What is a hernia?
Weakness in the abdominal wall or connective tissue with organ or fatty tissue protruding. Hernias often occur at weak points of the abdominal wall where there was either a weakness that developed from birth or due to exertion or injury. The inguinal canal and the umbilicus are areas where hernia can develop that were previous openings during our fetal development.
What are the types of hernias?
There are many types of hernias:
- Inguinal - in the groins
- Ventral - in the front part of the abdomen
- Incisional - anywhere there has been an incision before
- Umbilical - isolated to the belly button
- Hiatal - located where the esophagus passes through the diaphragm
What will you feel?
The symptoms of a hernia usually start by feeling a bulge. These usually do not cause any pain at first, or only causes pain during certain activities such as lifting or exerting. But with time, the hernia gets larger and the size of the hernia can cause problems. If the contents of the hernia, fat or intestines protrudes through the opening and gets stuck this can cause a strangulation that may require emergency surgery.
How are they diagnosed?
The first person to identify a hernia is usually you, the patient. You notice a lump, bump or bulge where there wasn't one before. Physical exam by a trained professional is necessary to confirm the diagnosis of a hernia. Often, imaging is requested to give a clearer diagnosis and to assist in operative planning
How are they repaired?
Open Repair
Open repair of the hernia (herniorrhaphy) is accomplished by a surgeon making an incision 3-5 inches in size, depending on the size of the hernia, dissecting through the layers of skin, fat, muscle, and fascia and identifies the hernia. The hernia is then repaired with a material called suture that brings the natural tissues together. A synthetic material called mesh is usually placed during the hernia repair to re-enforce the repair to decrease the recurrence of the hernia.
Laparoscopic Repair
Minimally invasive or "keyhole" surgery, uses small incisions and long skinny instruments to access the abdomen and perform the hernia repair. In order to see within the abdomen, the space is filled with CO2 gas and a small camera is inserted. The hernia is identified any contents of the hernia are put back where they belong, while any scar tissue is removed. The hernia defect can be closed in many ways, most of those including closing of the hernia with stitches and then re-enforcing the repair with mesh. The mesh when possible is covered by peritoneum, the special lining of the abdominal wall, so the intestines are protected.
Laparoscopic repair is more advantageous as there are less incisions, less post-operative pain, fewer days in the hospital if any, and faster return to work.
Laparoscopic repair is more advantageous as there are less incisions, less post-operative pain, fewer days in the hospital if any, and faster return to work.