Over half a million hernia surgeries are performed annually in the United States. A hernia is an opening or weakness in the wall of a muscle, tissue, or membrane that normally holds an organ in place. If the opening or weakness is large enough, a portion of the organ may be able to push through that area. If you can imagine an inner tube poking through a hole in an old tire - that is what a hernia is like.
Inguinal (groin) hernia: Making up 75% of all abdominal wall hernias and occurring up to 25 times more often in men than women. These hernias occur in the groin area. These hernias get their name from the inguinal crease which is where the top of the thigh joins the torso.
Femoral hernia: The femoral canal is the path through which the femoral artery, vein, and nerve leave the abdominal cavity to enter the thigh. A femoral hernia causes a bulge just below the inguinal crease in roughly the mid-thigh area.
Umbilical hernia: These common hernias (10% - 30%) are often noted at birth as a protrusion at the belly button (the umbilicus). This type of hernia is more common in women. Umbilical hernias can appear later in life or in women who are having or have had children.
Incisional hernia: Abdominal surgery causes a flaw in the abdominal wall. This flaw can create an area of weakness where a hernia may develop. Even after surgical repair, incisional hernias may return.
Hernias by themselves are not usually life-threatening, but nearly all have a potential risk of having their blood supply cut off, therefore, becoming strangulated. If this happens, it becomes a medical and surgical emergency.
For inguinal, femoral, umbilical, and incisional hernias, symptoms may include:
- An obvious swelling beneath the skin of the abdomen or the groin; it may disappear when you lie down and may be tender.
- A heavy feeling in the abdomen that is sometimes accompanied by constipation or blood in the stool.
- Discomfort in the abdomen or groin when lifting or bending over.
What to Expect if Surgery is Required
Surgeries to address most types of hernias are similar to other laparoscopic procedures. General anesthesia is given, and a small minimally-invasive incision is made in or just below the navel. A thin, lighted scope called a laparoscope is inserted through the incision. Other instruments to repair the hernia are inserted through additional small incisions in the lower abdomen. Mesh is then placed over the defect to reinforce the abdominal wall.
Most people who have laparoscopic hernia repair surgery are able to go home the same day. Post-operative discomfort is usually mild to moderate. Frequently, patients will require pain medication and/or a device called "On Q" catheter. The "On Q" pump is filled with a local anesthetic toward the end of the surgical procedure. It is connected to one or two small gauge catheters, which are placed into the intra-operative site. The “On-Q” is a pain management system designed to provide patients with post-operative pain relief for up to three days and is separate from the administration of anesthesia for the surgery. The "On Q" is very effective in lessening post operative discomfort and promoting a quick recovery.
Recovery time is about 1 to 2 weeks. Patients are encouraged to engage in light activity while at home after surgery. Dr. Cole will determine the extent of activity, including lifting and other forms of physical exertion.
Aftercare should include constant icing of the incision site. This is very therapeutic and hastens recovery. Most patients are able to get back to their normal activities within seven days after surgery.