It is estimated that around 20 million hernias are repaired around the world every year, and this does not even account for those who are living with hernias that should be repaired but have not seen a doctor about it.
Hernias can happen suddenly and unexpectedly, and they can be incredibly painful. In severe cases, a hernia can be debilitating and put a person out of commission in an instant.
Fortunately, hernias are certainly treatable, with surgery being the primary option in a large majority of cases. There is a lot to know about hernias and how they are treated, which is why we have put together this Ultimate Guide to Hernia Surgery.
Continue reading below to learn about various types of hernias and how they are treated.
What is a Hernia?
Many people have likely heard the word, but still wonder what is a hernia? Before getting into the treatment options for a hernia, it is helpful to understand what a hernia is and how they occur.
Essentially, a hernia comes about when there is a weak spot in the abdominal tissue or an organ places enough pressure to protrude out through this hole. What ends up protruding through the hole depends on the location of the hernia, as they can occur in multiple places in the abdomen.
The weakened abdominal tissue that allows a hernia to occur can come about from multiple factors. Sometimes, the individual was predisposed by genetics or the tissue has been there since birth. In a majority of cases, the weakened tissue comes about later in life and could be from multiple different causes, including:
Whatever the case may be, the weakened tissue is something that an individual may not even know about until a hernia comes about unexpectedly.
The Multiple Types of Hernia
There are several types of hernia and they can come about as a result of different conditions and activities. The type of hernia is a large factor in how it is treated and what the best steps are to prevent recurrence. Types of hernias include:
01 - Inguinal Hernia
An inguinal hernia is the most prevalent type of hernia, with it accounting for somewhere around 96% of all cases. This type of hernia occurs when fatty tissue, part of the bladder, or intestine protrudes through the abdominal tissue into the groin near the upper inner thigh. Inguinal hernias occur in the inguinal canal, which is different for men and women. In men, the inguinal canal houses spermatic cords and blood vessels, whereas, for women, it holds a ligament that helps support the womb.
02 - Femoral Hernia
Femoral hernias occur in a close location to inguinal hernias, but they are slightly lower in the groin area. These are much less likely to occur than inguinal hernias, but they are more common in women, particularly those who are pregnant or obese.
03 - Incisional Hernia
As the name implies, an incisional hernia happens in an area where there was a previous surgical incision site. The scar tissue left behind may cause that part of the muscle tissue to be weakened, allowing for tissue or organs to push through. This type of hernia is unlikely, as long as the surgery is performed properly, but it is more likely in the elderly.
04 - Umbilical Hernia
An umbilical hernia happens when part of the small intestine protrudes near the belly button. This type is more common in obese women who have had multiple pregnancies and in newborns.
05 - Epigastric Hernia
Epigastric hernias are similar to umbilical hernias, except that they occur in the upper abdomen.
06 - Spigelian Hernia
A Spigelian hernia occurs in the Spigelian fascia, which is a tissue layer that splits the muscle groups in the front of the abdomen. When there is an opening in this fascia, an organ or tissue can protrude through it, creating a Spigelian hernia.
There are two other types of hernia that need to be covered in a bit more detail, purely because they may require special attention to address and prevent recurrence
What is a Hiatal Hernia?
A hiatal hernia occurs in the diaphragm, which is the muscle that separates the abdomen from the chest. When this muscle tissue is weakened, it can allow part of the stomach to protrude through it, causing a hiatal hernia.
Hiatal hernias differ from other hernias because of the location and because they sometimes need to be combined with other surgical procedures to prevent them from occurring again.
Hiatal hernia surgery is commonly paired with weight loss surgery, as obesity and a sedentary lifestyle can be large risk factors for this type of hernia.
What is a Sports Hernia?
A sports hernia differs from other types of hernia in that it is not technically a hernia. The medically accurate name for this condition is Athletic Pubalgia. The symptoms can be very similar to those of a hernia, but it actually comes about from the tearing of tendons that attach to the pelvis.
These hernias occur as a result of hard or repetitive motions, like those that can occur in various sports like soccer, football, hockey, and more. The twisting of the pelvis is one of the motions that can particularly contribute to the formation of a sports hernia.
Treating a sports hernia can involve rest, anti-inflammatory medication, and physical therapy in many cases. However, severe cases may require surgical intervention to repair the damaged tendons.
Treatment for Hernia
Fortunately, while hernias can be incredibly painful, they are far from untreatable. In a large majority of cases, repairing a hernia will require surgery.
