What is a hernia?
A hernia is a bulge or protrusion of an organ or fatty tissue through a weakened area in the muscle or connective tissue in which the organ is enclosed. A hernia can develop in any part of the body. However, the muscles of the abdominal wall are most commonly affected. Hernia can occur in babies and in adults. Hernia in babies usually heals by itself within four years, but for others, hernia repair surgery or herniorrhaphy is the standard treatment.
There are many types of hernia that are classified based on their anatomical location and these types include:
- Inguinal: part of the intestine protrudes through the lower abdominal muscle into the groin
- Femoral: fat tissue or part of the intestine protrudes through the abdominal muscle into the femoral artery present in the upper part of the thigh
- Incisional: tissue protrudes through a previous surgical wound, which becomes structurally weak
- Umbilical: fat tissue or part of the intestine protrudes through the abdominal muscle near the belly button
- Hiatal: part of the upper stomach protrudes through an opening in the diaphragm into the chest region
If you have been diagnosed with a hernia then there is expert help available through GI Alliance. Contact GI Alliance to learn more about your options for hernia surgery.
What are the symptoms of a hernia?
The symptoms depend on the type of hernia, its causes, and its severity. The main symptom is the appearance of a lump (a swollen area) in the region involved. The lump may be painless and only be felt on exertion such as lifting heavy objects, coughing, etc. Some hernias can cause pain during exertion. The lump is not felt when the person is lying down; it becomes prominent on standing and particularly on straining. Some hernias can get strangulated, interrupting blood supply to the herniated tissue. A GI Alliance physician can usually diagnose a hernia by physical examination (for example: for an inguinal hernia, a lump can be seen or felt in the groin). Ultrasound and X-rays are other tests that your doctor can order to diagnose a hernia.
What are the treatments for a hernia?
To treat a hernia, your doctor may push the hernia back into its normal location and have you wear a belt to hold the hernia in place. However, surgical repair is recommended for hernias that cause pain and other symptoms, and for irreducible hernias (structures that cannot be returned to their normal locations) that are incarcerated or strangulated. Surgery aims at closure and repair of the muscle wall through which the hernia protrudes. Surgery at GI Alliance can be performed in a traditional, open fashion or with a laparoscope.
What is open hernia surgery?
Open surgery, also called herniorrhaphy, can be done under general or local anesthesia. Your surgeon makes an incision about 5-10cm long (depending on the size of the hernia) to view and access the surgical site. Your surgeon pushes the part of the intestine that protrudes back into its normal position and repairs the weakened muscle layer by sewing the edges of the healthy muscle wall together. A synthetic mesh is often placed and sewn over the weakened area to provide additional support and strength, by a procedure called hernioplasty. The incision is closed after the procedure using dissolvable stitches.
What is hernia surgery with a laparoscope?
Laparoscopy, also called keyhole surgery, is a less invasive surgical method that uses a device called a laparoscope (a small thin tube with light and a tiny video camera connected to a television monitor), which helps visualize the internal organs during the operation.
The surgery is performed under general anesthesia. The surgeon makes small incisions through which the laparoscope and other surgical instruments are inserted. Air or carbon dioxide is injected into the abdomen to inflate the abdominal cavity, enabling your surgeon to better visualize the internal organs. The inner lining of the abdomen known as the peritoneum is then incised so that the weakened muscle wall is exposed. Your surgeon repairs the hernia using a synthetic mesh by placing it over the weakened area. The incision in the peritoneum is then closed using staples or sutures. Once the procedure is completed, the small abdominal incisions are closed with stitches or surgical tape.
Advantages of a laparoscopic procedure over the open surgical method include a shorter hospital stay, smaller incisions, less post-operative pain, and faster recovery. You can resume normal activities in a few days.
Post-operative care and possible risks
Your GI Alliance physician will give you detailed post-operative instructions. Following surgery, you:
- Can take a shower only after 48 hours post-surgery
- Can go home the day of the procedure
- Should avoid driving while taking pain killers as they induce drowsiness
- Can resume daily activities slowly while strenuous activities should be resumed only after consultation with your surgeon
- Use an ice pack on the wound to reduce pain, prevent swelling and lessen bloody discharge from the incision if present
- Recover in about 3 weeks
Like most surgical procedures, hernia repair is associated with some risks and complications which include:
- Reaction to anesthesia
- Infection
- Bleeding at the operation site
- Nerve damage and numbness of the skin
- Damage to surrounding tissue
Although the recurrence of hernias is seen in less than 5% of patients after surgery, you would need to follow preventive measures. Be sure to discuss all the risks and benefits of surgery with your GI Alliance physician.
Surgical care for a hernia
Hernia Repair FAQs
Are there risks to hernia repair surgery?
Like any surgical procedure, hernia repair surgery comes with certain risks, although it is generally considered safe. Possible complications include infection, post-operative pain, hernia recurrence, scar tissue adhesion, damage to adjacent tissues, and, in mesh repairs, complications like mesh migration. It’s essential to weigh these risks against the benefits of the surgery with a healthcare provider.
How do I prepare for hernia repair surgery?
To prepare for hernia repair surgery, it’s important to follow a few key steps to ensure safety and the best possible outcome. Firstly, discuss any medications you’re taking with your doctor, as some may need to be stopped before surgery. Fasting is usually required, often starting at midnight before the day of the operation to prevent complications during anesthesia. Arrange for someone to drive you home after the surgery, as you won’t be able to drive yourself.
What should I avoid after hernia repair surgery?
After hernia repair surgery, it’s important to avoid activities that can strain the surgical site and impede healing. This includes lifting heavy objects, vigorous exercise, or any strenuous activity that increases abdominal pressure for at least four to six weeks post-surgery. Patients should also avoid driving until they are free from the sedative effects of any pain medication and can perform emergency stops without discomfort. Dietary restrictions might include avoiding foods that can cause constipation or gas, as these may lead to discomfort or strain. It’s also advisable to avoid smoking, as it can slow the healing process and increase the risk of complications. Always follow the specific guidance of your surgeon, as recommendations can vary based on individual circumstances and the specifics of the surgical procedure performed.