Hernia Surgery
Our team is skilled at repairing complex inguinal, umbilical, and also ventral hernias, consisting of primary and recurrent hernias as well as hernias previously considered irreparable. We use the most recent bioprosthetic materials as well as robotic, laparoscopic techniques to prevent recurrence, decrease pain and assist in a more rapid return to normal daily activity.
What is a Hernia?
A hernia is a weakness that usually happens in the wall of the abdomen, allowing an organ, a part of a body organ, or fat to protrude. A hernia is among the most common medical disorders. Hernias may happen at any age, and they can be congenital (existing at birth) or obtained during stressful activities. A common location for hernia is in the groin, and males often tend to develop groin (or inguinal) hernias more often than females. The primary symptom is discomfort, which may become worse with long periods of standing or lifting heavy items, and also is usually accompanied by a lump in the abdomen or groin. Although inguinal hernias are one of the most common, hernias may also occur in the navel (umbilical), above the navel (epigastric), and at the site of previous surgery (incisional).
Complications of Hernias
Hernias do not improve without treatment, although some people find relief from non-prescription pain remedies. A supportive garment called a ‘truss’ may supply some relief for inguinal hernias. If left untreated, some hernias may become “incarcerated,” meaning that the protruding structure (particularly the intestine) gets trapped in the hole that makes up the hernia. This can lead to two harmful conditions: obstruction or strangulation. When the intestinal tract comes to be blocked, absorbed food can not pass, leading to vomiting, a lack of ability to pass feces or gas, and ultimately severe dehydration and potential damage to the intestine if not treated within hours. Strangulation occurs when a section of the intestine cannot obtain adequate blood flow. This potentially life-threatening condition causes symptoms such as blood in the stool, severe abdominal pain, vomiting, fever, and even shock. It also requires emergency treatment.
Inguinal and Ventral Hernias
Inguinal hernias are one of the most common of all hernias and are in some cases described as groin hernias. They take place near the fold in between the lower abdomen and the upper thigh. When an inguinal hernia develops, the intestine may protrude through the defect in the abdominal wall, creating a bulge on the right or left side. Inguinal hernia bulges are frequently, though not always, painful. Between 10 and 15 percent of males and two percent of females will develop inguinal hernias in their lifetime.
Ventral hernias are less common than inguinal hernias, with some 10 percent of both males and females expected to develop one during their lifetime. These hernias occur outside the inguinal area of the abdomen, in the epigastrium, the part of the abdominal wall above the umbilicus (belly button), and/or within the umbilicus itself. The Spigelian hernia, another more rare type of ventral hernia, occurs in the mid-abdomen.
Inguinal and ventral hernias may develop as a result of a number of factors. These factors may include obesity, aging, as well as strenuous physical activity requiring heavy lifting, such as construction work. Certain rare conditions such as collagen vascular disease or genetic defects involving connective tissue may also cause abdominal hernias.
Incisional hernias occur where prior abdominal surgery has weakened the abdominal wall, or where infection in a healing surgical incision causes the breakdown of the wound closure. Incisional hernias are common in patients who have had intestinal surgery complicated by wound infections. About 25 to 30 percent of both males and females will develop an incisional hernia when a wound infection occurs after abdominal surgery.
Hiatial hernias take place in the diaphragm, the large muscle separating the chest cavity and the abdomen. The diaphragm is responsible for much of our breathing. Surgeons in Columbia’s Division of General Surgery repair hiatial hernias.
Hernia Risk Factors
You may be at risk for developing a hernia if you experience one or more of the following:
- A chronic cough, such as a smoker's cough
- Obesity
- Chronic straining during bowel movements or while urinating
- Pregnancy
- Straining to lift heavy objects
- Persistent sneezing, such as might be caused by allergies
- Aging
- Previous wound/surgery in the area
These factors can either cause or worsen a weakness of the abdominal wall, allowing an organ or fatty tissue to protrude.
Types of Hernia Surgeries
Precise robotic technology enables us to visualize and repair the hernia. Using robotic instruments, we make small incisions near the hernia and insert thin, flexible tools. We reinforce the abdominal walls and may use surgical mesh to give additional support to the muscle or membrane.
-Laparoscopic Reconstruction
-Open Surgery
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