Frequently-asked questions (F.A.Q.)

1. Are there hernias that cannot be operated on endoscopically?
2. Does the endoscopic procedure carry any risks?
3. The endoscopic procedure takes place under local anaesthetic. Does it hurt?
4. Can you end up in a wheelchair if a hernia goes untreated?
5. How long will I be unable to work?
6. I have already been operated on in the classical, open way. Is an endoscopic procedure then still possible?
7. My doctor has told me I have a hernia. What should I do next?
8. How long will I have to wait before a consultation and operation?
9. Will the costs of surgery be reimbursed? Is it covered by insurance?

1. Are there hernias that cannot be operated on endoscopically?
There are still colleagues who believe that not all hernias can be removed endoscopically. What they have in mind then are very large hernias or hernias with loose sequesters lying in the central spinal canal (loose fragments of the disc). However, by applying the instruments and procedures developed in the Dr. Hoogland Spine Center in collaboration with the firm Joi Max, it is now possible to remove virtually any hernia, no matter how large or where it may be situated.

2. Does the endoscopic procedure carry any risks?
Every operating procedure is accompanied by risks. However, complications are extremely seldom with endoscopic procedures. If any, then they are limited to bleeding or a painful wound that will normally be alleviated within a few days. Since 2004 we have performed endoscopic back surgery on more than 330 patients. Until now, no patient has experienced serious complications. The complications sometimes feared with open surgery, such as persistent limited nerve functions, scarring and tumouring, postoperative pain, instability of the spinal column, increased risk of infection, bleeding and even paralysis, are highly unlikely under our minimally-invasive method.

3. The endoscopic procedure takes place under local anaesthetic. Does it hurt?
The use of local anaesthetic avoids the complications that can sometimes arise when general anaesthesia is used. The anesthesist introduces a drip that gives the patient a 'relaxed' feeling that is rather pleasant. Yet another advantage of the local anaesthetic is that the patient is fit again soon after surgery; moreover, it has less of an effect on the circulation. It is therefore much less stressful for the heart than surgery under a general anaesthetic. For diabetics the risk of infection is also reduced.

4. Can you end up in a wheelchair if a hernia goes untreated?
Fortunately, few patients experience this. When this does happen, the cause is usually a large, acute hernia resulting in paralysis of the lower limbs and the loss of control over the bladder and bowels. Even in these cases, prompt surgical intervention can usually prevent permanent damage.

5. How long will I be unable to work?
The period of medical unfitness for work depends partly on the patient's condition prior to surgery, and the operation he or she has undergone. Most patients are capable of performing light office work within a week of surgery. Full recovery usually takes 4 to 6 weeks.

6. I have already been operated on in the classical, open way. Is an endoscopic procedure then still possible?
The endoscopic method is very suitable for a second back operation because the access chosen is not from behind (where scar tissue has formed) but through the side, via the foramen.

7. My doctor has told me I have a hernia. What should I do next?
You can contact us by telephone at +31(0)85-2103004 or by e-mail to info@rugkliniek-iprenburg.nl; we will be pleased to inform you as to how to proceed. If you already have recent MRI photos, then you can send them to us (please include the completed pain questionnaire); we will then send you our opinion and a cost estimate, at no obligation on your part.

8. How long will I have to wait before a consultation and operation?
An appointment is normally possible within just a few days. An operation can also usually be scheduled within a week.

9. Will the costs of surgery be reimbursed? Is it covered by insurance?
Health insurers often have very different views on what they will cover. This is why we give our patients a cost estimate for insurance purposes well in advance, so that they know where they stand in terms of the costs before the first appointment. If your health insurer will not reimburse the full cost, you may find your employer and/or his absenteeism insurer prepared to make a contribution.