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East Hospital surgeons pioneer a new and effective hernia surgery technique in Latvia
Surgeons at Riga East Clinical University Hospital (East Hospital) in the General and Emergency Surgery Department led by Dr. Med. Aleksejs Kaminskis are now successfully performing hernia surgeries, using a modern and effective method new to Europe, known by the abbreviation LIRA (Laparoscopic Intracorporeal Rectus Aponeuroplasty). East Hospital surgeons were the first in Latvia to perform complex hernia surgeries using this advanced laparoscopic method on patients who had undergone several previous surgeries without long-term success. This new approach offers an effective solution for managing complicated medical conditions and significantly improves patients’ chances of regaining an active and meaningful lifestyle.
The LIRA method represents a meaningful advancement in minimally invasive hernia surgery. It offers an alternative to conventional techniques, with the potential for improved outcomes and reduced complication risk. It opens new and effective treatment possibilities for patients who have undergone multiple unsuccessful hernia surgeries. East Hospital surgeons have already successfully operated on five patients using the new technique.
The new surgical method is particularly beneficial for individuals with incisional and anterior abdominal wall hernias, especially those who have undergone repeated surgeries for incisional hernias. “So far, this has been a particularly challenging group of patients, given that with each repeated surgery of the same type, healing becomes more difficult and involves the build-up of scar tissues and development of lesions, and previous surgical mesh remains in place. Technically, it becomes increasingly difficult for the surgeon to achieve a good medical outcome,” explains Associate Professor Igors Ivanovs, Lead Physician of the Day Surgery Unit at East Hospital.
Incisional hernias are a major health concern. They cause not only severe pain and discomfort but also limit a person’s ability to work or move. Some patients are unable to walk even short distances due to persistent abdominal pain and the protrusion or even “falling out” of internal organs. “Hernias can cost people their jobs. They may no longer be able to do physically demanding work, such as lifting or moving heavy objects. This health condition affects not just individual lives but the country’s overall economic health,” points out Associate Professor Igors Ivanovs.
In response to this challenge, surgeons at East Hospital have become the first in Latvia –– to master and successfully apply the effective LIRA method for hernia treatment. Five patients have already successfully undergone surgeries at the East Hospital, using the new surgical method, following long-standing health issues. The outcomes have been positive, and these patients are expected to return to active, social lifestyles very soon.
The key advantage of this new hernia surgery method is that surgeons not only close the hernia laparoscopically but also restore the anatomical body structures, which leads to improved functional outcomes. Laparoscopic surgery also means that no large scars remain, as the procedure is performed through small incisions. With this innovative surgical technique, the abdominal muscles are surgically repositioned so that the hernia site closely resembles its preoperative state. “This is not just about appearance. The internal abdominal organs are restored to their anatomically correct position, which also restores their physiological functions, so the patient can return to the same work and basically regain the physical abilities,“ emphasizes Associate Professor Igors Ivanovs.
Complex hernia surgeries are intricate procedures. They typically take several hours to perform, and patients should expect to stay in the hospital for an average of four days, as they require postoperative care. It is crucial for medical professionals to make sure the patient is recovering well and offer guidance to support a smoother healing process. After such a surgical hernia repair, patients must avoid lifting or carrying heavy objects for two to three months and are advised to wear a special medical support belt.
The LIRA technique was developed by a group of Spanish surgeons, among them Professor Salvador Morales-Conde, who is currently the President Elect of the European Hernia Society. Among the Society’s members are also lead surgeons from the General and Emergency Surgery Clinic at East Hospital, who have established a dedicated hernia unit to perform complex hernia repairs. The method was initially piloted and implemented at a specialized clinic in Spain, and Spanish specialists later shared their knowledge and experience with international colleagues, including Associate Professor Igors Ivanovs, Lead Physician at East Hospital’s Day Surgery Unit, who received training in the technique. Today, as surgeries are performed at East Hospital, the method is being passed on to surgeons, young physicians, and residents.
East Hospital’s hernia unit encourages patients to seek advice and schedule an outpatient consultation to explore whether the new surgical method could be a solution to their hernia-related health problems. The surgery is fully funded by the state.
Incisional hernias frequently develop after open surgical procedures involving an incision, e.g., major oncological surgeries. Globally, it is estimated that around 30% of patients, or roughly one in three, will develop a hernia following major surgery. This is linked to the fact that about 30% of the population carries what is known as a defective connective tissue gene. As a result, some individuals have weakened connective tissue following major surgery, leading to slow healing and an increased risk of hernia formation. At present, no effective preventive method or solution has been developed to fully avoid hernias. Factors such as excess weight, diabetes, smoking, and heavy physical activity can contribute to hernia development. Immunocompromised patients or patients with weakened immune systems, including those with cancer, HIV/AIDS, or other chronic conditions, are also at elevated risk.
About the East Hospital
Riga East Clinical University Hospital is the largest and strategically significant multi-profile hospital in the country. The hospital consists of five inpatient facilities – Gaiļezers, Latvian Oncology Centre, Biķernieki, Tuberculosis and Lung Disease Centre, and Latvian Infectious Diseases Centre, along with various specialised centres and clinics. The hospital provides highly specialised inpatient and secondary outpatient healthcare, offering multidisciplinary tertiary-level treatment and care in line with modern technology and medical knowledge. Approximately 80% of all cancer patients in Latvia are treated at the hospital. It serves as a practical training base for both Latvian educational institutions and foreign students, providing further education and knowledge transfer to healthcare specialists within and beyond the country. The hospital engages in scientific research and develops innovative methods for patient treatment. As the third-largest employer in the country, the hospital employs around 5000 staff members.
