A hernia occurs when part of an internal organ bulges through a weak area of muscle. Most hernias occur in the abdomen. The only curative procedure available for a hernia is surgery. Hernias are progressive, meaning that they will only get worse if left untreated. Some people may live with a hernia for their entire life, having no discomfort at all and will not require surgery. Others will have significant discomfort requiring surgery sooner rather than later.
Types of Hernia
There are several types of hernias, including
- Inguinal, the most common type, is in the groin
- Femoral, in the upper thigh
- Umbilical, around the belly button
- Ventral, in the abdomen
- Incisional, through a scar
- Hiatal, a small opening in the diaphragm that allows the upper part of the stomach to move up into the chest.
Causes of a Hernia
Hernias are common. They can affect men, women and children. A combination of muscle weakness and straining, such as with heavy lifting, might contribute. Some people are born with weak abdominal muscles and may be more likely to get a hernia, especially in the groin (inguinal) or the belly button (umbilical).
Risks of an Untreated Hernia
Most hernias go unnoticed by the patient and many live decades or even their whole lives never realizing they have a hernia.
Others will see or feel the effects of a hernia in the form of a bulge under the skin and possibly discomfort or pain in the area. Some hernias create referred pain, meaning that patients will feel pain in areas other than where the hernia is locates.
The risk of a serious complication due to hernias is relatively low. The greatest risk of his incarceration and strangulation. Incarceration occurs when tissue – typically intestinal tissue or abdominal fat becomes stuck in the hernia defect. This requires an urgent visit to a surgeon and prompt surgical care.
Strangulation occurs when incarcerated tissue becomes pinched and loses blood flow. This is an emergency situation that must be resolved immediately with surgery. If a strangulated hernia is not addressed quickly, secondary colon surgery may have to be performed to excise dead intestinal tissue which carries a significantly higher risk than hernia surgery alone.
Hernia Treatment & Surgery
The usual treatment for a hernia is surgery to repair the opening in the muscle wall. While a hernia can be repaired using traditional open surgery, most hernias are now performed in a minimally invasive manner meaning that only 3-4 small incisions are made in the abdomen. This is often even completed using a robotic approach.
During surgery, the contents of the hernia are reduced, and the defect is closed. A surgical mesh is placed over the defect to strengthen the repair. Unlike hernia surgeries of old, where only sutures were used to shut the defect, the mesh means that no tension is placed on the surrounding tissue. This usually leads to a longer lasting repair with a much lower risk of recurrence.
The surgical mesh creates a mild inflammatory response in the body and natural scar tissue begins to form around the mesh. Once the mesh is fully integrated into the body, the repair is stronger than natural tissue alone and results in a significant decrease in the risk of the hernia recurring. Although you may be concerned over the use of mesh, there are millions of patients that have had mesh placed with no change in their lifestyle.
Risks of Hernia Surgery
As with any operation, hernia surgery does come with some risks that include:
- All of the risks inherent in abdominal surgery including infection, pain and blood loss
- Recurrence of the hernia
- Complication of mesh implantation including chronic pain or mesh migration that may require removal or revision
The risks of hernia surgery as they relate to each individual patient will be discussed during consultation.
For more information and to schedule a consultation with Dr. Henke, please call us or e-mail us.
Reviewed by Dr. Jeff Henke and updated on September 5, 2018