HERNIA REPAIR SURGERY
Hernias are among the most common problems that general surgeons treat. A hernia occurs when an organ or segment of tissue protrudes through a hole in the muscle wall that should hold it in place. This hole can result either from previous surgery in that area, from increased pressure due to obesity, or from a natural opening or muscle weakness that is present at birth and turns into a problem over time.
Types of Hernias
There are multiple kinds of hernias that we treat, including:
- Inguinal Hernia-This is the most common type of hernia and involves a protrusion of the contents of the abdomen, through a weak area of the abdominal wall in the groin. Inguinal hernias can occur on both sides and should be repaired as soon as the diagnosis is made.
- Ventral Hernia-These types of hernias will arise in a weak area of the abdominal wall, where the umbilical passed through during development. Patients will often complain of a midline bulge, which becomes prominent when the patient tries to sit up from a lying position.
- Incisional Hernia-Occasionally incisional hernias will occur at the site of a surgical scar, due to incomplete healing of the abdominal musculature. This type of hernia most often occurs at the midline and can be quite large. Incisional hernias should be repaired as soon as a diagnosis is made.
- Sports Hernia-This type of hernia likely results from sudden twisting or straining and can involve both an indirect hernia and a tear or instability in the musculature of the groin. Surgery done with a minimally invasive technique will usually relieve the pain associated with this type of hernia.
- Umbilical-Most umbilical hernias will close spontaneously by the age of three. However, if the hernia is still present at the age of three, repair is recommended.
- Inguinal-These hernias present with a protrusion in the groin, and should be repaired when diagnosed.
- Other Types-Femoral hernias, obturator hernias, and spigelian hernias are very rare types of hernias that can be very difficult to diagnose without evaluation by an expert.
The signs and symptoms of hernia depend on the type of hernia. Some hernias do not cause any symptoms but are discovered during medical exams. Some common symptoms include:
• A bulge under the skin in the groin or other abdominal area
• A burning or aching sensation at the bulge
• Groin pain or discomfort, especially when bending over, coughing or lifting
• Groin weakness or pressure
Sudden pain, discoloration of the bulge, vomiting and constipation can be signs of “strangulation”. This occurs when the intestines or abdominal tissue becomes trapped in the weakened muscle layer. This condition can cut off the blood supply and requires immediate medical attention.
Who Is at Risk of a Hernia?
Hernia can affect men, women, and children. A hernia may be the result of a defect or weakness in the abdominal wall at birth, or a weakness caused by age, injury, or a previous surgical incision. Factors that can increase your risk of hernia include:
• Improper heavy lifting
• Straining during bowel movements
• Sharp blows to the abdomen
• Chronic cough
• Poor nutrition
• Family history
Painful or enlarging hernias usually require surgery to relieve discomfort and prevent serious complications. For common small hernias such as an inguinal or umbilical hernia, the hole or weakness is often repaired using a mesh material to reinforce and support the weakened area. A hernia may be repaired using an open or laparoscopic technique. Hernia repair is one of the most common surgeries in the United States. According to the FDA, over one million Americans undergo some type of hernia surgery annually.
In this minimally invasive procedure, a few small incisions are made in your abdomen. The surgeon places a tiny laparoscope (a viewing tube with a camera) and small instruments through the incisions. The organs or tissues are pushed back into their original position and the abdominal wall is reinforced with a special mesh that is secured by sutures, stables, or tacks.
Most non-complex hernia laparoscopic repair patients experience less pain and scarring and a quicker return to their normal activities. Laparoscopic hernia repair may be a good choice for patients who have previously had traditional hernia surgery because it can allow the surgeon to avoid scar tissue from the earlier surgery.
Laparoscopic hernia surgery may not good option if you:
• Have a hernia on both sides of the body
• Have a very large hernia
• Have undergone previous pelvic surgery
• Can’t undergo general anesthesia
Open Hernia Repair
In this procedure the surgeon makes an incision in your abdomen or groin and the bulging intestine or tissue is pushed back into place and sewed securely. The weakened area is usually reinforced and supported with a mesh material.
You will be encouraged to move about soon after surgery, but it may be 4-6 weeks before you are fully able to resume normal activities.
Complex Hernia Repair
Our physicians treat all types of hernias -from routine to very complex cases, such as recurrent hernias.
Hernia Surgery Basics
With so many types of hernias and the unique needs of each patient, there are many different approaches to surgery and recovery, and your surgeon will guide you through the best approach for you. But, there are some basics related to many hernia repairs that you can familiarize yourself with.
The first is that mesh is often the preferred method of repair. Rather than suturing the body’s tissue together at the site of the opening, sewing in mesh can help to strengthen that weak spot and reduce the risk of recurrence. The location and severity of the hernia plays a major role in deciding what type of mesh to use and how to incorporate it into the repair.
If the organ caught in the hernia has become strangulated (i.e., lost blood flow) and that section has started to die, part of the organ may need to be removed and the hernia then repaired.
Many hernias can be repaired laparoscopically, which is great news for patients. This reduces scarring and hospital stays. It also speeds up recoveries. Furthermore, because the incisions made are small, this could also lower the chance for recurring incisional hernias.
Your hernia surgery, whether open or laparoscopic, will require general anesthesia and may be followed by a short hospital stay. It will be important to take it easy in the first few weeks after you go home, particularly in terms of lifting heavy objects or other strenuous activity.
Overall, the surgery and resultant recovery will vary from patient to patient. So, to get the best understanding of your prognosis, ask plenty of questions when you come in for your appointment.