By Dennis Diaz, MD
A hernia is best described as a weakness or opening through the layers of the abdominal wall. This in turn results in the protrusion of an organ or tissue through this opening. The majority of hernias are not noted until a physical examination is performed, as most are not producing symptoms. Typical symptoms include seeing a bulge and/or pain in the region of the hernia. There are several different types of hernias, the most common being umbilical, inguinal, and incisional.
An umbilical hernia represents a bulge at the belly button. These are very common since the belly button is the entry point for the umbilical cord and thus a weak point on the abdominal wall. Commonly called an “outie,” these hernias typically contain a thin layer of fat that resides behind the muscular layer of the abdominal wall. An inguinal hernia typically is noted as pain or a bulge in the groin. There are two types of inguinal hernias. The indirect type is typically congenital and associated with the development of the spermatic cord in men or the round ligament in women. The direct type is typically an acquired hernia related to lifting over the years. An incisional hernia represents a bulge beneath a scar from a previous operation.
Surgical repair is the mainstay of hernia treatment. Several different options are available. Some, like a small umbilical hernia, can be repaired in an open fashion with a couple of stitches. Inguinal hernias and incisional hernias usually require mesh-based repairs. Nowadays these can be approached laparoscopically, aka keyhole surgery. Laparoscopic hernia repairs afford patients a quicker recovery and a quicker return to normal activity. Sometimes incisional hernias may be so large that laparoscopy is not feasible and muscles may have to be moved in order to reconstruct the abdominal wall.
The majority of hernias are reducible and can be managed on an elective basis. You may awake feeling fine and develop an increasing bulge throughout the day. In most cases, the bulge will disappear when an individual lays flat. Sometimes the hernia can become incarcerated. This is when the bulge will not go back down. The skin overlying the hernia may become hot and red. If ignored, the blood supply could potentially be cut off to the herniated contents and become strangulated. These situations are surgical emergencies and require immediate medical attention.
Regardless of the type of hernia an individual may have, it is best to have hernias repaired and not ignored. Recovery is easier and quicker with elective operations as opposed to emergent surgeries.
Dr. Diaz is a board-certified general surgeon and a Fellow of the American College of Surgeons. He specializes in minimally invasive surgery and has been in the community since 2010. For more information visit NorthOrlandoSurgical.com.