involving the groin or lower abdomen.

How should I plan for recovery after hernia surgery?

Planning ahead for recovery is critical to ensure a smooth healing process. Arrange for transportation home, as you will not be able to drive after receiving anesthesia. The Iskandar Complex Hernia Center advises patients to prepare meals in advance, stock up on groceries, and arrange for help with tasks like housekeeping or childcare. If you live alone, consider asking a friend or family member to stay with you for the first few days after surgery. Set up your home so you can avoid lifting, bending, or straining your abdomen. Effective planning helps reduce complications, lowers stress, and supports a healthier recovery process.

What steps can I take to manage stress and prepare mentally for surgery?

Managing stress and preparing emotionally for surgery can improve recovery and reduce pain levels afterward. Patients at The Iskandar Complex Hernia Center are encouraged to ask questions, understand what to expect, and take an active role in their care. Studies show that addressing anxiety, practicing relaxation techniques, and staying informed can reduce the need for analgesics and support better outcomes. Therapy, journaling, and deep breathing exercises can also help manage emotional stress and prepare your nervous system for surgery. Feeling prepared mentally is just as important as physical readiness.

Ready for Surgery, Ready for Recovery

Taking steps to prepare for hernia surgery can make a real difference in how you heal and how you feel afterward. From improving your fitness and nutrition to adjusting medications and managing stress, prehabilitation gives your body the best chance at a smooth recovery. Dr. Iskandar and the team at The Iskandar Complex Hernia Center are here to guide you every step of the way with expert care and compassionate support. Schedule a consultation today and take the first step toward a safer surgery and stronger recovery.

source https://iskandarcenter.com/hernia-surgery/how-to-prepare-hernia-surgery-pre-habilitation-tips/

Should I Use a Hernia Belt or Abdominal Binder?

At The Iskandar Complex Hernia Center, we often hear from patients wondering whether a hernia belt or abdominal binder can help manage their symptoms or even treat their hernia. These support devices are easy to find and often recommended for hernia discomfort, but knowing when and how to use them isn’t always clear. While they may provide short-term relief or aid in recovery after surgery, they are not a substitute for expert surgical care. Using them without medical guidance can sometimes do more harm than good. In this article, we’ll explain the role these devices can play in hernia care. To get expert guidance and a long-term solution for your hernia, schedule a consultation with The Iskandar Complex Hernia Center.

What is the role of hernia belts in hernia management?

At The Iskandar Complex Hernia Center, we sometimes recommend hernia belts—also called trusses—as a temporary way to relieve discomfort caused by a hernia. These belts provide gentle, targeted pressure to the affected area, helping to support the abdominal wall and reduce the visible bulge and pain that may come with certain types of hernias, including inguinal, femoral, umbilical, or groin hernias. Hernia belts are most often used when a hernia is reducible and the patient is waiting for scheduled surgery or not yet ready for an operation. They are never meant as a permanent solution, and proper fit and medical guidance are essential to avoid complications. At our practice, Dr. Iskandar carefully considers whether a hernia belt will benefit a patient’s specific situation, offering this option only when it truly supports your path to healing. We understand that living with a hernia can be stressful, and we’re here to walk with you—every step of the way—until a long-term solution is in place.

When should a hernia belt be avoided?

Hernia belts should never be used over a hernia that cannot be pushed back in or if there are signs and symptoms of serious complications. If you experience sharp pain, redness around the hernia, nausea, vomiting, or fever, these may be symptoms of a strangulated hernia—an emergency that requires immediate medical attention. Using a belt in these situations can worsen the problem and lead to further damage. At The Iskandar Complex Hernia Center, we prioritize safety and careful evaluation before recommending any supportive device. Dr. Iskandar will determine whether your hernia is reducible and whether a belt is appropriate for your condition. We take this responsibility seriously because your well-being is always our highest concern.

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Can a hernia belt cure or stop a hernia from getting worse?

A hernia belt cannot cure a hernia or prevent it from progressing. While it may reduce symptoms temporarily, the underlying problem—a defect in the abdominal wall—remains. Surgery is the only definitive treatment for hernias, and relying on a belt long-term can increase the risk of complications like incarceration or strangulation. At The Iskandar Complex Hernia Center, Dr. Iskandar may suggest using a belt as a short-term measure if surgery is not immediately possible, but we will always discuss the risks and limitations openly. We want our patients to feel informed, supported, and confident in the care plan we create together.

