A Hernia is the bulging of an organ or tissue from one space to another through an abnormal opening. They may result from an abnormal opening present at birth or caused by prior surgery or injury. Hernias are theorized to be worsened by high intra-abdominal pressure from coughing, obesity, pregnancy and heavy lifting to name a few. Hernias can be cosmetically undesirable and asymptomatic or symptomatic. Those that are symptomatic should be repaired. Those that are cosmetic in nature and asymptomatic can be Electively repaired at the patients discretion.
Symptoms include pain, nausea, vomiting, inability to have bowel movements, or inability to reduce the bulge back into the abdomen.
There are multiple types of hernias including:
- Inguinal (groin) Hernias
- Incisional Hernias
- Umbilical (belly button) Hernias
- Recurrent Hernias
- Incarcerated (stuck) or strangulated hernias (dying tissue)
The basic principles of all hernia repair are the same:
- Reduce the hernia back to its normal location
- Remove/reduce the hernia sac to prevent recurrence
- Close the abnormal opening (excluding inguinal hernias)
- Mesh Placement. Mesh placement is the gold standard repair with the least risk of recurrence.
The most common approach to this surgery is through small incisions either performed laparoscopically or robotically. Sometimes open surgery is warranted depending on the patient and presentation, which can be discussed at your one on one consultation. Most hernia surgery is considered outpatient and is not an emergency, however if you present with the inability to reduce the bulge back into their abdomen, severe pain, nausea, vomiting, or constipation you should go to your nearest Emergency room immediately.
Recovery includes discharge from the hospital the same day, lifting restrictions >15lb for up to a month to avoid recurrence, and time from work depending on the nature of your employment. You may drive when you are no longer taking narcotic medications and >24h after anesthesia and you may shower the next day. A regular diet is appropriate. The most common complication of hernia surgery, specifically inguinal hernia repair, is the inability to urinate or urinary retention therefore you are required to pass urine prior to leaving the hospital.