Each year, while an estimated 5 million Americans develop hernias, only 700,000 have them surgically repaired. Most physicians believe people avoid treating their hernias because they fear painful surgery. Today, there is little reason to fear. Hernia surgery is usually performed on an outpatient basis and patients are able to return to most normal activities in a matter of a few days.
What is a hernia?
A hernia occurs when the inside layers of the abdominal wall weaken then bulge or tear. The inner lining of the abdomen pushes through the weakened area to form a balloon-like sac. This, in turn, can cause a loop of intestine or abdominal tissue to slip into the sac, causing pain and other potentially serious health problems.
Men and women of all ages can have hernias. Hernias usually occur either because of a natural weakness in the abdominal wall or from excessive strain on the abdominal wall, such as the strain from heavy lifting, substantial weight gain, persistent coughing, or difficulty with bowel movements or urination. Eighty percent of all hernias are located near the groin. Hernias may also occur below the groin (femoral), through the navel (umbilical), and along a previous incision (incisional or ventral).
What are the symptoms of hernias?
A noticeable protrusion in the groin area or in the abdomen
Feeling pain while lifting
A dull aching sensation
A vague feeling of fullness
How can a hernia be repaired?
Hernias usually need to be surgically repaired to prevent intestinal damage and further complications. The surgery takes about an hour and is usually performed on an outpatient basis (which means the patient can go home the same day of the procedure). This surgery may be performed by an open repair (small incision over the herniated area) or by laparoscopic surgery (minimally invasive). Your surgeon will determine the best method of repair for your individual situation.
Open Repair Surgery
During the surgery
An anesthesiologist (a physician who specializes in pain relief) will recommend a type of anesthesia according to your condition and health status. You will not feel pain during the surgery.
A small incision or cut is made in the skin.
The hernia “sac” containing the bulging intestine is identified.
The surgeon pushes the intestine inside the hernia sac back into its proper position behind the muscle wall.
The muscle wall is reinforced with stitches or synthetic mesh to complete the repair.
After the surgery
Most patients will be able to go home a few hours after surgery. If needed, a 23-hour extended recovery area is available. Typically, most patients feel fine within a few days after the surgery and resume normal eating habits and activities. Strenuous activity and exercise are restricted for 4 to 6 weeks after surgery.
How is laparoscopic hernia repair performed?
Laparoscopic surgery uses a thin, telescope-like instrument (known as an endoscope) that is inserted through a small incision at the umbilicus (belly button). Usually, this procedure is performed under general anesthesia. This requires an evaluation of your general state of health, including a history and physical exam, possibly including lab work and EKG. The endoscope is connected to a tiny video camera – smaller than a dime – that projects an “inside view” of the patient’s body onto television screens in the operating room. The abdomen is inflated with a harmless gas (carbon dioxide) to allow your doctor to view your internal structures.
The peritoneum (the inner lining of your abdomen) is cut to expose the weakness in the abdominal wall. A mesh patch is attached to secure the weak area under the peritoneum.
The peritoneum is then closed with staples or sutures. Following the procedure, the small abdominal incisions are closed with a stitch or two or with surgical tape. Within a few months, the incision is barely visible.
Benefits of laparoscopic hernia surgery:
Three tiny scars rather than one larger incision
Reduced postoperative pain
Faster return to work
Shorter recovery time and earlier resumption of daily activities (a recovery time of days instead of weeks)
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