Hernia Surgery

What is a Hernia?

A hernia is essentially a hole:  a hole in the wall of a cavity (for example, the abdomen) that allows something normally contained within that cavity to protrude outside of that cavity.  Hernias are often named in terms of their location:  Inguinal (left or right groin), Umbilical (bellybutton), Ventral (along the midline of the abdomen but not involving the bellybutton or groins), Femoral (just below the left or right groin), and Hiatal (stomach protrudes into the chest through the diaphragm).  Sometimes, hernias occur following a previous operation and are called Incisional Hernias.  There are other types of hernias as well (Spigelian, Lumbar (Petit’s, Grynfeltt’s), and Obturator) but these are far less common than the types mentioned above.

A hernia is also often described by its clinical status.  A reducible hernia means that the contents protruding through the hernia can be massaged or pushed back into the cavity where it normally resides.  An incarcerated hernia is a hernia that is trapped (just like if you incarcerate a criminal, that criminal is trapped in a jail cell) outside of the body.  A strangulated hernia is a hernia where the protruding contents are lacking blood flow and dying (if the hernia contents contain bowel, then this is a surgical emergency).  Finally, a recurrent hernia is a hernia that has undergone repair before.

So, typically a description/diagnosis will have several of these terms to convey the condition:  A right recurrent incarcerated inguinal hernia is very different from a reducible umbilical hernia.

Are Hernias Common?

Hernias are common.  It is estimated that 1 in 4 men (approximate 25-27% lifetime risk) will develop an inguinal hernia making them the most common type of hernia.  As of 2003, it was estimated that over a million hernia repairs are performed each year in the United States (Approximately 800,000 of them representing inguinal hernias with the rest for the other types)¹.

Hernia Symptoms

Many hernias are asymptomatic (they produce no symptoms).  Most hernias, however, over time, will.  The most common symptom is pain (or discomfort) at the site.  This generally increases during heavy activity (prolonged walking/running, lifting, other physical activities) and decreases after rest (often people wake up in the morning without any discomfort).  In general, a completely asymptomatic hernia does not need repair.  But again, over time, most hernias will become symptomatic and ultimately require some form of treatment that ranges from supportive garments (corset, binder, or truss that support the hernia and helps to slow progression and discomfort) to operative repair.  Most hernia operations are performed when convenient for the patient.  Occasionally, hernia operations may need to be performed emergently.  Signs and symptoms to seek immediate medical condition include:  severe pain at the site of the hernia, the hernia no longer feels soft but hard like a rock, the skin overlying the hernia becomes red or bruised-appearing, or the hernia contents have enlarged and now is associated nausea or vomiting.  It is much better to see a specialist before the hernia becomes an emergency.

Hernia Operations/Repairs

The basic goal of a hernia operation is to essentially patch or close the hole in the wall of the cavity.  Different approaches are utilized from laparoscopic/robotic techniques that involve multiple small incisions and utilizing a camera and other tools to work from the inside of the cavity to patch/close the hole to an open technique.

Recovery

It usually takes 3 to 6 weeks for a full recovery after hernia surgeries. Usually, it will take 1 to 2 weeks before a person can go back to everyday activities and work.

 ¹ Rutkow, IM. (2003).  Demographic and Socieconomic Aspects of Hernia Repair in the United States in 2003.  Surgical Clinics of North America; 83(5):1045-51, v-vi.