Hernia Surgery FAQs

What is the recovery of hernia surgery?

You cannot lift heavy objects (greater than 10 pounds) for 6 weeks. You can return to a desk job or any other job that requires no lifting after a week.

When Can I drive?

You can drive one week after surgery if you are off of narcotics and have minimal pain.

I live out of town and was interested in surgery. What is the process of having surgery at your facility?

You will have your consultation on Monday Wednesday or Thursday and then have blood work and EKG after your consultation. You will then have surgery the next day on Tuesday Thursday or Friday. We recommend that you stay the night and have someone drive you home in the morning if you live in Florida. We have had patients driven home after the surgery if they live 2-3 hours from Fort Myers. They are instructed to walk around at a rest stop half way home to encourage circulation to the lower extremities. If you live out of state we recommend you stay for 2-3 days and leave after your postoperative appointment.

Will I have general anesthesia or IV sedation for my surgery?

Majority of cases are done with local (inguinal block) and IV sedation (propofol). General anesthesia is used if the patient is obese, the hernia is extremely large or patient requests general anesthesia

How will my incision be closed?

All inguinal and umbilical incisions will be closed with absorbable sutures. No staples are used. No stainless steel wire is used as in the shouldice hernia repair.

How many hernia surgeries does Dr Robert Tomas perform a week?

On average 10-15 hernia surgeries a week. Dr. Tomas has been personally trained by Dr. Desarda in the No Mesh hernia repair (Desarda Technique). He even recently visited the center to observe several patients having surgery. Dr. Tomas has performed over 2500 Desarda hernia repairs in total.

What is the data on your 1% recurrence rate for inguinal hernias?

These are the number of no mesh inguinal hernia surgeries Dr. Robert Tomas has performed over the last 6 years.

2010 – 69

2011 – 134

2012 – 181

2013 – 403

2014 – 345

2015 – 392

Total – 1,524 no mesh inguinal hernia repairs.

To date we have approximately 11 (0.7%) documented recurrences and the majority of these were within the first few years.

Is the surgery center credentialed with the state?

Yes our surgery center is certified and has been inspected with the state. We have also been inspected and certified by the AAAASF which is an ambulatory surgery center inspecting board.

Who does anesthesia at U First Surgical Center?

An anesthesiologist or a nurse anesthetist will be providing anesthesia at our center.

Do you accept insurances?

We do not accept any insurances and all patients are treated as self pay. We are mainly a one price all inclusive concierge surgical practice. Why? The answer is that there is a tremendous amount of staff needed to handle insurance confirmation/billing/denials. This was not cost effective for our practice so we dropped all insurances. We do offer senior citizen discounts for patients over 68 years of age.

What Hotel would you recommend?

Please see the Marriott Fairfield Inn logo on our home page, ufirsthealth.com. Click on this logo and look on the left of the page and input your check in and check out date as well as number of guests/rooms. We have arranged a discount of $89.00 per night for our patients. Please use the corporate/promotional code YY1.. Pick up to and from the airport and surgical center is complimentary for your convenience.

What is the difference between Shouldice and Desarda repair?

The Shouldice repair involves a multiple layered repair of the floor of the inguinal canal. One of the layers that the Canadian surgeons use is a running stitch that is a stainless steel suture. In the United States many surgeons use a non-absorbable suture instead of a stainless steel suture. In the Desarda repair we are laying a one inch strip of your muscle on the floor of the inguinal can to strengthen the floor. The muscle is sewn in with all absorbable sutures, so nothing will be left behind on the floor of the canal except you own muscle. I don’t know about you, but I would rather not have stainless steel suture in my groin.

Why aren't more surgeons performing the Desarda repair?

The surgeons in the United States are trained using mesh techniques. This is what is taught in surgical residency programs.

Are there any surgeon on the west coast performing the Desarda technique?

You may find a surgeon performing a no mesh technique on the west coast and it will most likely be a Shouldice or McVay repair which are tension repairs. The Desarda is a tension free repair and all the sutures used to sew the muscle in are all absorbable. Dr. Robert Tomas repairs hernias exclusively with The Desarda no mesh technique and this is another reason to travel to Fort Myers to have your hernia repaired. You don’t want a surgeon that repairs hernias with no mesh only as only a small percentage of their practice.

Do you remove mesh?

Dr. Tomas will only remove mesh from a previous inguinal hernia repair only if it was an open technique. We will need the operative report faxed to 239-236-1595 or emailed to [email protected] Dr. Tomas does not remove mesh if the repair was done from a laparoscopic approach. If it was an umbilical hernia repair with mesh, then the operative report will need to be reviewed by the surgical team before your case is accepted.

Is the Desarda repair better than a laparoscopic repair using a mesh?

