Hernia

The term “hernia” is used to describe an abnormal opening in a patient’s muscle that will allow tissue or organs to pass through the opening in the muscle. If this tissue, as it passes through the hernia opening becomes “trapped or incarcerated”, the blood supply to the affected tissue or organ may be compromised resulting in “strangulation”. Strangulation can result in death or necrosis of the affected tissue or organ. In most patients, repair of the hernia defect is recommended, however, in some patients with small asymptomatic hernias and other severe compromising medical illnesses, the hernia will be followed on a regular basis.

There are multiple types of hernia defects that can and should be surgically repaired;

Inguinal hernia

Once a hernia has developed, there are no exercises of the muscles that can strengthen or close the hernia defect. There are no medications that will cause the muscular defect to close either. Most hernias will require surgical repair and intervention. Fortunately, Dr. Smith is well trained and has performed many hundreds of surgical hernia repairs through the laparoscope. The laparoscopic technique, in most cases, can be performed on an outpatient basis. The hernia is repaired through small holes rather than large incisions and thereby allows the patient to recuperate much more quickly and with less pain. During the laparoscopic repair of hernias a piece of artificial material called “mesh” is used to cover the hole and prevent incarceration or strangulation. As mentioned above Dr. Smith has extensive experience with the laparoscopic repair of multiple types of hernias.

Dr. Smith performing Laparoscopic Surgery

The laparoscopic technique of hernia repair will allow the patient to resume his normal activities much quicker and with much less pain and discomfort than open surgical procedures. Of course, the grandfather of General Laparoscopic Surgery was the development of laparoscopic cholecystectomy. This is probably one of the greatest advances that have occurred in General Surgery over the past two decades. Dr. Smith has extensive experience in laparoscopic cholecystectomy. The vast majority of laparoscopic hernia repairs and laparoscopic cholecystectomies are done on an outpatient basis and allow the patient to recover in the comfort of his/her own home.

Inguinal hernia

This type of hernia accounts for the vast majority of hernia surgical repairs. An inguinal hernia is located in the inguinal region of the body where the thigh meets our pelvis. A specific type of hernia called a femoral hernia is most often associated with female patients and can more easily become incarcerated than other inguinal hernias. The most common types of inguinal hernias are either direct or indirect hernias and these are found more often by far in men rather than women. Some hernias are result of a defect that occurs at birth, and some develop throughout a patient’s life secondary to straining and heavy lifting. [back]

Umbilical hernia

This type of hernia occurs at the level of the naval and are usually the result of the failure of the abdominal wall defect to close after the patients umbilical cord falls off as an infant. Most of these hernias defects will close in childhood by the age of five. Remaining umbilical hernias however can enlarge over time and require repair in the adult patient. [back]

Epigastric hernia

This type of hernia occurs in the area between the breast bone and the umbilicus and often times do not have to be repaired if they are not causing symptoms. [back]

Spigelian hernia

This type of hernia is a rare form of hernia defect that can occur at the level of the umbilicus but actually lateral to it. These hernias are often difficult to diagnose. [back]

Incisional hernia

This hernia is the result of a separation of the muscle layers at the site of a previous surgical incision. The hernia defect may appear shortly after a surgical procedure or many years after a surgical procedure has been performed. Several risk factors that are associated with the development of an incisional hernia include a wound infection at the time of the original surgery, an obese patient, diabetes, chronic steroid use, chronic lung disease, or resumption of strenuous activity following the initial surgical procedure before the muscular closure has had time to heal properly. [back]