What is the purpose of an abdominal binder after hernia surgery?

Abdominal binders are typically used after hernia surgery to provide gentle support to the healing abdominal wall. These wide, stretchy bands wrap around the abdomen and can help reduce early postoperative pain and support mobility during the first few days of recovery. Some patients find that binders give them added confidence when getting up, walking, or moving after surgery. At The Iskandar Complex Hernia Center, Dr. Iskandar may recommend a binder for the first 48 to 72 hours after your procedure if it aligns with your recovery needs. We know the early days after surgery can be challenging, and our goal is to ease your discomfort while supporting your healing process with care and attention.

Do abdominal binders help prevent hernias from coming back?

While abdominal binders may help with short-term comfort, they do not prevent hernia recurrence. Research shows that binders may ease pain and improve mobility in the first few days after surgery, but they don’t reduce the likelihood of a hernia returning or protect against wound complications. At The Iskandar Complex Hernia Center, Dr. Iskandar bases each postoperative recommendation on the latest clinical evidence as well as each patient’s unique situation. We may suggest a binder if it helps you feel more comfortable during recovery, but never as a substitute for surgical precision and follow-up. Our approach is always centered on what will support your long-term health, not just temporary relief.

Are abdominal binders safe to use?

Abdominal binders are generally safe when used for a short time after surgery and under the guidance of your surgeon. They’re designed to be worn over closed surgical incisions and provide support without putting harmful pressure on healing tissues. At The Iskandar Complex Hernia Center, we give patients clear instructions on how and when to use a binder if one is recommended. While complications are rare, overuse or poor fit can cause discomfort or skin irritation. Dr. Iskandar’s team is always available to answer questions and adjust your care plan to ensure your recovery is smooth, safe, and as comfortable as possible.

What are the differences between hernia belts and abdominal binders?

Although both are support devices, hernia belts and abdominal binders serve very different roles. Hernia belts are used before surgery to provide temporary relief from a reducible hernia, while abdominal binders are used after surgery to support the healing process. Hernia belts must be carefully applied to avoid complications and are only appropriate in select cases. Abdominal binders, by contrast, are broader and gentler and are typically used for a short time postoperatively. At The Iskandar Complex Hernia Center, Dr. Iskandar helps patients understand the appropriate role of each device and whether it fits their individual care plan. We believe that clear information and thoughtful recommendations are essential to helping you feel secure in your care and confident in your next steps.

Are abdominal binders and hernia belts helpful for different types of hernias?

Yes, the usefulness of a support device often depends on the type and location of the hernia. Hernia belts are sometimes used for inguinal hernias or umbilical hernias, particularly when the hernia is reducible and surgery is planned. These belts are designed to apply targeted pressure near the navel or groin area to help keep tissue from protruding. Abdominal binders, on the other hand, are more commonly recommended after hernia repair—especially in cases involving incisional hernias or repairs in the midsection. These broader supports act as a compression garment over healing surgical sites. However, they are not designed to “hold in” the hernia, nor do they prevent bulging due to weakness in connective tissue or the gastrointestinal tract. Dr. Iskandar customizes recommendations for each patient, ensuring the right device is used at the right time, whether you’re managing symptoms or recovering from surgery. If you’re unsure whether that “bulge near your belly button” is something to worry about, we’re here to help you get clarity and next steps.

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Does it help to wear an abdominal binder after surgery when it hurts to cough?

Yes, wearing an abdominal binder after surgery can help reduce discomfort when you need to cough. After hernia repair, especially in the first few days, even a simple cough can put pressure on the surgical site and cause pain. A well-fitted binder offers gentle support to the abdominal muscles, helping to stabilize the area and lessen the strain during involuntary movements like a cough or sneeze. At The Iskandar Complex Hernia Center, Dr. Iskandar may recommend a binder for short-term use after surgery to improve comfort, particularly during activities that momentarily increase abdominal pressure. While it won’t eliminate all discomfort, many patients find it helps them move, breathe, and recover with more confidence in those early days.

Do I need a hernia belt or an abdominal binder?

