Hernia

What is a Hernia?

A hernia, commonly referred to as a "rupture", is a weakness or tear in the wall of your abdomen. A hernia might be recognized as a bulge under your skin, or you may feel pain when you lift heavy objects, cough, or strain when urinating or having a bowel movement. The pain may be sharp and immediate, or it may be a dull ache and get worse towards the end of the day. An old tire can help demonstrate the mechanics of a hernia. The outer wall (rubber tire) is like the layers of tissue surrounding your abdomen and the inner-tube is like the thin inner lining of your abdomen. The outer wall is usually strong enough to hold the contents in place, but if the wall gets weak, a hernia, or bulge, may form.

Congenital hernias result from a weakness in your abdomen, which is present at birth. Children's hernias are almost always congenital. Hernias can also be caused by wear and tear over the years, often called acquired hernias. An acquired hernia develops when the abdominal wall weakens or tears. A loop of intestine or fatty tissue may push against the inner lining, forming a sac. The intestines push into the sac where it may become trapped (incarcerated) or strangulated and lose its blood supply and die. If this occurs, emergency surgery is required to repair the bowel and possibly to remove a portion of the bowel. This is done in addition to the hernia repair.

A hernia can occur in various locations on the abdominal wall. An incisional hernia is found at the site of a previous surgical incision on the abdominal wall. You can also have an umbilical (belly-button or navel) hernia, inguinal (groin), or femoral hernia.

Repair includes reducing the bulge with reinforcement and repair of the weakness. The reinforcement can be done with suturing the tissue together or by using a synthetic mesh graft or plug placed in the area of weakness. Some hernias are repaired using a laparoscope, while many are repaired in an open fashion.

Risks and complications of hernia repair can include, but are not limited to, infections, bleeding, bruising, swelling, chronic pain, loss of sensation in the region, nerve or muscle damage, urinary retention, reaction to medications, loss or injury to the testicle (inguinal hernias only), injury to internal organs, reactions to mesh graft (if used), fluid in the wound requiring drainage, and altered contour of the region.

The surgery is usually done on an outpatient procedure. You normally will go home after surgery that day. Recovery involves no strenuous activity until your surgeon releases you, which is generally 4-6 weeks, but can vary with each individual case.