Yes the Desarda repair is better than the laparoscopic repair because it does not involve mesh. Laparoscopic repairs use mesh for the repair on inguinal hernias.

The Desarda Technique is essentially a muscle graft that is laid across the floor of your inguinal canal. It will grow into the surrounding structures and remain with you for the rest of your life. You can resume normal lifting after 6 weeks from your surgery. There will be no deformities or weakness of the musculature associated with the repair. There is no foreign body like mesh and all the sutures are absorbable.

Is your facility credentialed by any board?

Yes. U First Surgical Center is credentialed by AAAASF credentialing board. We are inspected every two years and must and must pass a rigorous inspection process.

How are umbilical hernias repaired? Is this the same technique for ventral hernias?

Our umbilical or ventral repairs require a three layered closure that closes the naval or ventral defect and repairs the tissue three inches above and below the defect to lower the recurrence. These three rows of sutures to reinforce the area above and below the defect or hole lower the recurrence dramatically. Recurrence rate for this technique is less than 5%. Again, no mesh is involved in the repair. Umbilical hernia repairs are $3,750.00 and ventral hernia repairs are $4,750 which are all inclusive rates if done in our center.

What happens if a complication arises during the postoperative coarse?

Complications rarely occur with our surgeries. However, if they do it will be within the first 2-3 days from surgery and that is why we require a visit within this period. These complications can me remedied usually with the office setting. The other small complications like a small wound infection or rash from a medication at a later date can be handled by your family physician.

Is my hernia repair guaranteed?

I am sorry, there are no guarantees with any surgery. We will make exceptions at times if there is a recurrence within the first 3 months. This has only happened once and there was a reason for the recurrence because of the patient lifting prematurely.

How many patients that you repair are athletes?

We have repaired hernias on all types of athletes including basketball, soccer, tennis, football and even jujitsu fighters.

Is there any deformity or weakness of the muscle after the Desarda Repair?

The Desarda Technique is essentially a muscle graft that is laid across the floor of your inguinal canal. It will grow into the surrounding structures and remain with you for the rest of your life. You can resume normal lifting after 6-8 weeks from your surgery. There will be no deformities or weakness of the musculature associated with the repair. There is no foreign body like mesh and all the sutures are absorbable.

Desarda –  No Mesh Tension Free Hernia Repair Questions

1) What are the risks and consequences of cutting or entrapping nerves given that this is an open procedure?

There is a very rare chance (1%) of this occurring because Dr. Tomas identifies the ilioinguinal nerve as well as the spermatic cord and isolates them  once he enters into the inguinal canal on all surgeries. Therefore, damage to the nerves or spermatic cord is extremely rare.

2) I have read that others (including Desarda himself) are using dissolvable sutures. Any chance of using those with me?

Dr. Tomas uses absorbable sutures on the skin and subcutaneous tissue and uses absorbable sutures for re-constructing the floor with a one inch strip of the external oblique aponeurosis which is the muscle that covers the inguinal canal..

3) What is the likelihood you open me up and end up having to do a mesh repair?

In only rare cases the tissue is so damaged that mesh is the only alternative in order to prevent a high rate of recurrence. This is mainly with patients that have had multiple inguinal hernia recurrences. Dr. Tomas rarely uses mesh for primary (first) hernias.

4) Can you please confirm how long you have been performing the Desarda, how many per week, how many total, and recurrence/problem rate?

Dr. Tomas has been performing the Desarda technique since 2009, He performs 10-15 hernia surgeries a week and has performed over 3000 cases using no mesh tension free repair (Desarda Technique). Recurrence rate is approximately 1% which is very low for hernia surgeries.

5) Does the Desarda technique work for women?

Yes, the Desarda technique is as effective for women as it is in men. There is still a 1% recurrence rate for women with inguinal hernias. As far as umbilical hernia repairs, women can have the the triple layered umbilical repair and still get pregnant later in life.

6) Will the Desarda repair work for the rest of my life and can I resume normal lifting after having it repaired?

Yes the Desarda Technique is essentially a muscle graft that is laid across the floor of your inguinal canal. It will grow into the surrounding structures and remain with you for the rest of your life. You can resume normal lifting after 6-8 weeks from your surgery. There will be no deformities or weakness of the musculature associated with the repair.

An internet rate / discount involves a discount of 30% and drops the rate to $3,499.00 all inclusive price for No Mesh inguinal hernia and umbilical hernia repair. This price covers facility fee, anesthesia fee and surgeon’s fee. It also includes blood analysis and an EKG if indicated and postoperative medictaions. One price hernia surgery for your convenience. THE CONSULTATION IS FREE, but there is a $300.00 deposit for the surgery date that will be applied to your balance if surgery is booked!

No insurance, no problem / High deductible, no problem.
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