Hernias occur when muscle or tissue holding an organ in place weakens and allows the organ to break through. One common example is an abdominal hernia in which intestines push through a weak spot in the abdominal wall. While hernias are indeed most common in the abdomen, they can take place in other areas as well, such as the groin, upper thigh or belly button. They can develop quickly or over a period of time, with symptoms including a bulge in your abdomen or groin that gets larger when you stand, cough, or strain. You may also feel some pain or discomfort.
Most hernias aren’t immediately dangerous, but they will not go away on their own, and surgery is often needed to prevent complications. When to schedule a procedure will depend on the extent of the hernia and your symptoms. There are many types of hernias, but the most common include:
- Inguinal – 70% of hernia surgeries fall into this category that involves the inguinal canal found in the groin. In men, it involves the spermatic cord which passes from the abdomen to the scrotum and holds up the testicles. In women, it involves ligaments that help hold the uterus in place. Surgery is typically recommended for these types of hernias to avoid complications such as strangulation, in which a loop of intestine becomes trapped (incarcerated) and cuts off the blood supply to the affected intestine.
- Umbilical – this type of hernia develops in the belly button area, and is most often seen in young children or babies. It can also occur in women who are pregnant, as well as people who are obese or overweight.
- Hiatal – this refers to a hernia involving the diaphragm, which is the muscle that separates your abdomen from your chest. In this case, part of the stomach can also protrude.
Left untreated, a hernia can grow larger and become more painful. A portion of your intestine can become trapped in the abdominal wall, obstructing your bowel and causing severe pain, nausea, or constipation. It can also put too much pressure on surrounding tissues and cause increased swelling and pain.
Blood will have difficulty reaching the trapped intestine resulting in strangulation causing intestinal tissue to become infected or die. This is life-threatening and requires immediate medical attention.
Clearly, the risks of leaving a hernia untreated far outweigh the typical risks of a surgical procedure, which are typically bleeding or infection.
The kind of surgery you’ll need depends on the type of hernia you have, it’s size, and where it is located. Your lifestyle, age, and overall health will also be considered.
With minimally invasive procedures, you will receive local or spinal anesthesia to numb the lower part of your body). Or, you may receive general anesthesia, receiving medication through an IV.
For laparoscopic surgery, general anesthesia is used.
With either procedure, you will need to take some pre-operative tests and likely have dietary and medication restrictions.
What Happens in Surgery
The two main surgical procedures performed to repair hernias are:
- Open surgery: A small incision is made through which the protruding organ is gently pushed back into place, tied off, or removed. The weakened area where the hernia occurred will then be closed with stitches. If it is a large hernia, the surgeon may use a piece flexible mesh for added support to help prevent recurrence.
Laparoscopic surgery: with this minimally-invasive technique, a harmless gas is used to inflate your abdomen to allow the surgeon a better view of your organs. Three small incisions are made, and a laparoscope — a thin tube with a tiny camera on the end — is inserted. The images provided by the laparoscope are then used as a guide to repair the hernia with mesh using specially designed tiny surgical tools.
We will help you determine which procedure is right for you.
It is typical to experience some discomfort, swelling and bruising at the surgical site after your procedure. You may also feel a pulling or tugging sensation. Recovery varies by patient and depends on a number of factors, however, typically the recuperating process lasts about a month.
Days 1 – 4: You can expect to be off from work or school during this time. You will likely need medication and you should rest from any significant activity other than basic daily functions.
Days 4 – 7: Most patients will be able to return to work or school, with limitations. Avoid heavy lifting (over 10 pounds) and don’t overdo it. At home, light activities may resume such as stretching or walking.
Week 2: At this point, all patients are able to return to work or school but with restrictions of lifting no more than 20 pounds. You may slowly return to a low-impact exercise routine such as light jogging, biking, swimming or yoga. You may still experience occasional discomfort, stiffness or soreness.
Week 3: Exercise activity can be increased.
Week 4: Lifting limitations are no longer necessary. You can safely return to all athletic activities, training and competitions including contact sports and heavy lifting. It’s normal to experience some pulling, tugging, swelling, and other discomforts for months after hernia surgery, however, these occasional symptoms should diminish and become less and less frequent over time.
NOTE: Recovery is usually faster with laparoscopic surgery. On average, patients are back to their normal routine a week sooner than with open surgery.