What is a Hernia?

A hernia occurs when an organ or tissue protrudes through weak spots in the muscle walls, resulting in a bulge. Without treatment, patients are at risk of developing this life-threatening condition. If you are diagnosed with a hernia, it is important to consider hernia surgery as a treatment option. 


Ironically, the exact cause of hernias remains unknown. Contrary to common myths, strenuous activities and exercises do not directly lead to hernias. The only reliable treatment for a hernia is hernia surgery. In recent years, robotic hernia surgery has emerged as an advanced approach for the procedure.


Hernia Surgery

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. Hernia surgery repairs the weakened muscle layers.
inguinal hernia
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Common Types of Hernia

inguinal hernia


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 hernia


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 hernia surgery


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 hernia


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.

Hernia Surgery Procedure

Hernia surgery

Open Technique

Traditionally, hernias are 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 robotic hernia surgery enables hernia 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

Best Hernia Surgeon in Ramsey, NJ 

The award-winning General Surgeon, Dr. Anthony Pozzessere, has been able to undertake many successful hernia surgeries. He provides hernia surgical consultations (including robotic surgery)and routine follow-up on patients. Dr. Anthony Pozzessere offers patients in Ramsey, New Jersey, these quality services.

Robotic Hiatal Hernia Repair Surgery

Robotic surgery, or robot-assisted surgery is when the surgeon controls the arms of a robot while seated at a computer console near the operating table. We can:


Robotic Hiatal Hernia Repair Surgery

Hiatal hernia is a medical condition where the upper part of your stomach sticks out into your hiatus (an opening for your diaphragm that connects your esophagus with your stomach). If the hernia is diagnosed as fatal, surgery is needed. There are three common types of surgery for hiatal hernia, these are:

Types of Hiatal Hernia Repair Surgery Ramsey NJ

Hiatal hernia is a medical condition where the upper part of your stomach sticks out into your hiatus (an opening for your diaphragm that connects your esophagus with your stomach). If the hernia is diagnosed as fatal, surgery is needed. There are three common of surgery for hiatal hernia, these are:

Laparoscopic Surgery

It is a procedure that involves small incisions into which your surgeon inserts a laparoscope (a tiny tube with a camera attached to its end) and other surgical instruments for the procedure. The camera will provide a live feed during the procedure while it is inside your body. This technique is minimally invasive which offers less blood loss, less pain, smaller scars, shorter stay at the hospital, and fast recuperation process. The only limitation of this procedure is that it only offers 2D imagery, and it has a limited range of motion which makes it difficult for surgeons to work with tight spaces in the body.

Robotic Surgery

This procedure includes the use of robotic arms controlled by a computer console. The procedure of this method is much similar to laparoscopic surgery, it provides greater accuracy, flexibility, and faster recuperation.

Through the help of a computer console, surgeons are able to deliver cutting edge precision on cuts and incisions. In addition, the robotic arms are able to reach areas that are previously unreachable in laparoscopic surgery.

With its high definition camera, surgeons are able to magnify 3D images to achieve greater accuracy and vision of the surgical area.

During the Procedure

Robotic and Laparoscopic surgery are very much alike. In robotic surgery, general anesthesia will be introduced to you before the operation begins. This implies that you will remain unconscious throughout the

hiatal hernia repair

. The laparoscopic and robotic surgeon will then position himself on the computer console to control the robotic arms for the operation. From here, your surgeon will make small incisions (using the robotic arms) strategically on your abdomen to access your hiatal hernia. After that, an endoscope and other surgical instruments are inserted through the incisions. The camera provides an expansive view of the operating site which allows your surgeon to find a way around to avoid damaging nearby muscles and nerves during the operation. Once on the operating site, your surgeon will try to pull back the protruding portion of your stomach back in place from the hiatus. From here, the upper portion of your stomach near the esophagus will be wrapped to tighten the sphincter, to avoid further acid reflux. The surgeon will then proceed to stitching every incision made inside your body, then one by one withdrawing all the surgical instruments out from your abdomen. Finally, the surgeon will close the incision through stitching and patch it up with bandages.

Recuperation Process

After the operation, your surgeon will proceed to preparing your discharge paper once you meet certain conditions. Pain in the surgery area will keep coming for a couple of days. Expect to have a full recovery about one to two weeks, but avoid strenuous activities during the recuperation period.

Schedule a Consultation Today!

If you’re experiencing discomfort due to hiatal hernia or any other hernias, book a consultation with us today! We are committed to providing patient-centered care for you, and we make sure to guide you through the whole process. Contact us now!

Laparoscopic Hernia Surgery

Top hiatal surgeons prefer minimally invasive procedures to improve patient outcomes. We can:


Laparoscopic Hernia Surgery

Laparoscopic hernia surgery is similar to other laparoscopic surgery variations. It uses a laparoscope (an instrument with a tiny camera on its end) that will be inserted in one of the four incisions on your abdomen including other surgical instruments. The hernia surgeon will then proceed to releasing the strangulated organ or tissue. Then a mesh is placed on the inside to cover up the weak hiatus to prevent any tissue from going out.

Techniques of Laparoscopic Hernia Surgery

Laparoscopic hernia surgery, also known as keyhole surgery, is classified into two techniques;

Transabdominal Preperitoneal (TPP)

The transabdominal preperitoneal (TPP) technique entails the bypassing of the peritoneal cavity by a surgeon who then inserts the mesh on the hernia sites. It is an evolving technique that is associated with the well-known advantages of a minimally invasive approach.

