What is a Hernia?
A hernia is a defect or weakness in the abdominal wall. This weakness can be caused by everyday wear and tear, or it could be present from birth. The contents of the abdomen can push outward through the weakness or break in the abdominal wall and cause a bulge. Hernias are most common in men, but they can occur in women and children too. Hernias are very common and usually not life threatening. An individual of any age can get a hernia. Surgery to repair a hernia can relieve any pain and discomfort. Some common symptoms of a hernia include:
- A bulge in the abdomen, groin, or thigh area that may get larger when you stand and go away when you lie down
- A feeling of pressure or weakness in the groin
- Pain or discomfort during bowel movements or urination
- Pain during lifting, coughing, sneezing, or other physical activities
How Hernias Develop
The abdominal wall is made up of several layers of tissues like muscle, connective tissue, and fat. These layers serve as protection and help keep the abdominal organs in their proper positions. There are small openings in the layers of connective and muscle tissue called canals. Canals allow structures such as nerves, blood vessels, and ligaments to pass through them. Should these canals or other areas in the abdominal wall become weakened, the intestines and other abdominal organs can press against it, resulting in a hernia. Some common areas for hernia include:
- Umbilical – where the umbilical cord once passed through the abdominal wall
- Inguinal area – around the inguinal canal where ligaments and other structures pass between the abdomen and the groin
- Femoral area – at the femoral canal
- Incisional – at the site of a previous surgical incision
When the abdominal wall is first weakened or damaged, a hernia sac can form when the abdominal lining bulges out through the weakened area. A hernia sac may or may not cause a visible bulge and contains intestines, fat, or other tissues. With time, continued exertion and gravity allow more of the intestine to push into the hernia sac. The intestine may be reducible or able to be pushed back into the abdomen. However, the hernia sac containing intestine can become trapped by muscle. This leads to an incarcerated hernia that cannot be flattened or pushed back into the abdomen. If the intestine is trapped tightly, the tissue becomes strangulated and can lose blood supply and even die. With both incarcerated and strangulated hernias, prompt treatment is needed to prevent further complications.
Why Surgery Works
Hernia surgery treats the problem by repairing the weakness in the abdominal wall. Dr. Robbins will make an incision so he has a clear view of the hernia. He then puts any displaced tissue back where it normally goes. Dr. Robbins then repairs the abdominal wall by either stitching together the muscle tissue surrounding the defect or by sewing a piece of special mesh like a patch over the defect. Stitching the surrounding muscle tissue back together is known as a traditional repair and can be used to repair any type of hernia. Hernia repair using mesh is tension free and can be less painful than a traditional repair. There are several different types of mesh repair, and the kind used depends on your type of hernia. The mesh reinforces the abdominal wall, and tissue eventually grown into the mesh preventing the hernia from reoccurring. The types of mesh repair include:
- Front repair – the mesh is placed in front of the weak area and sutured to nearby tissues to hold it in place.
- Back repair – the mesh is placed behind the weak area, allowing pressure inside the abdomen to help hold it in place. The mesh is sutured to nearby tissues to hold it in place.
- Combination repair – mesh is placed both in front of and behind the defect, and sometimes a special kind of mesh connects the front and back pieces.
- Plug repair – a mesh plug fills a hole in the abdominal wall and is secured with a mesh patch and stitches.
Hernia surgery is low risk and complications are rare, but as with any surgery there are possible complications that can occur.
Risks and Complications
Some risks and complications of hernia repair include:
· Pain or numbness in groin or leg
· Mesh complications
· Re-occurrence of hernia
· Anesthesia risk
· Bowel or bladder injury
Preparing for Your Procedure
You will be told by our office how to prepare for your procedure. This includes special instructions about medications. Be sure to follow the instructions we give you, or your surgery may have to be canceled.
A Week Before
- Tell us about any allergies you have.
- Tell us about any medications you take, including prescriptions, over-the-counter medications, supplements, and herbs.
- Make medication changes as we direct you. This can involve stopping certain medications you normally take or starting certain medications before surgery.
The Day Before
- Don’t drink or eat after midnight the night before you surgery. Do not smoke, chew tobacco, or chew gum after midnight. If you were instructed to continue any medications, take them with a sip of water only.
- Arrange a ride home for when your recovery is finished.
- Follow any special instructions we give you.
The Day of the Procedure
- Arrive on time to the hospital.
- Bring all medications you take with you to the hospital.
- Hospital staff will prepare you for the procedure.
Usually you will be discharged from the hospital the same day as your hernia surgery. You will receive specific instructions about your home recovery when you are discharged from the hospital. Soreness, some swelling, and discoloration or bruising are common after hernia repairs, especially if the repair was in the groin area. A bag of frozen vegetables or an ice pack can be wrapped in a thin towel and applied to the area to reduce swelling for 15 to 20 minutes 3 to 5 times a day. You should be able to return to normal activity as soon as you feel ready, but some basic guidelines for home recovery are:
- Avoid heavy lifting from 2 – 6 weeks depending on the type of hernia
- Eat healthy, high-fiber foods and drink plenty of water
- Keep the incision site clean and dry
- Take short walks to aid with circulation
- Take all medications as directed
When to Call VascularTyler
Call our office if you experience any of the following:
- A large amount of bruising or swelling
- Increasing pain
- Nausea or vomiting
- Increasing redness or pain of the incision
- Trouble urinating