Battle of the Bulge
Hernia causes and treatment options.
Did you know that nearly 40 percent of all Americans have experienced a hernia and those over the age of 50 are twice as likely to have one? A hernia occurs when an organ pushes through an opening in the muscle or tissue that holds the organ in place, forming a bulge. Hernias appear in the upper thigh, belly button, groin and in the abdomen. Although most hernias are not fatal, they do not vanish on their own and may require medical intervention, such as surgery, to prevent any complications. Over time, hernias tend to get bigger as the muscle walls become weaker and more tissues push through.
What Causes a Hernia?
Hernias are caused by a combination of muscle weakness and strain. Muscle weakness and strain may be caused by factors such as age, chronic coughing, damage from injury or surgery, fluid in the abdomen, pregnancy, constipation, heavy lifting or sudden weight gain.
Types of Hernias
- Inguinal hernias occur when the intestines push through a weak spot or tear in the lower abdominal canal (often in the inguinal canal, which is found in the groin). This is the most common type of hernia, and most often occurs in men.
- A hiatal hernia occurs when part of your stomach extends up through the diaphragm (a sheet of muscle that helps you breathe) and into your chest. This type of hernia is most common in patients over 50 years old and often causes gastro esophageal reflux (GERD). This is when the contents of the stomach leak backwards into the esophagus and cause a burning sensation. There is no noticeable bulge with this type of hernia.
- Umbilical hernias occur when the intestines bulge through the abdominal wall near the belly button. An umbilical hernia produces an ‘outie’ belly button and typically occurs in children and babies under six months old. An umbilical hernia is the only type of hernia that can go away on its own, however if the hernia has not gone away by the time the child is one year old, surgery may be recommended.
- An incisional hernia occurs after an individual has had abdominal surgery. It is formed when intestines push through the incision scar or the surrounding, weakened tissue.
Do I Need Hernia Surgery?
- Timing of hernia surgery depends on the status of the hernia and its ability to be reduced.
- If a hernia is able to be pushed back into the abdomen and is not causing pain or discomfort, it can often be repaired when it is convenient for you.
- If your hernia is small and you are not experiencing symptoms, surgery may not be necessary.
- Hernia repair surgery may be needed if your hernia increases in size or pain.
- Surgery is often recommended for those with inguinal hernias to avoid complications such as strangulation, which is when a loop of intestine becomes tightly trapped in the hernia and cuts off the blood supply to that part of the intestine. If this happens, emergency surgery is needed.
Types of Hernia Surgery
Hernia repair surgeries are typically done on an outpatient basis, can be performed minimally invasive, are low risk and have short recovery times. If surgery is necessary, your doctor will discuss which option is best for you.
In open hernia repair, an incision is made in the groin and if the hernia is bulging out of the abdominal wall, the bulge is pushed back into place. The surgeon often completes the repair by utilizing mesh, especially for larger or recurring hernias. The mesh is applied over the weakened tissue which helps reduce tension in the area and lowers the rate of recurrence. Open hernia repair may require a larger, single incision and longer recovery time which averages about three to six weeks.
Laparoscopic surgery uses a small camera and surgical equipment to repair the hernia using a few small incisions. The surgeon uses the camera to guide their movements and assist with completing the repair. Laparoscopic surgery also utilizes mesh, but because the surgery is done with several smaller incisions rather than one large incision, the recovery time is usually quicker than with open hernia surgery.
Enhanced 3D imaging and the help of the daVinci ® robotic surgical system, allows your surgeon to have precise control over surgical tools to perform a surgery that is minimally invasive. This state-of-the-art daVinci ® robot features “wristed instruments” which allows for greater movement than the human hand is able to replicate. These instruments enable your surgeon to operate through a few keyhole-sized incisions, rather than a large open incision. Because robot-assisted surgery eliminates large access incisions, patient recovery is generally easier and has fewer complications. The 3D visualization provides your surgeon with a magnified view that is 10 times greater than other tools available allowing your surgeon to have the best view possible during the procedure. There are many patient benefits including smaller, less noticeable scars, quicker recovery, less pain and decreased blood loss.
The type of surgery required depends on a number of factors including size, location and type of hernia. The surgeon will also take into consideration age, overall health and lifestyle of the patient to determine which procedure is most appropriate. If you have a hernia, schedule a consultation with a surgeon to determine when and if hernia repair surgery is the right treatment for you.