With its new Abdominal Core Health Initiative, Johns Hopkins joins an emerging movement to establish a distinct medical field expanding beyond traditional hernia care to offer a holistic and multidisciplinary approach to treating issues that affect the abdominal core.

Johns Hopkins is spearheading the third such multidisciplinary program in the world and the first on the East Coast. 

The growing medical trend attempts not only to better reflect the full complexity of care that hernia surgeons provide, but also to widen the umbrella and address related or underlying conditions — including pelvic floor dysfunction, urinary incontinence, rectus diastasis, core muscle injuries and abdominal tumors. Above all, physicians in the field embrace a big-picture approach to treat abdominal core stability as a key function of overall health, well-being and longevity.

“The goal is to bring each patient back to their full function and quality of life,” says Andrew Jung, an assistant professor of surgery at Johns Hopkins who, along with Gina Lynn Adrales, director of minimally invasive surgery at Johns Hopkins; Hien Tan Nguyen, director of the Comprehensive Hernia Center; Alisa Coker, director of robotic surgical education; and Brenda Zosa, assistant professor of surgery, is leading the new program.

The Abdominal Core Health Initiative unites experts from multiple specialties across Johns Hopkins, including general surgery, urology, gynecology, plastic surgery, gastrointestinal surgery, colorectal surgery, interventional radiology, physical therapy and occupational therapy. Many are trained in robotic and minimally invasive surgery.

“There’s a need for a one-stop shop where patients can find a personalized and multidisciplinary approach,” Jung says. “Our experts are collaborating and bouncing ideas off one another. If surgery is needed, we’re helping patients through all stages of that, such as core strengthening beforehand and pain management and physical therapy afterward. In some other cases, we’ll look to nonsurgical or alternative fixes.”

In 2019, Adrales and fellow members of the American Hernia Society wrote an editorial in the Journal of the American Medical Association about the need to carve out a distinct field for abdominal core health — “a fresh, new and innovative brand for a discipline of surgery that has historically appealed only to a narrow clinician demographic.”

They wrote: “Core strength, function and balance are becoming increasingly critical aspects of care for the aging U.S. population. Incorporating these concepts in an overall effort to maintain health and focus on disease or injury prevention … reaches far beyond the treatment of hernia. Here is an opportunity to re-define the field in a more positive light by focusing on health and not disease.”