Dr. Clarke

photo of Dr. Clarke

Doctor Clarke was educated at the University of Virginia, majoring in French before entering the School of Medicine. He received his surgical training at the University of Florida and was a faculty member there before being assigned to Andrews Air Force Base. There he became Chief of the General Surgery service and an assistant on the Thoracic Surgery service. He rose to the rank of Lieutenant Colonel and was a rated Flight Surgeon before leaving the Air Force to begin private practice in St. Petersburg.

He is certified by the American Board of Surgery and has been an associate examiner for that Board. He is also a Fellow of the American College of Surgeons, for which he served for ten years as Chairman of the Committee on Applicants for his state district.

Dr. Clarke has extensive experience in surgery for hernia and hernia related problems and has authored and co-authored numerous articles and scientific papers on hernia repair. He also wrote the chapter on incisional hernia in a recently published textbook of surgery.

More information:

Clarke, J. Incisional hernia repair by fascial component separation: results in 128 cases and evolution of technique. 2010; 200:2-8.

Since this article was submitted about 18 months prior to its publication, I have made some changes in my approach to the incisional hernia problem, based on further followup and experience. I originally thought most or all major incisional hernias could be successfully repaired with fascial component separation and primary closure, without prosthetic material. I was wrong. I now believe that some larger midline defects also require prosthetic mesh reinforcement. I remain convinced that the fascial component separation and sliding myocutaneous flap thus created are important adjuncts to repair of major abdominal hernias, but alone may be inadequate for larger hernias. I also strongly support the “perforator preservation” technique when fascial component separation is used, and my version of the balloon technique seems a simple and effective way to accomplish this goal.

My current approach, however, often includes retromuscular extraperitoneal lightweight polypropylene mesh, in the manner described by Flament1 and more recently very clearly depicted by Rosen2, who combines this “French” technique with fascial component separation. Early results are encouraging.

Although great strides have been made, the incisional hernia problem remains unsolved, both from preventive and curative aspects.

John M. Clarke, MD, FACS
July, 2010

Dr. Ernest Rehnke

photo of Dr. Rehnke

Dr. Ernest Rehnke, who grew up in St. Petersburg, Florida, attended medical school at St. George University School of Medicine in Grenada, West Indies. He then completed his five-year training in General Surgery at Methodist Hospital in New York, which included a Pediatric Surgery rotation at Kings County Hospital in Brooklyn, N.Y. and a Transplantation rotation at Downstate Medical Center in Brooklyn, N.Y. Following this training, Dr. Rehnke completed a one-year fellowship in Cardiovascular Surgery at the Texas Heart Institute in Houston, Texas.

Dr. Rehnke established his surgical practice in General/Peripheral Vascular Surgery in St. Petersburg, Florida, in 1987. He has been a member of the Active Medical Staff at Palms of Pasadena Hospital in St. Petersburg, FL, since January 1988. Dr. Rehnke is Medical Director of the Palms of Pasadena Hospital Continent Ostomy Center and Weight Loss program and performs Gastric Bypass and the LAP-BAND® procedure for weight loss.

Dr. Rehnke is experienced in hernia and hernia related problems, providing patients with a customized approach. Laparoscopic and open procedures are incorporated in his approach to hernia repair.

Dr. Rehnke is Board Certified by the American Board of Surgery and a Fellow of the American College of Surgeons. He is also a member of the American Society for Metabolic and Bariatric Surgery (ASMBS) who has recognized him and Palms of Pasadena Hospital as a Center of Excellence for Bariatric Care.

Kevin L. Huguet, M.D., F.A.C.S.

photo of Dr. Huguet

Dr. Huguet was born and raised in St. Petersburg, Florida. His undergraduate studies were completed at Florida State University in 1995. He received his Master's of Public Health at the University of South Florida College of Public Health in 1997 in Infectious disease and Immunology. He received his medical degree from the University of South Florida College of Medicine in 2001, where he graduated in the top 10% of his class and received the prestigious membership to the Alpha Omega Alpha Honor Medical Society. His internship and residency in general surgery were served at the Mayo Clinic College of Medicine and completed in 2006. In addition, Dr. Huguet completed a post-graduate fellowship in minimally invasive surgery at the Mayo Clinic College of Medicine in 2007. He joined Dr. Collins in private practice in 2007. He is a diplomate of the American Board of Surgery, and a fellow of the American College of Surgeons, and a member of the American Society for Metabolic and Bariatric Surgery, Society of American Gastrointestinal Endoscopic Surgeons, Southeastern Surgical Congress and the Pinellas County Medical Association. He currently serves as Chief of Surgery at St. Anthony's Hospital in St. Petersburg, FL. Dr. Huguet's special interests include laparoscopic adjustable gastric banding, laparoscopic treatment of gastric and esophageal disorders, laparoscopic colorectal surgery, laparoscopic hernia surgery, laparoscopic solid organ surgery and pancreatic, adrenal and splenic disorders.