A hernia occurs when the inner layers of abdominal muscle become weakened. The lining of the abdomen then bulges out into a small sac, and part of the intestine or abdominal tissue may enter the sac. Hernias are most common in the groin (inguinal hernia), the navel (umbilical hernia), and at the incision site of a previous surgery (incisional hernia). A hiatal hernia occurs when the lower part of the esophagus and a portion of the stomach are pushed above the esophagus.
Some people with hernias remain relatively free from symptoms. But a hernia can cause severe pain and other potentially serious problems, such as infection and bowel obstruction. A hernia will not repair itself, so surgery is necessary to correct them. At Alabama Surgical Associates, our team will use either open surgery or laparoscopic surgery to repair your hernia.
What are the types of hernias?
There are four main types of hernias, with inguinal hernias being the most common.
Inguinal hernia — In this type of hernia, the intestine or the bladder protrudes through the abdominal wall. Most inguinal hernias occur in men because there is a natural weakness in the abdominal wall in this area.
Umbilical hernia — In an umbilical hernia, part of the small intestine passes through the abdominal wall near the navel. It is common in newborns and obese women or women who have had multiple children.
Incisional hernia — Here the intestine pushes through the abdominal wall at the site of a previous abdominal surgery. This type of hernia is most common in the elderly or those who are overweight and sedentary.
Hiatal hernia — Totally removed from the lower abdomen hernias, hiatal hernias occur when the upper stomach squeezes through the hiatus, an opening in the diaphragm through which the esophagus passes.
What causes a hernia?
To get a hernia, a person needs to have a combination of pressure and weakness. There needs to be weakness or even an opening in the muscle wall or its lining (fascia). Then when pressure occurs in the area an organ or tissue pushes through the weak spot. Some people have the weakness at birth, but it more typically develops later in life. Obesity and poor nutrition can play a role in this development.
Here are some causes of pressure in the abdomen:
- Lifting heavy objects without stabilizing the abdominal muscles
- Persistent coughing
- Intense sneezing
What are the symptoms of a hernia?
For the abdominal hernias, these are the symptoms:
- Discomfort in the abdomen or groin when bending over or lifting something
- A point of obvious swelling beneath the skin of the groin or abdomen
- A heavy feeling in the abdomen that may be accompanied by constipation or blood in the stool
- Hiatal hernias can show themselves through heartburn and upper abdominal pain.
People often simply live with hernias, as they don’t know they have one. But if you are nauseated and vomiting, aren’t having bowel movements or passing gas, you may have an obstruction or a hernia causing strangulation of your intestine. This needs immediate medical attention.
How are hernias repaired?
At Alabama Surgical Associates, we repair lower abdomen hernias with either open or laparoscopic surgery. For hiatal hernias, we use a different procedure called Nissen fundoplication.
In open hernia surgery, we make an incision near the location of the hernia and carefully open the hernia sac. We then push the intestine or other tissue back inside the abdomen. To strengthen the weakened area we usually reinforce it with synthetic mesh or sutures that pull the abdominal muscle tissue back together. This type of hernia repair takes about an hour to complete the entire procedure.
When doing hernia repair surgery laparoscopically, instead of a single longer incision we make four of five tiny incisions. Through one of the incisions we insert a laparoscope, a miniature scope attached to a video camera. Through the laparoscope, the surgeon can then see the hernia and the surrounding tissue and organs. Instruments used to repair the hernia are then inserted through the other incisions and the procedure proceeds the same way as open surgery. While laparoscopic hernia surgery makes for a somewhat easier recovery, the patient needs to be under general anesthesia, compared with local anesthesia for open surgery. If a person is obese, has health problems that preclude using general anesthesia, or has large amounts of scar tissue on his or her abdomen, they may not be eligible for laparoscopic hernia surgery.
Laparoscopic hernia repair has only been used for a few years, and while research shows it to be safe and effective, long-term results are unavailable.
What is recovery like?
Most people who have hernia surgery can return home the same day, with from one to two weeks for basic recovery from laparoscopic surgery, three weeks for open surgery. Any strenuous activity or lifting needs to wait for four to six weeks after surgery to not create any stress on the lower abdomen.
You can trust your hernia repair to the skilled, board-certified surgeon at Alabama Surgical Associates (ASA) in Huntsville, AL. Contact Alabama Surgical Associates today to schedule your repair or with any further questions.
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You can trust your hernia surgery to the skilled, board-certified surgeon at Alabama Surgical Associates (ASA) in Huntsville, AL. For more information about your hernia surgery, please click here to contact our office or call us at (256)-880-1977.