Whether you need a hernia belt or an abdominal binder depends entirely on your specific condition, symptoms, and treatment timeline. At The Iskandar Complex Hernia Center, we never take a one-size-fits-all approach. Dr. Iskandar carefully evaluates whether short-term support could be helpful, but always within the context of your overall health and surgical plan. If you’re waiting for surgery and dealing with a reducible hernia, a belt might offer temporary relief. If you’ve just had surgery, a binder could help reduce discomfort and support healing. Either way, we’re here to guide you with compassion and clinical expertise so you never feel like you’re navigating this process alone.

Move Toward Relief with Expert, Compassionate Care

Hernia belts and abdominal binders can be useful tools in specific situations, but they are never a replacement for expert surgical care. At The Iskandar Complex Hernia Center, Dr. Iskandar takes a personalized approach to every treatment plan, helping patients understand when these devices may be helpful—and when they may pose a risk. If you’re living with a hernia or recovering from surgery, you deserve clear answers and compassionate support. We’re here to help you feel better, move forward with confidence, and get the long-term results you need. Schedule a consultation today to take the next step toward relief with a team that puts your safety and comfort first.

source https://iskandarcenter.com/hernia-surgery/should-i-use-a-hernia-belt-or-abdominal-binder/

Bathing and Showering After Hernia Surgery: A Complete Guide

After hernia surgery, many patients have questions about when and how they can safely bathe or shower. Proper hygiene is important, but so is protecting the surgical site during the early stages of recovery. At The Iskandar Complex Hernia Center, we provide clear post-operative instructions to help you heal safely and confidently. In this guide, we’ll walk through the key considerations for bathing and showering after your procedure. If you have additional questions or need expert care, schedule a consultation with The Iskandar Complex Hernia Center.

When can I bathe or shower after hernia surgery?

Most patients can begin showering 24 to 48 hours after hernia surgery, as long as Dr. Iskandar or your surgical team gives the go-ahead. For those who have undergone open or minimally invasive hernia repair at The Iskandar Complex Hernia Center, showering is generally safe after 24 to 48hours depending on the method of wound closure. Before stepping into the shower, you’ll be instructed to remove any outer dressings if applicable, but steri-strips can stay in place. Afterward, gently pat the incision dry without rubbing. Full baths, hot tubs, and swimming should be avoided for at least one to two weeks, or until you’ve been specifically cleared by Dr. Iskandar, as soaking the incision too soon can raise the risk of infection. If hygiene is needed sooner, sponge bathing is an option as long as the incision stays dry. If waterproof skin glue is used then a shower is possible without any additional steps.

Are there any specific showering techniques to follow after hernia surgery?

Yes, there are specific showering techniques to follow after hernia surgery, and your surgeon will provide personalized guidance based on your recovery. During the shower, let water and mild soap gently run over the incision without scrubbing. Steri-strips and surgical glue can get wet and will naturally begin to peel off after several days—never pull them off. If you have a waterproof dressing, it can remain in place during the shower but should be replaced if it becomes wet. After showering, carefully pat the incision dry with a clean towel and allow any steri-strips or glue to air dry. Avoid applying ointments, lotions, or soaking the area in baths, hot tubs, or pools until Dr. Iskandar confirms it is safe. Always monitor the incision for signs of infection and contact The Iskandar Complex Hernia Center if you notice anything concerning.

How long should I wait before taking a bath after hernia surgery?

You should wait at least two weeks before taking a bath after hernia surgery unless Dr. Iskandar provides different instructions based on your specific recovery. Soaking in a tub, hot tub, or pool too soon can increase the risk of infection and interfere with the healing process. During the initial two weeks, showering is usually permitted starting 24 to 48 hours after surgery, but it’s important to avoid submerging the incision in water and to gently pat the area dry afterward. Every recovery is unique, so be sure to follow the personalized guidelines you receive from The Iskandar Complex Hernia Center.

7 Tips for Bathing or Showering After Hernia Surgery

1. Wait at least 1 to 2 weeks before soaking in a bathtub, hot tub, pool, or any body of water, unless Dr. Iskandar gives you different instructions.
2. Do not apply ointments, creams, or lotions to the incision site unless Dr. Iskandar has specifically directed you to do so.
3. Avoid shaving over or near the incision area until the skin is fully healed to prevent irritation or injury.
4. Monitor the incision closely for signs of infection, including redness, swelling, drainage, or warmth, and contact The Iskandar Complex Hernia Center if you notice any of these symptoms.
5. If surgical glue was used, it is waterproof and allows for showering as instructed, but do not pick at or remove the glue.
6. Always pat the incision dry with a clean towel after showering; never rub the area.
7. If you are unable to shower during early recovery, sponge bathing is acceptable as long as you avoid soaking the incision.

