A hernia is a weakness that generally occurs in the wall of the abdomen, permitting an organ, a part of an organ, or fat to protrude. Hernia is among the most common medical disorders. Hernias may occur at any age, and they can be congenital (present at birth) or acquired (see Hernia Risk Factors). A common location for hernia is in the groin, and men tend to develop groin (or inguinal) hernias more often than women. The primary symptom is pain, which may get worse with long periods of standing or lifting heavy objects, and is often accompanied by a bulge in the abdomen or groin. Although inguinal hernias are the most common, hernias may also occur in the navel (umbilical), above the navel (epigastric), and at the site of previous surgery (incisional).
|A hernia with intestine bulging through a hole in the abdominal muscles.|
|Mesh is used to repair the defect in the abdominal muscles and prevent intestine from bulging out.|
Hernias do not get better without treatment, although some people find relief from over-the-counter pain remedies. A supportive garment called a 'truss' may provide some relief for inguinal hernias. If left untreated, some hernias may become "incarcerated," meaning that the protruding structure (particularly intestine) gets trapped in the hole that makes up the hernia. This can lead to two dangerous conditions: obstruction or strangulation. When intestine becomes obstructed, digested food cannot pass, leading to vomiting, an inability 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.
Hernias may be repaired using conventional open techniques or via a laparoscopic approach, in which a long, thin camera and instruments are introduced via small incisions. Most hernia repairs require the use of surgical mesh used to cover the weakened area. Although laparoscopic surgery usually requires general anesthesia, open hernia repairs can frequently be performed with local or regional anesthesia. In some settings, patients experience a shorter recovery time and less post-operative discomfort with laparoscopic than with open surgery. However, the decision about the optimal approach for repair of a particular hernia is an individual one.
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
- Chronic straining during bowel
- Movements or while urinating
- Straining to lift heavy objects
- Persistent sneezing, such as might be caused by allergies
- Previous wound/surgery in the area
These factors can either cause or exacerbate a weakness of the abdominal wall, allowing an organ or fatty tissue to push through. See your primary care physician to confirm a diagnosis of hernia. Discuss whether you are a candidate for laparoscopic hernia repair with a surgeon who specializes in this minimally invasive technique.
Hernia repair is performed at the Columbia Hernia Center.