Hernias are a common and treatable condition. There are several different types of hernias, which most often occur between the chest and hips. A hernia occurs when an internal organ protrudes through the abdominal wall, often creating a noticeable bulge. Privia Medical Group North Texas general surgeons provide hernia repair treatment throughout the Dallas/Fort Worth area.
Inguinal Hernias
The most common type of hernia is the inguinal hernia, accounting for 75% of all hernias. An inguinal hernia occurs when part of the intestine or fatty tissue pokes through the abdominal wall near the top of the thigh. Inguinal hernias are eight times more likely to affect men than women. In fact, 25% of all men will develop an inguinal hernia at some point.
A hernia may be painful, especially when coughing or bending over. On the other hand, sometimes hernias do not cause any discomfort. The hernia is not necessarily dangerous, but it may lead to health complications if not treated.
Symptoms
An inguinal hernia may cause:
- A bulge in the abdomen near the pubic bone
- Pain and discomfort in the area of the bulge or in the groin area
- A feeling heaviness or pressure in the groin
Occasionally, an inguinal hernia can become incarcerated or trapped in the abdominal wall. This can lead to blood flow to the affected tissue being cut off, also known as strangulation. This is a potentially life-threatening condition and requires immediate, emergency medical attention. Symptoms of a strangulated hernia include:
- Nausea or vomiting
- Fever
- Sudden, intense pain
- A hernia bulge that becomes red or purple
- Severe constipation
Causes and Risk Factors
Inguinal hernias are more likely when there is a weakness in the muscle of the abdominal wall. Such a weakness may be present at birth, or it may develop over time. Additionally, strenuous activity, repeated straining during bowel movements and chronic coughing are all potential contributors to hernias.
Key risk factors include:
- Being male
- Getting older
- Family history of hernias
- Smoking – a chronic cough can weaken the abdominal walls
- Repeated constipation
- Pregnancy
- Previous history of inguinal hernias
Diagnosis and Treatment
An inguinal hernia can usually be diagnosed with a physical examination by your primary care provider. Occasionally, a CT scan or other imaging test may be used to confirm a suspected hernia.
If a hernia is not causing problems, it may be recommended to take a “wait and see” approach. This may be fine for a while, but many hernias will become larger over time if not treated. Most hernias can be repaired through surgery.
There are three types of surgery used to repair hernias.
Open Hernia Repair
In this traditional surgical procedure, the surgeon makes an incision in the groin and pushes the protruding tissue back into place. The weakened part of the wall is repaired by sewing it and possibly inserting a mesh reinforcement. The incision is then sewn or stapled to close it.
Minimally Invasive Hernia Repair
Minimally invasive, or laparoscopic, surgery is a highly effective way to repair hernias.
The advantages of laparoscopic surgery are numerous. Instead of making a large incision of several inches in length, the surgeon can perform the surgery by making three or four small incisions and then inserting small tools and a thin, flexible tube with a video camera on the end. The images from the camera are displayed on a television monitor that the surgeon utilizes to see inside the patient’s body and guide the surgical instruments accordingly. This process results in less cutting on the patient and therefore, minimal scarring.
Laparoscopic surgery also provides the advantage of reduced blood loss and decreased risk of infection. Recovery time is faster and hospital stays are shorter – in fact, an overnight stay in the hospital may not be necessary. While there is some risk associated with all surgeries, laparoscopic surgeries have a decreased overall risk when compared to traditional, open surgery.
Robotic Surgery
Surgeons increasingly use robotic surgery to repair hernias. Robotic surgery allows for the surgeon to view a three-dimensional image of the inside of the abdomen and often results in even smaller incisions than laparoscopic surgery.
Every patient’s situation is different, so the surgeon will recommend the surgical approach best suited to the patient. There are more than 1 million inguinal hernia repair surgeries performed in the United States each year, making it one of the most common surgeries. Privia Medical Group North Texas surgeons have performed hundreds (accurate to say thousands?) of hernia repairs and are experienced in all types of surgical approaches.
Prevention
While the cause of inguinal hernias is not always evident, there are definitely some things you can do to lower your risk of developing one:
- Eat a well-balanced diet that includes plenty of whole grains, fruits and vegetables – this helps prevent constipation and straining to complete a bowel movement.
- Be careful when lifting heavy items. Always use proper form.
- Do not smoke. The chronic cough that results from smoking weakens the abdominal wall.
- Maintain a healthy weight. Being obese or overweight is a key risk factor for developing a hernia.
Ventral Hernias
Ventral hernias are the second-most common type of hernia, accounting for more than 600,000 repair surgeries in the U.S. annually. This type of hernia occurs in the front abdominal muscles. There are three kinds of ventral hernias:
- Umbilical hernia: This is a protrusion that occurs near the belly button. Most umbilical hernias are present when someone is born but may not cause problems until later in life.
- Hiatal hernia: This happens when part of the stomach pushes upward toward the chest through an opening in the diaphragm.
- Incisional hernia: Is caused when tissue protrudes through an abdominal scar from a previous surgery.
Many of the causes of ventral hernias are similar to those associated with inguinal hernias.
Other Types of Hernias
While inguinal and ventral hernias are the most common, there are several other types of hernias:
- Femoral hernia: Occurs when part of the intestine or fatty tissue protrudes into the groin. A femoral hernia primarily affects older women.
- Epigastric hernia: This is when tissue protrudes through the area between the navel and the sternum.
- Spigelian hernia: This occurs on the side of the abdominal muscle, below the navel.
- Diaphragmatic hernia: When abdominal organs move upward into the chest cavity through an opening in the diaphragm, this type of hernia may result.
“With more than 3 million cases a year in the United States, hernias are not unusual. In some cases, they can lead to serious health complications if not diagnosed and treated,” says Dr. John Birbari, a general surgeon in Fort Worth. “The good news is that hernia repair surgery is a common, highly effective surgery – if you believe you may have a hernia, see your primary care provider as soon as possible.”
This article has been reviewed and approved by a panel of Privia Medical Group North Texas physicians.
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