Hernia

An abdominal wall hernia is a weakness or hole in the abdominal muscles through which organs or tissue may protrude. Some people may be born with a hernia. Others may acquire one over time. If left untreated, hernias can get worse.

About the condition

You might see a bulge under your skin that gets larger when you stand. You also may notice the hernia when you lift something, cough or even urinate.

Most hernias require surgical repair by pushing the bulging tissue back into the abdominal cavity and securing the weakened tissues. Often, a mesh material is used to help repair the weakness and prevent further hernias.

Types of Hernias

Inguinal

Located near the inner groin, inguinal hernia are the most common type of hernia. They are especially prevalent in men because of a natural weakness in this area.

Femoral

Occurs in the outer groin and is most common in women, especially those who are pregnant or obese.

Umbilical

Located near the navel, umbilical hernia are common in newborns, obese women or those who have had many children.

Incisional or Ventral

Results from an incompletely healed incision at the site of a previous abdominal surgery. Incisional hernia occur most often in elderly or overweight people who are inactive after abdominal surgery.

Hiatal

Occurs when the upper stomach pushes through an opening in the diaphragm through which the esophagus passes.

Hernia Symptoms

The signs and symptoms of hernia depend on the type of hernia. Some hernias don’t 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 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
  • Smoking
  • Obesity
  • Pregnancy
  • Poor nutrition
  • Family history

Treatment

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.

Before Surgery

Prior to your hernia repair surgery, please follow these pre-surgery guidelines:

Stop Smoking Stop smoking for one month prior to your surgery. Nicotine decreases blood flow and prevents healing after surgery and increases your risk of infection.
Be Active Increase your activity. Aim for 30 minutes of walking or other aerobic activity daily to build strength.
Improve Nutrition Add protein supplements such as Boost or Ensure to help your body heal after surgery.
Lose Weight You may be asked to lose weight prior to hernia surgery for a more successful repair and reduced rate of recurrence.

Surgery

Our surgeons perform open surgery, as well as minimally invasive surgeries, for hernia repair. Your surgeon will explain your particular procedure in more detail.

Minimally invasive surgery

Minimally invasive surgery is performed with laparoscopy or robot-assisted surgery using the da Vinci Surgical System.

Laparoscopic surgery

Laparoscopic surgery requires only a few small incisions into which your surgeon will fit long, thin surgical instruments and a tiny camera. The camera will provide images to guide the surgeon during the procedure.

Robotic surgery

Some laparoscopic surgeries may be performed using the da Vinci Surgical System. This robotic option gives your surgeon a magnified 3D high-definition view inside your body. The system also enables the surgeon’s hand movements to be translated into precise movements of small instruments inside your body.

Open surgery

With open surgery, your physician will make an incision at the site of the abnormality large enough so he or she can see and touch your internal organs while operating.

After Surgery

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  • You will be encouraged to walk to prevent blood clots, muscle weakness and constipation.
  • For large hernias, you may have surgical drains in place to help your incision heal. You may want to have someone help you with this care when you return home.
  • You may not be hungry at first, so return to a normal diet slowly. Check with your physician about using supplements if your appetite is poor.
  • Your abdomen may feel tighter after hernia repair, and there may be some swelling.
  • You may experience constipation. If so, you may take a laxative such as Miralax or Milk of Magnesia.
  • Ice may help to reduce the swelling for the first 48 to 96 hours. Then use heat to ease muscle soreness and relax tight muscles.
  • You may use ibuprofen in addition to prescription pain medication to help with pain control.
  • For men, swelling and bruising in the penis and scrotum can be normal. To reduce these symptoms, an athletic supporter (jock strap) may be helpful after inguinal.
  • A small amount of bleeding or drainage is expected from the wound during the first one or two days.
  • You may shower one or two days after surgery, but avoid baths, hot tubs, soaking or swimming for at least two weeks.
  • An abdominal binder may be helpful in providing support to your abdominal wall.
  • Always talk to your surgeon about weight restrictions and return-to-work options.
  • Most patients who have had laparoscopic or robotic surgery for inguinal or umbilical hernias are discharged the same day of their surgery.
  • You will be asked to see your surgeon in one to three weeks after surgery.
  • If you notice a fever greater than 101 degrees Fahrenheit or drainage from your wound, let your surgeon know by calling +number here

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