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Hernia

Hernia Repair

A hernia occurs when a small sac containing tissue protrudes through an opening in the muscles of the abdominal wall. A hernia develops when the outer layers of the abdominal wall weaken, bulge, or tear. The hole in this outer layer allows the inner lining of the cavity to protrude and form a bulge or swelling. Any part of the abdominal wall can develop a hernia. Hernias commonly develop in the groin, or around the navel or a previous surgical incision. A dangerous situation will occur if the intestines become trapped (incarcerated). This can occur when you are unable to flatten the bulge. Loss of the blood supply (strangulation) may occur if the intestines become tightly trapped. Both would require emergency surgery.

Ways You Can Develop a Hernia

  • Present at birth
  • Come about slowly or suddenly
  • Excessive straining
  • Obesity
  • Heavy work or lifting
  • Persistent coughing
  • Chronic constipation
  • Sudden twists, pulls, or muscle strains

Signs and Symptoms:

  • Visible bulges in the scrotum, groin, or abdominal wall
  • A feeling of weakness or pressure in the affected area
  • A burning feeling at the bulge
  • A gurgling feeling
  • Severe, continuous pain
  • Dull ache that gets worse by the end of the day

A hernia does not get better and cannot heal itself. If left untreated, it will gradually get worse, and become larger. Severe pain may indicate "trapping" or incarceration, or strangulation of intestines, which may require emergency surgery.

Types of Hernia

Inguinal Hernia: A hernia in the groin area is called an inguinal hernia. Inguinal hernias account for 80 percent of all hernias. In an inguinal hernia, the sac protrudes into the groin towards and sometime into the scrotum. Although most common in men, groin hernias also occur in women.

Umbilical Hernia: Another type of hernia develops through the navel, and it is called an umbilical hernia. Small hernias do not need repair by laparoscopic method. They are easily accessible through a small incision and a few simple stitches. Larger hernias require surgery.

Incisional Hernia: A hernia that pushes through past a surgical incision or operation site is called an incisional hernia.

Hiatal Hernia: A hiatal hernia forms when the upper portion of the stomach slides into the chest cavity through the normal opening created by the esophagus. This is usually associated with "Reflux Gastro-Esophageal Disease" (GERD). Patients suffer acid reflux, heartburn, pain behind the sternum, etc.

Surgical Procedures

Traditional Approach: This surgery is done from the outside through an incision in the area of the hernia. The incision goes through the skin, fat, and allows the surgeon to get to the level of the hernia.

Laparoscopic Hernia Repair: A laparoscope connected to a camera is inserted through a small hollow tube, allowing the surgeon to view the hernia and surrounding tissue on a video screen. The hernia is repaired form behind the abdominal wall.

Surgical Options:

  1. Tissue to tissue repair
  2. Flat mesh patch in front of muscle
  3. Flat mesh patch behind muscles
  4. Mesh patch as a plug
  5. Mesh patch as a double disc
  6. Flat mesh patch converting to a plug
  7. Butterfly Mesh™ for ventral/incisional hernias

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