Hernia Center Beograd

Hernia Open Surgery Centre

Prof. Dr Marinko Žuvela

Hernia center is a specialized center for treatment of all types of primary and recidivious hernias of the front and lateral abdominal wall. The latest tesnion-free surgical method is used in planting prosthetic mesh implants. We treat the following types of hernia:

• inguinal (direct and indirect), phemoral
• ventral (umbillical, epigastric)
• incisional (postoperative)
• spigelian hernia.

Small to medium inguinal or inguinoscrotal hernias are treated with Lichenstein technique under local anesthesia. Light meshes are implanted and the patient need not be hospitalized. Prof. Žuvela presented the results he achieved in patients by applying Lichenstein technique at numerous international congresses such as: 29th Congress of European Hernia Association in Athens (2007), VI Conference of International Association of Endoscopic Hernia Surgery in Belgrade (2012), X World Congress of International Association for Ambulatory Surgery in Budapest (2013) and 36th Congress of European Hernia Association in Edinburgh (2014).

Phemoral hernia is usually treated by plough method (light mesh) in combination with Lichenstein technique under local anesthesia in ambulatory conditions. The patient leaves the clinic two hours after the surgery. Rives technique is used for larger hernias and recidivious phemoral hernias under regional or full anesthesia. Usually, patients need 24-hour hospitalization. Prof. Žuvela presented the results he achieved in treatment of large and complicated phemoral hernia in the scientific paper published in Acta Chirurgica Iugoslavica, 2003;50(4):53-67.

Giant inguino-scrotal hernias are treated by Rives technique via direct inguinal approach (hard mesh) in regional or full anesthesia. The patient typically requires up to 24 hours of hospitalization. The results of prof. Žuvela’s practice of surgical treatment of giant inguinal hernias was presented at the 26th Congress of European Hernia Association in Prague (2004), 29th Congress of European Hernia Association in Athens (2007), 27th International Congress European Hernia Association in Turin (2005), 35th Congress International European Hernia Association in Gdansk (2013) and 36th Congress of European Hernia Association in Edinburgh (2014).

For all small to medium-sized ventral hernias (umbillical, epigastric), small incisional and spigelian hernias prof. Žuvela developed an original surgical technique “Open Pre-peritoneal Flat Mesh Technique” which involves implanting of a light mesh in local anesthesia. The patient need not be hospitalized. This original technique was presented at  the 29th Congress of European Hernia Association in Athens (2007), 27th International Congress of European Hernia Association in Turin (2005), 30th International Congress European Hernia Association in Seville (2008), 4th World Congress of  European Hernia Association and American Hernia Association in Berlin (2009), 32nd International Congress of European Hernia Association in Istanbul (2010), X World Congress of International Association for Ambulatory Surgery in Budapest (2013) and 36th Congress of European Hernia Association in Edinburgh (2014). Prof. Žuvela had  a paper published in the official EHS Journal Hernia  Aug; 17(4): 483-486.

Large ventral (umbillical, epigastric) and incisional hernias are treated by Rives sublay  technique which involves implanting of a large heavy mesh in full anesthesia. The patient is hospitalized for a few days. Prof. Žuvela reported on his results in applying Rives sublay technique at 27th International Congress of European Hernia Association in Turin (2005) and at the 29th Congress of European Hernia Association in Athens (2007).

Monstruous ventral or incisional hernias are commonly treated by Rives sublay or Chevrel onlay technique in combination with different component separation techniques (Ramirez CST, Maas CST, Ennis CST, Lindsay CST, Levine-Karp CST). Such surgery uses one or two large heavy meshes 30X30 cm in size. Complex surgeries of front abdominal wall reconstruction and their results were presented at 29th Congress of European Hernia Association in Athens (2007), 30th International Congress European Hernia Association in Seville (2008), 32nd International Congress of European Hernia Association in Istanbul (2010), 33rd 35th Congress of  International European Hernia Association  in Ghent (2011), International European Hernia Association in Gdansk (2013) and 36th Congress of European Hernia Association in Edinburgh (2014).

Here at Hernia Centar in Belgrade we treat and solve all complications occurring after front abdominal wall hernia surgery. Such complicationst may include:

1.  chronic pain following hernioplasty with inguinal hernia mesh.

– mesh removal with triple neurectomia ( cutting three sensory nerves: n.                    ilioinguinalis, n. iliohipogastricus i r. genitalis n. genitofemoralis)

1. recidivism following hernioraphy without meshes and hernioplasty with inguinal, phemoral, ventral and incisional hernia meshes.

– mesh removal followed by new inguinal or phemoral mesh being implanted.

– mesh removal from the front abdominal wall followed by Rives sublay or Chevrel onlay hernioplasty with new large mesh with or without Ramirez CST.

Prof. Žuvela’s results in treating post-operative complications were presented at the 30th International Congress European Hernia Association in Seville (2008), 32nd International Congress of European Hernia Association in Istanbul (2010), Scientific Conference on the Treatment of Wounds with Negative Pressure Wound Therapy 6th KCI CEE VAC Symposium in Belgrade (2014). Prof. Žuvela had a number of papers published on this topic in renowned medical journals including the official journal of EHS Hernia 2014, Feb: 18(1): 138-140 and Hepato-Gastroenetrology 2011; 58:1-6., Hellenic Journal of Nuclear Medicine 2011;14(2):181-183.,  and Surgery Today 2012;42(12):1253.

Most inguinal, phemoral, umbillical, epigastric, spigelian and small incisional hernia surgeries are perforemd in local anesthesia and in conditions of ambulatory surgery. The patient needs no hospitalization and walks home the same day. Giant inguinoscrotal, ventral and incisional hernias are operated while the patient is under full anesthesia. 24-hour hospitalization is required. Large incisional and ventral hernias are  operated with  the patient  under full anesthesia. Hospitalization usually lasts for a few days.