Okay so let’s discuss hernia surgery first of all when is surgery yeah you gotta get surgery immediately well you of course gotta get surgery immediately when you’re strangulated in the emergency room like we saw in that video so if somebody is strangulated in the emergency room and cannot be reduced and pushed back in then you go straight to the operating room you also need surgery if you have a strangulation it’s pushed back in and as they mentioned in that video you need to have eventual surgery sometimes it means that you’re admitted you’re brought into the hospital the doctors check on your heart your lungs and you’re kind of cleared and you have surgery in a day or two days sometimes it means you go home and then we schedule your surgery as an outpatient so those are kind of the immediate situations in regard to having surgery and then the patients who have symptoms we talked about pain in the groin and swelling and discomfort those patients that come and see us in the office and where the hernias are impacting their life then those patients should have surgery as well of course if you have medical care access and you of course are a candidate to have surgery in other words your primary physician feels that you can have surgery because of your medical conditions are stable then you really should have surgery let’s bring back that graphic that we had earlier on the different types of hernias and doctor walk me through to tell me with each of these cases how the treatment of surgeries might differ yeah so of course you know whenever you can you could you should have minimally invasive surgery and we’ve learned that through the years since the late 80s with gallbladder surgery we no longer open patients to have a gallbladder surgery we do it with three little holes and so the same applies with inguinal hernia and so of course thank God at Baptist Health we have experts like myself who do minimally invasive surgery for hernias now if you’re in a small town you may not have a surgeon that can perform minimally invasive hernia surgery because it’s more complex than a gallbladder surgery and so any of these hernias if it’s possible should be done in a minimally invasive fashion so inguinal and femoral hernias are in the groin location and those are done with small little holes umbilical hernias are in the belly button now of course if they’re hernia is small and you’re a thin individual it may be done with small little cut and so it may not need the invasive approach an incisional hernia is sometimes they are amenable to minimally invasive approaches and sometimes hernias are so big that you can’t do them in a minimally invasive fashion so there are limitations still to what we have though there’s been a lot of progression and technology and advancement in surgical care there is limitations and so not all hernias are amenable to minimally invasive surgery you