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What should I do if my wound gets wet during a shower?

If your wound gets wet during a shower, gently pat it dry with a clean towel—never rub the area. If there was a dressing in place that became wet, it should be removed and replaced with a clean, dry one as soon as possible. If your incision is healing without stitches and Dr. Iskandar has approved showering, it’s generally safe for water to run over the area briefly, but soaking should still be avoided. After drying the area, inspect the incision for any signs of infection such as redness, swelling, drainage, or warmth. If you notice any of these symptoms, contact The Iskandar Complex Hernia Center. Always follow Dr. Iskandar’s specific wound care instructions, especially if you’ve been advised to keep the area dry for a longer period.

Take the Next Step Toward a Confident Recovery

Knowing how to care for your incision after hernia surgery is key to healing safely and avoiding complications. If you have any concerns about your recovery or need personalized guidance, Dr. Iskandar and his team are here to help. Schedule a consultation with The Iskandar Complex Hernia Center today to get expert support every step of the way.

FAQ’s About Bathing and Showering After Hernia Surgery

Can I use soap and shampoo normally after hernia surgery?

Yes, you can use mild soap and shampoo when showering after hernia surgery, but it’s important not to let products directly contact the incision site. Dr. Iskandar advises patients to allow water and soap to gently run over the area without scrubbing. Rinse thoroughly and pat the area dry afterward. If you experience irritation or inflammation, contact The Iskandar Complex Hernia Center for guidance.

What should I do if I accidentally scrubbed the incision?

If you accidentally scrub the incision, gently rinse the area with clean water and pat it dry with a clean towel. Apply a fresh piece of sterile gauze if advised by your care team. Watch for signs of redness, drainage, or tenderness, and contact Dr. Iskandar’s office to determine if further care is needed.

Can I shower with surgical sutures in place?

Yes, most patients can shower with surgical sutures still in place, but you should not scrub or apply pressure to the incision site. At The Iskandar Complex Hernia Center, Dr. Iskandar will give you detailed instructions on how to care for your incision depending on the type of closure used, including whether you have sutures, staples, or surgical glue.

Is it normal to feel pain while showering after surgery?

Some discomfort while moving or touching the incision area during a shower is normal after hernia surgery. If the pain feels sharp or worsens over time, it may indicate a complication. Dr. Iskandar recommends managing post-operative pain with prescribed medication and contacting the clinic if pain becomes difficult to control.

What if I develop a fever after showering?

A fever after surgery may indicate infection and is not directly related to showering unless the wound was not properly protected. Dr. Iskandar advises patients to monitor their temperature closely and contact The Iskandar Complex Hernia Center if they develop a fever, chills, or notice increased drainage from the incision.

Can I use an ice pack after a shower to reduce swelling?

Yes, using ice packs after showering can help reduce swelling and discomfort around the surgical site. Wrap the ice pack in a cloth and apply it for short intervals. Dr. Iskandar may recommend this especially in the first few days following surgery to help manage edema and localized inflammation.

How soon can I shower after inguinal hernia surgery?

Showering is typically safe 24 to 36 hours after inguinal hernia surgery, but always wait for approval from Dr. Iskandar. The timing may vary slightly based on whether your repair was open or laparoscopic. Clear instructions will be provided before you leave The Iskandar Complex Hernia Center.

What if I notice fluid leaking from the incision after a shower?

Some minor fluid drainage can be normal, especially in the first few days, but it should not have a foul odor or color. If you notice an increase in drainage or other signs of infection after showering, contact Dr. Iskandar. Proper incision care, including gently drying the area, helps prevent complications.

Should I avoid walking right after showering?

It’s safe to walk after showering, and light walking is encouraged to support healing and reduce the risk of blood clots. However, take care to move slowly and avoid slipping. The team at The Iskandar Complex Hernia Center will guide you on when and how to resume normal activities safely.

What signs after showering should prompt me to call my doctor?

