Hernias occur when a part of the abdominal wall with a weakness or tear allows part of a nearby organ to slip through creating potential medical situation. There is no cure for hernias and they do not go away. Treatment for a hernia is usually surgical, often laparoscopic surgery.

The cause of a hernia is very often due to heavy straining of the abdomen muscles making the area of weakness susceptible to protrusion. Aging, injury, a previous incision, or congenital abdominal wall weakness are also causes of hernias.

The symptom of a hernia is almost always pain or feeling a bulge in the abdomen or groin. Straining to lift heavy items, coughing, or defecating may cause pain which recedes when the activity is discontinued. Often people are unaware of the hernia until they do something which puts pressure on it or when a physician notices it during an examination. Since pain is not always a hernia symptom, when severe, on-going pain, redness and tenderness suddenly occur, it may indicate a strangulated (or entrapped) hernia which can lead to necrosis of the entrapped tissue.

While hernias can occur anywhere there is a weakness in the abdominal wall, several types of abdominal hernias occur more frequently.

1. An inguinal hernia is located in the lower abdomen just above the groin and are seen more often in men. They may be caused by an activity or may be congenital.
2. An umbilical hernia is most common in infants when a part of the intestines slips up through the muscles under the umbilicus. When the baby cries, one can see a bulge in the belly button. This type of hernia often recedes on it's own.
3. A ventral hernia is synonymous with an incisional hernia meaning it occurs at the site of a previous surgical incision anywhere in the abdomen, commonly along the center line. Such hernias result from increased pressure on the incision during the initial three to six months following surgery, although it's possible for them to become problematic years late.

The diagnosis of a hernia usually happens when the patient or parent notices a worrisome bulge, or when the patient feels a stabbing pain or ache upon straining. The physician asks the patient to lay down and he will feel the abdomen, putting pressure in one area to encourage the bulge to pop up in another. A diagnosis of a bowel obstruction may cause the doctor to search for a hernia since they can cause an obstruction.

Occasionally, a hernia presents no discomfort or interference with a patient's life. The doctor may suggest watching it without rushing to surgery. However, a majority of them will eventually require hernia surgery. In the long-established, open repair procedure, the surgeon makes an incision in the abdomen, locates the hernia, pushes it back to its proper position, and secures the weakened area of the abdomen. This procedure, while successful, requires a long and usually painful recovery. It's complications include bleeding, incisional infection, reaction to the anesthesia, and injury to neighboring organs.

Laparoscopic hernia surgery, referred to as minimally invasive hernia repair, can be performed under general or spinal anesthesia and takes place in an outpatient facility. After making several very small abdominal incisions the surgeon inserts a laparoscope and several other tubular instruments. The same process is performed as in the traditional surgery but with the surgeon viewing a video monitor transmitted by a tiny camera in the laparoscope. To secure the weakness of the abdominal wall, a synthetic mesh material is used, holding the area together without sutures. The recovery time and patient's comfort level are improved by using laparoscopic surgery.

The risks of any surgery, such as bleeding, infection, and anesthesia complications, are less likely to occur in laparoscopic hernia surgery, however, depending on the location of the hernia, there is always a risk of damaging nearby organs, tissues, or vessels. The mesh material may cause an allergic reaction and may also contribute to adhesions with nearby structures. Additional risks are: fistulas, intestinal obstruction, the development of an incisional hernia. The benefits of laparoscopic surgery do not affect the likelihood of a hernia returning.

Our surgeons are certified in Laparoscopic minimal invasive hernia repair.

Lear more about postoperative care for ventral hernia repair.

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Dr. Alshkaki Lap Ing



Dr. Alshkaki Lap Umb