Hernia surgery : What patients should know
Hernias occur in regions of the abdominal wall where there is a defect in the muscle layer, allowing contents inside the abdomen to bulge out, or “herniate.” Common locations for hernias include the groins, umbilicus, and at old incisions from prior surgeries. A hernia is often discovered when a patient notices a bulge in the groin or abdomen, which may have been brought on by heavy lifting or straining.
Common Types of Hernia
Inguinal
An inguinal hernia occurs in the groin and is named for its location, as hernia contents protrude through the inguinal canal. Most commonly, symptoms of bulging, pain, and discomfort are noticed after doing activity throughout the day, then improve when laying down. Increased use of the abdominal wall can worsen symptoms.
Umbilical
The umbilicus is a natural area of weakening in our abdominal wall, as it is the location where the umbilical cord was attached to our mother in development. Very small umbilical hernias can be monitored with observation. If symptoms develop or it increases in size, repair is indicated.
Incisional
Whenever an incision is made in the abdominal wall and the muscle layer is cut, the resulting scar never regains the same strength as the natural tissue. It typically heals to about 80% of its original strength by 6 weeks. As a result, the weakened tissue is at risk for developing into a hernia.
Hiatal
Hiatal hernias are not located on the abdominal wall, but rather on the inside of the abdomen where the esophagus meets the stomach.
The “hiatus” refers to the opening in the diaphragm where the esophagus passes through from the chest into the abdomen and empties into the stomach.
When this opening becomes larger than normal and the stomach slides up into the chest, a hiatal hernia is present. Symptoms often include heartburn, reflux, regurgitation, and a feeling that food gets stuck in the lower part of the chest or upper abdomen and does not pass through easily. CLICK HERE for more on Hiatal Hernia Surgery.
Surgery
Open Technique
Traditionally, hernias have been repaired with open surgery. In many instances, such as emergency cases and very large hernias, open surgery may be required. In this surgery, an incision is made overlying the region of the hernia. The contents of the hernia are either removed or placed back into the abdomen in their natural location, and sutures are placed to close the defect in the abdominal wall muscle layer. A mesh may also be placed to reinforce the repair and reduce the risk of recurrence.
Minimally Invasive Techniques
Laparoscopy and robotics have enabled surgeons to repair hernias with smaller incisions and allow for a less painful recovery than open surgery. Instruments are placed into the abdomen through small incisions and the hernia is repaired from behind by separating the muscle layers, rather than cutting through the abdominal wall. Mesh is routinely used with laparoscopic and robotic surgery for hernia repairs.
For details on hiatal hernia surgery, please visit my page on Anti-reflux Surgery
Hernia Surgery, Ramsey, NJ with Dr. Anthony Pozzessere
The award-winning surgeon has been able to undertake many successful hernia surgeries. The services entail consultations and routine follow-up on patients. Patients in Ramsey, New Jersey, can enjoy these quality services.