If you notice symptoms like spreading redness, warmth, worsening pain, unusual drainage, or a fever after showering, it could be a sign of infection. Dr. Iskandar recommends contacting The Iskandar Complex Hernia Center if anything seems off with your incision. If these symptoms come on suddenly or severely, it may require emergency attention to prevent further complications.

source https://iskandarcenter.com/hernia-surgery/bathing-and-showering-after-hernia-surgery-a-complete-guide/

Robotic incisional hernia repair post ALIF (eTEP, bilateral transversus abdominis release) VIDEO: Dr. Mazen Iskandar Narrates the Procedure

In this video, Mazen Iskandar, MD, FACS, FASMBS narrates as he performs a Robotic incisional hernia repair post ALIF (eTEP, bilateral transversus abdominis release.)

Imagery of surgical content does appear in this video.

source https://iskandarcenter.com/hernia-surgery/robotic-incisional-hernia-repair-post-alif-video/

Preventing Hernias With Drugs: Is It In Our Future?

At The Iskandar Complex Hernia Center, we stay at the forefront of research that may impact how hernias are treated in the future. A recent study from Northwestern University has identified a promising new approach—blocking estrogen receptors to potentially reverse muscle fibrosis related to inguinal hernias. While hernia repair surgery remains the standard of care, this research raises important questions about whether drug therapies could one day play a role in treatment. While it’s an exciting development, more evidence is needed before it changes how patients are cared for. If you’re experiencing symptoms of a hernia, schedule a consultation with The Iskandar Complex Hernia Center to explore your treatment options.

Could Hormone Research Change the Way We Treat Hernias in the Future?

Emerging research into hormone signaling is beginning to reshape how we think about hernia formation and treatment. The recent discovery that estrogen receptors may influence muscle fibrosis opens up new possibilities for targeting the biological processes that lead to hernias in the first place. While surgery is still necessary to repair the physical defect, understanding these underlying mechanisms could lead to medical therapies that support or enhance surgical outcomes. At The Iskandar Complex Hernia Center, we’re closely watching these developments to evaluate how they might one day fit into a more comprehensive, personalized approach to hernia care.

Is Surgery Still the Only Effective Treatment for Hernias?

Yes—for now, surgery remains the only proven and effective way to repair a hernia. At The Iskandar Complex Hernia Center, we see firsthand how hernias progress when left untreated. They do not heal on their own and typically worsen over time, sometimes leading to complications. This is why surgical repair is still the gold standard. Although the hormone research is exciting, it’s still early-stage. Any medications based on this data would need to undergo extensive human trials before they could be safely used in clinical practice. For patients currently dealing with a hernia, surgical evaluation and treatment are still essential.

What Did the Researchers Discover About Hormones and Hernias?

The study, led by Dr. Serdar E. Bulun and Dr. Hong Zhao, focuses on a hormone receptor called Estrogen Receptor Alpha (ESR1). This receptor was found to play a key role in triggering muscle fibrosis—essentially the buildup of scar tissue in muscle—which can weaken abdominal walls and contribute to inguinal hernia development. Their research, titled “Estrogen Receptor Alpha Ablation Reverses Skeletal Muscle Fibrosis and Inguinal Hernias,” suggests that blocking ESR1 could lead to new medical strategies that work alongside surgery. As a surgeon, I find the idea of combining surgery with targeted medical therapy to improve long-term outcomes especially intriguing.

What Exactly Is an Inguinal Hernia?

An inguinal hernia occurs when tissue—usually part of the intestine—pushes through a weak spot in the lower abdominal wall. This can create a visible bulge and cause pain during activities like lifting, coughing, or bending. Inguinal hernias are the most common type of hernia, particularly among men. At our center, we routinely treat these using advanced surgical techniques tailored to the patient’s anatomy and health status. While the idea of non-surgical therapies is interesting, hernia repair remains a procedure that should be handled by experienced specialists.

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What Did the Study Find Using a Mouse Model?

To understand how hormones might influence hernia formation, researchers used a genetically modified mouse model (called Aromhum) that develops hernias in ways similar to humans. They discovered that:

• ESR1 is active in fibroblasts—cells involved in connective tissue—in the abdominal wall.
• When this receptor is overactive, it leads to excessive scarring (fibrosis), which compromises muscle strength.
• Blocking ESR1 with drugs like fulvestrant helped reverse this fibrosis and reduced the hernia’s severity.

While these findings were in mice, they suggest that modifying hormone receptor activity could one day be part of a broader treatment strategy. It’s a fascinating insight, and one I’ll be watching closely as more research becomes available.

