Hernia Surgery

Hernia Information

A hernia is protrusion of the contents of one compartment outside its boundaries into another compartment.  An exception is internal hernia which occurs  inside the abdominal cavity.

Umbilical hernia

This type of hernia appears as a bulge in the umbilicus (belly Button).  The size and shape vary depending on the duration and the contents.   The majority of umbilical hernias contain fat, with which the body is trying to plug up the defect, as the defect (the opening ) in the abdominal wall gets bigger, the intestines may go through the defect and eventually become incarcerated (unable to go back) or strangulated (when unable to go back the blood supply may get cut off killing the incarcerated loop of intestine) .   The presentation of the latter is usually more dramatic with pain, abdominal distention (bloating), constipation and vomiting.

On a healthy person, the hernia repair surgery is usually performed on outpatient basis, through a small incision in the crease around the umbilicus.    In most cases a mesh is not needed because the defect is small (one to two cm), and he repair is done with simple closure with none dissolving sutures.

Inguinal hernia

This type of hernia appears as a bulge the inguinal (groin) region.   The hernia may be apparent or appears only on  coughing or straining.   Initially the hernia can be reduced by relaxing and gently massaging pressure over the swelling.    The hernia may contain fat or part of the intestine, small intestine on the right and usually large intestine on the left.   The presentation of the latter is usually more dramatic with pain, abdominal distention (bloating), constipation and vomiting

On a healthy person, the hernia repair surgery is usually performed on outpatient basis, through a small incision in the affected groin.   The hernia is reduced (pushed back)  into the abdominal cavity and a mesh (screen) is used to enforce the weakened abdominal wall (inguinal floor).   There are two very small nerves that supply the inguinal area and the inner upper thigh and scrotum or labia majora, injury to the nerves is frequent and causes numbness and/or pain  in these areas that take 3 to 6 months to recover.   There is also the risk of scrotal swelling from bleeding or serous fluidnia, as the body fills up the space that used to be occupied by the hernia.

Femoral hernia

This develops on the inner aspect of the groin, just below the inguinal hernia, along the exit of the Femoral artery, vein and nerve onto the thigh.  There is a high chance of incarceration and strangulation of the herniated structures whether fat or intestines

Incisional hernia

This develops in old abdominal incisions, where the wall is weakened.     The repair is more detailed and in most cases a mesh is required and it may have to be done in a hospital on inpatient basis.

Once a hernia is performed, care should be taken to avoid strenuous activities to avoid recurrence.  My incisions are usually covered with plastic or Dermabond which keep the wound sealed for one week.  The patient is able to take showers