Total Extraperitoneal (TEP)

For the total extraperitoneal (TEP) technique, the surgeon places the mesh outside the thin membrane covering organs in the abdomen, known as the peritoneum. In this case, the surgeon does not penetrate through the peritoneal cavity. The patient can get a break down about laparoscopic hernia surgery from the subsequent text.

It is critical for you to distinguish the two processes. Which is why it is prudent to consult your doctor about your Laparoscopic Surgery.

What Does the Procedure Consist of?

Unlike open surgery, the patient has to be put under general anesthesia before undergoing laparoscopic hernia surgery. This implies that the patient will not be conscious during the procedure. The surgeon will proceed to make two to three half-incisions adjacent to the umbilicus.

From this point, the surgeon will fit a thin tube on one of the incisions. The narrow tube, known as a laparoscope, is unique in that it has a video camera on one of the ends. Here, the doctor avoids causing damage to blood vessels and vas deferens around the groin area.

Carbon dioxide gas is then filled in the abdomen of the patient. This is done to allow the surgeon to have a clear vision of the inner abdomen lining and hernia sac. Onwards, the surgeon will use special cutting equipment to remove hernia sac.

A sterile mesh is then inserted on the weak or damaged abdominal muscles. Over time, the muscles will grow around the mesh. Finally, the surgeon will stitch the small incisions, thus completing the laparoscopic hernia surgery. Usually, laparoscopic surgery takes about thirty minutes to an hour.

Prepping for Surgery

The patient should be well-prepared before undergoing laparoscopic hiatal hernia surgery. After the surgeon evaluates the general health of the patient, it is critical that the patient schedules the appointment in advance. Medical practitioners recommend booking to be done four months before the laparoscopic hernia surgery.

As the d-day approaches, the patient should stop specific medicines as per the guidelines of the surgeon. Also, the patient will have to refrain from drinking fluids and eating meal hours before laparoscopic surgery.

Recuperation Period

Once the surgeon stitches the patient, he or she will go ahead to discharge the patient after meeting certain conditions. This includes being able to tolerate fluids and pass urine. The patient will feel some pain around the surgery area for a couple of days. Full recovery takes between one to two weeks. Over this period, the patient will have to avoid engaging in strenuous exercises. Besides, the patient should not lift items exceeding ten pounds (equivalent to a medium-sized bowling ball). It is usual for patients to feel some pain around the groin in the first few days of recovery.

When Do Patients Undergo Laparoscopic Hernia Surgery?

When the surgeon detects the presence of any hernia during the tests, he will advise the patient to undergo laparoscopic hernia surgery. If the hernia is not removed, it may result in a strangulated or incarcerated hernia. Strangulated hernia poses significant health risks to your health.

Medical studies also show that laparoscopic hernia surgery is suitable for the removal of double hernias. Here, the surgeon can be able to remove both hernias simultaneously through the small incisions made on the abdomen. The laparoscopic hernia surgery can also be performed on patients undergoing recurrent surgery.

What Qualifies You for a Laparoscopic Hernia Surgery?

You must possess the signs and symptoms of hernia and undergo tests to confirm if you really have a hernia before a laparoscopic hernia surgery. At this point, the surgeon looks into your medical background and will evaluate whether you have scar tissues on the abdomen lining or not.

Consequently, the surgeon has to ensure that you do not have any lung diseases such as emphysema. The introduction of carbon dioxide gas to patients that have it disease could result in breathing difficulties. Patients who are elderly and excessively obese cannot undergo laparoscopic hernia surgery.

Also, patients that use blood thinners are not fit for laparoscopic hernia surgery as it may result in excessive bleeding. 

Risks of Laparoscopic Hernia Surgery

Laparoscopic hernia surgery has a set of risks that you should bear in mind. One of them is the possibility of the hernia recurring. You may experience numbness in the high. In other cases, you may feel pain in the groin area or experience difficulties when urinating. There is also the risk of infection of the mesh or sutures. When an inexperienced surgeon performs the laparoscopic hernia surgery, there is a risk of damage to bowel muscles. Also, the mesh inserted in the muscles may move to other areas, thus causing pain in your abdomen. In other cases, you may experience an allergic reaction to general anesthesia which could result in other complications. Nevertheless, the chances of the hernia recurrence after laparoscopic hernia surgery are slim. According to a study done by the University of Wisconsin Madison, School of Medicine and Public Health, 1 to 10 out of 100 operations lead to the recurrence of inguinal hernia.

Edge of Laparoscopic Hernia Surgery Over Open Surgery

When discussing laparoscopic hernia surgery, you have to understand the results of open surgery. Laparoscopic hernia surgery has several advantages. One of them is that the operation is minimally invasive, meaning the patient will not have large scars on their abdomen after the surgery; and it is much safer compared to open surgery.

Furthermore, laparoscopic hernia surgery is suitable for cosmetic purposes. The small incisions made around the belly button are barely visible. There is also less muscle damage as compared to open surgery.

When it comes to the time frame, laparoscopic hernia surgery takes less time in comparison to open surgery. Also, you will be able to recover within days instead of weeks. The merit of this procedure is that you can resume normal activities in no time. 

Get Examined Today!

Dr. Anthony Pozzessere specializes in performing Laparoscopic Hernia surgery — a robot-assisted procedure which calls for small, precise incisions to the operating site. Committed to patient-centered care, Dr. Anthony prefers to adopt methods which cause minimal disruption to a patient’s life, and help them recover as quickly as possible after surgery.