How Could This Benefit Patients Who Need Surgery?

From my perspective as a hernia surgeon, one of the most exciting possibilities is how this research could one day improve surgical outcomes. Medications that block ESR1 might:

• Improve tissue quality before a hernia repair
• Help prevent recurrences by reducing underlying fibrosis
• Serve as a short-term treatment before surgery in patients with more complex hernias

In the mouse model, even a seven-day course of medication showed measurable improvement in muscle structure and hernia size. If similar results were seen in humans, it could mean that preoperative therapy might play a role in reducing complications or improving healing.

What Does This Mean for the Future of Hernia Treatment?

This study points to a potential shift in how we think about treating hernias; while surgery will remain essential, medications that target the estrogen receptor might serve as complementary tools to enhance outcomes. The researchers also identified specific genes and biological pathways tied to hernia development—opening doors to more targeted therapies in the future. Drugs like Fulvestrant and Raloxifene, already approved for other conditions, showed effectiveness in this early research by reducing fibrosis and improving tissue health. For complex hernia surgeons, the prospect of incorporating medical management into hernia care is an exciting development that deserves attention.

What Needs to Happen Before These Treatments Are Available?

Before any hormone-based treatments can be offered to patients, they must go through rigorous clinical trials to ensure they are safe and effective. Right now, this therapy is still in the research phase, and there are no approved medications for hernia prevention or reversal. However, the fact that these drugs are already approved for other uses could streamline the process if results in human studies are positive. As a surgeon committed to advancing patient care, I’ll continue to follow this research and evaluate how it could be integrated responsibly into our treatment protocols in the years ahead.

What Should You Do if You Have a Hernia Today?

While the future may hold more options, the best course of action for patients with hernias right now is to seek surgical evaluation. At The Iskandar Complex Hernia Center, we offer specialized care for all types of hernias, including complex and recurrent cases. If you’re experiencing symptoms like a bulge in the abdomen or groin, discomfort when lifting, or pressure that doesn’t go away, don’t wait. Schedule a consultation so we can discuss the most effective treatment plan for your situation and keep you informed about future options as they become available.

FAQ’s About Treating Hernias With Drugs

Can estrogen-blocking drugs actually reverse a hernia?

Right now, estrogen-blocking drugs like Fulvestrant are not capable of fully reversing a hernia, but early research suggests they may help improve the quality of muscle tissue impacted by fibrosis. At The Iskandar Complex Hernia Center, I explain to patients that while these medications show promise in lab models, they aren’t a substitute for inguinal hernia surgery. Instead, they may someday be used as a complement to improve outcomes in select cases.

How would blocking estrogen receptors help with hernia prevention?

Blocking estrogen receptors may reduce fibrosis in the abdominal wall muscles, which is a contributing factor in hernia formation. By preventing or reversing this process, future treatments could potentially lower the risk of hernia development in vulnerable areas of the gastrointestinal tract. As a hernia specialist, I’m watching this area of medicine closely to see how it might fit into surgical planning and long-term care strategies.

Are hormone therapies for hernias being tested in people in the United States?

Not yet. The current research has been conducted in animal models, and human trials would be the next step before anything could be offered to patients in the United States. At The Iskandar Complex Hernia Center, I help my patients stay informed about advances like these so we can evaluate new options as they become available through safe, regulated pathways.

Could estrogen receptor blockers be used before or after hernia surgery?

That’s one of the most exciting possibilities. If proven effective in humans, medications that block estrogen receptors could potentially be used before surgery to improve muscle quality or after surgery to aid healing and reduce recurrence. In my experience performing open and laparoscopic hernia repairs, including laparoscopy under general anesthesia, I can see real value in therapies that strengthen tissue around the surgical site.

What are the risks of using hormone-blocking drugs for hernia treatment?

Like any medicine, hormone-blocking drugs would come with their own set of risks and side effects, especially if used off-label. Dosing would need to be carefully studied in clinical trials to avoid unintended complications. At The Iskandar Complex Hernia Center, I always advise patients to weigh potential benefits with risks, especially when dealing with early-stage treatments that are not yet approved. Watching for signs and symptoms of complications—whether related to surgery or new medications—remains a critical part of personalized care.

source https://iskandarcenter.com/hernia-surgery/preventing-hernias-with-drugs-is-it-in-our-future/