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Preventing Hernia Recurrence with the BARS Procedure

Hernias are a common condition that is often managed with standard surgical treatment.  Some common causes of muscle weakness or strain that may lead to hernia formation include damage from an injury or surgery, strenuous exercise or lifting heavy weights, and being overweight or obese.

However, some hernias can be difficult to repair and, without proper treatment, may become recurrent hernias. Dr. Andrew Elkwood and the team at The Institute for Advanced Reconstruction developed a method for managing complicated hernias and preventing recurrent hernias, known as the Bony Anchored Reinforcement System (BARS).

Dr. Elkwood answers some commonly asked questions about the BARS procedure in the below Q&A.

    1. What is the BARS procedure?

      BARS procedure stands for Bony Anchored Reinforcement System.  It is a way to help prevent recurrences of large abdominal hernias.  Recurrence of a large abdominal hernia is a significant problem, with statistics in certain instances of hernias recurring more likely than not.  This is particularly true of large-standing hernias, hernias after large operations, and hernias in obese patients. The BARS procedure is not performed to repair the hernia primarily but to help prevent a recurrence.

    2. What makes the BARS procedure unique?

      The BARS procedure is a unique procedure where we insert orthopedic-type anchors into the pubic and pelvic bones to help place mesh to re-direct the vectors of the abdominal contents back into their natural position within the pelvis. When a large hernia is present, the weight of the contents is often left pushing against the repair, causing it to stretch and loosen over time. However, the BARS procedure directs the weight back into the pelvis, thereby taking the weight off of the repair.

    3. What is recovery like?

      Recovery from the BARS procedure is significant, as is often the recovery from the hernia repair itself.  The BARS procedure often does not lead to significant additional recovery above and beyond the hernia repair, but again that depends upon the personal patient’s case.

    4. What are the benefits of the BARS procedure?

      We have found significant benefits of a BARS procedure over isolated hernia repair.  At this point, our practice has performed between 500-1,000 of these procedures.  The benefit of the BARS procedure is that it greatly reduces the recurrence of hernias regardless of their method of repair.  It should be noted that we do not recommend the BARS procedure for “routine hernias” or common inguinal, umbilical, or other small hernias but for hernias with a high risk of recurrence.


If you are interested in learning more about this procedure or scheduling an appointment, please call our office!