The primary goal of hernia surgery is to return the protruding tissue or organ back to where it belongs and repair the weakened muscle tissue so that it will hold everything in place the way that it should.
The initial treatment for a hernia will begin with a surgical consultation to decide what the best approach is for the severity and location. There are multiple surgical options that may be used by themselves or in combination to repair a hernia and help prevent a recurrence. These include:
Open Hernia Surgery
Open hernia surgery is when a single larger incision is made in the abdomen to access the hernia. Ideally, minimally invasive procedures will be considered and used first, but some cases will require open surgery to properly repair.
This approach is commonly used in severe cases or for those who have had abdominal surgery in the past, as the previous incision or scar tissue can present risks for minimally invasive procedures.
Laparoscopic Hernia Surgery
Laparoscopic hernia surgery will often be the first treatment method to be considered, as it is minimally invasive. It involves making multiple small (keyhole) incisions that can be accessed with a laparoscope, which is a small and flexible device that can be used to see and repair the hernia site without full access to the abdomen.
This procedure will typically result in less pain and scarring than open surgery. When performed by a skilled surgeon, laparoscopic surgery has about the same risk of complications or hernia recurrence as that of open surgery.
Although, because not everyone will be a qualified candidate for this type of surgery, those who have had previous surgeries or severe hernias will often require more invasive surgical intervention for the best results.
Mesh Hernia Treatment
In cases of severe hernias or hernia recurrence, further surgical steps may need to be taken to best repair the area. One particularly effective method is the use of surgical mesh.
Surgical mesh is a special type of material that can be placed over the weakened area to help reinforce it and prevent the muscle tissue from being able to tear open again. This will not be required in every hernia surgery, but the surgeon will likely want to include it if there is a risk of the hernia recurring.
Reconstructive Surgery
When a hernia is particularly severe or there have been multiple hernias in the same location, the damage to the muscle tissue can be quite extensive. In these cases, it may require reconstructive surgery to repair and reinforce the muscle tissue enough to hold everything in place as it should.
Weight Loss Surgery
With certain types of hernias, the repair surgery may be paired with weight loss surgery to help prevent recurrence in the future. Obesity and a sedentary lifestyle can play a large role in the formation of hernias, as the extra weight places additional pressure in many areas.
This is why some surgeons may decide to pair hernia surgery with weight loss surgery to relieve some of that pressure and risk. If interested in weight-loss surgery, please visit our Bariatric Center.
Cases of Less Severe Hernias
While it is uncommon, there are some cases of hernias that are not severe and may not require surgical intervention. If the individual does not really notice the hernia or it is not causing any difficulty or issues, a doctor may recommend that they monitor it before engaging in surgical intervention.
This is very rare, as the hernia must be quite small and pose no risk or issue.
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Recovering from Hernia Surgery
The recovery time and steps for recovering from hernia surgery can vary depending on the type and severity of the hernia, as well as the type of surgery that was used to repair it.
If the hernia was repaired using laparoscopic surgery, then the individual will often be able to return home the same day or only need to remain in the hospital for one night. However, it is often recommended that another adult return home with the individual to monitor them for 24 hours in case of any complications or concerns. How long the post operative pain lasts can vary between people. Many people are feeling better after a couple weeks, but it may last up to a month or more for others.
The time frame before a person can return to work is generally between a few days to two weeks, but those in manual labor may be recommended to wait longer or take it easy.
Too much heavy activity can easily reopen the surgical site and cause hernia recurrence or dangerous complications. Whatever type of hernia or procedure is received, the best thing an individual can do is to follow their surgeon’s recommendations very closely and take care of themselves to promote healing. This includes:
• Proper nutrition
• Drinking plenty of fluids
• Avoiding heavy activity or lifting
• Getting ample rest
When to Contact the Doctor During Recovery
When healing from a hernia, it is important to keep a close eye on the incision site. It needs to be properly cleaned and cared for per the surgeon’s instructions to help prevent infection and complications. Furthermore, if anything seems off, whether it be increased pain or the incision looks infected, then the person should contact their doctor immediately. Some warning signs to look out for include:
• Proper nutrition
• Fever of 101 degrees or higher
• Bleeding
• Nausea
• Vomiting
• Chronic cough
• Shortness of breath
• Chills
• Difficulty urinating
• Swelling or redness at the incision site
• Severe pain that painkillers do not relieve
The bottom line is that if it seems like something isn’t quite right or the person is feeling any of the above, then it is better to contact the doctor instead of seeing if it improves. It is much better to find out that there is nothing to be concerned about, rather than it being a significant issue that does not get the needed attention.
