A Message from the Hernia Center Director
William J. Symons, MD, FACS
Division Director, General Surgery
Medical Director, Hernia Surgery
The Hernia Center offers a comprehensive approach to hernia care. We have assembled a multidisciplinary team to optimally support, treat, and guide our patients from the initial preoperative visit through recovery. Our team guides patients and their families with a concierge level of attention throughout the entire process.
The Hernia Center is your local resource for world-class hernia care. Whether you have been diagnosed with a small hernia or have a more complex situation, we will work with you to create a care plan that is right for you and expedites your recovery and return to full function.
What can I expect if I need hernia surgery?
To make sure you have the best outcome possible, we will evaluate your hernia prior to surgery and make recommendations that can enhance your recovery. Depending on your health prior to hernia surgery, we may suggest a nutritional plan or a modified exercise regimen. We'll provide patient counseling and education every step of the way to make sure you are well-prepared for your hernia surgery. After surgery, if needed, you'll receive physical therapy to restore full range of motion and help you return to activities safely and without risk to the surgical site. Everything we do is designed to help you heal and recover to get you back to full activity as soon as possible. Read our FAQs to learn more.
Types of Hernias and Risk Factors
What is a Hernia?
A hernia is a hole in the abdominal fascia, the strong connective tissue that your muscles sit on. Hernias develop at areas of weakness in the abdominal fascia. Major areas prone to hernia formation are:
- Certain areas of the abdominal wall. These areas include where fascia is not covered with overlying muscle such as the mid-line of your abdomen.
- Areas where the fascia had been previously weakened by surgery.
- Areas where structures, such as the cord for the male testicle, pass through the abdominal wall.
Risk Factors for Developing Hernias
Anything that strains the abdominal wall can predispose a person to a hernia.
- Heavy lifting can increase intra-abdominal pressure and cause a hernia.
- Chronic coughing leads to increased strain on the abdominal wall and hernia formation.
- Abdominal weight gain leads to stretching of the abdominal wall and the formation of hernias.
- During pregnancy, the body releases hormones to allow the abdominal wall to stretch but the hormones don’t completely counteract the strain on the abdominal wall and hernias can develop.
- Any surgical procedure on the abdominal wall weakens it and can lead to hernia. The risk is greatly increased if a surgical site infection occurs as this inhibits normal healing of the fascia.
- Some people are genetically more prone to hernia development. They have connective tissue/fascia that is inherently weaker than the general population.
What Types of Hernias Exist?
- Inguinal (groin)
- Femora hernia
- Umbilical hernia
- Incisional hernia
- Epigastric hernia
- Hiatal hernia
- Spigelian hernia
- Lumbar hernia
- Obturator hernia
Pediatric Hernia Care
Inguinal (groin) hernias in children can occur at any age from infancy to adolescents and although they’re more common in boys, both boys and girls can have hernias. It’s important to know that hernias are developed due to an underlying anatomic condition and not because of bad parenting or allowing a child to strain, cry or lift heavy objects. As with adult hernias, pediatric hernias need to be repaired to avoid potentially serious complications that may result if the hernia becomes trapped or incarcerated. Our team will work closely with you to evaluate your child’s condition and discuss treatment options. If surgery is needed, your child will be given the option to have the operation performed with our pediatric surgery team at Tully Health Center.
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There are two major types of hernia surgery: minimally invasive (sometimes called "laparoscopic") surgery and open surgery. Our multidisciplinary team is trained to guide you through the best option that suits your conditions and needs.
Minimally invasive surgery
- Most hernia repairs can be performed through minimally invasive surgery.
- Advanced, minimally invasive laparoscopic and robotic surgery uses 3 tiny incisions between 0.5-0.8 cm. in size.
- This type can lead to a faster recovery and result in less pain.
- There's also a decreased risk of wound infection and chronic pain.
- Requires general anesthesia.
- For smaller hernias, surgery can often be performed using only local anesthesia (a numbing medication applied near the site of the hernia) with sedation, which will be more suitable for patients with heart conditions and those looking to avoid general anesthesia.
- For patients who have larger, more complex hernias, you and your provider may opt to choose this treatment, as your hernia may require a component separation. This is a surgical technique of cutting the muscular attachments so that the muscles can slide over one another to cover larger defects.
Pediatric hernia surgery
- If your child is 14 or under, a pediatric surgeon will perform the hernia repair.
- Your child’s surgery will be performed under general anesthesia. Every precaution is taken by our team to see to it that your child has a safe anesthetic experience.
- The surgery generally takes about 45 minutes to one hour. In the vast majority of cases your child can go home after staying in the post-anesthesia care unit (recovery room) for about 1-2 hours.
- Recovery after hernia surgery is quite rapid. Most children will experience very little pain or discomfort and may return to their normal activities within a few days.
Frequently Asked Questions
Do hernias go away on their own?
First, it’s important that you are properly diagnosed and confirm with your general surgeon that you do in fact have a hernia. Other disease processes can sometimes be mistaken for hernias. If you do have a hernia, it’s important for you and your provider to monitor its progression and review treatment options that are right for you.
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What can happen if hernias are not treated?
Often, a part of the intestine pushes through a tear in the abdominal wall and a soft bulge is seen underneath the skin where the hernia has occurred. The risk is that this bowel can get stuck in the hernia, leading to an incarcerated hernia. This can cause the blood supply to be cut off and the hernia can quickly, within the space of six hours, go from an incarcerated hernia to a strangulated hernia. This strangulation of the blood supply leads to necrosis (death) of this piece of bowel and spillage of the bowel contents, which can lead to sepsis and even death. This is why hernias are usually surgically repaired on an elective basis to avoid these complications.
Is hernia surgery painful?
Your recovery experience will be unique to you depending on your condition and the treatment, as well as your threshold for pain. However, most patients can generally take over-the-counter pain medication after surgery to alleviate minor aches and pains from hernia surgery. Prescription medication is also prescribed after surgery so it is available to you if you need it.
How long will my recovery be after hernia surgery?
Most laparoscopic and open hernia surgeries do not require an overnight stay. The most common form of hernias are inguinal (groin) hernias and surgery usually takes about 45 minutes. Recovery time will depend on your condition and treatment but many patients are able to return to work and their normal routines after three to four days. Recovery time is different for everyone so it’s important to discuss any concerns you may have with your surgeon.
Is the use of hernia mesh worrisome?
Over the last 40 years all of the medical data has supported the use of mesh in hernia repair to greatly decrease the risk of recurrence but there has been concerns related to this due to reported complications with mesh products that have since been recalled. Our hernia surgeons are here to address any questions or concerns you may have about this and to further improve hernia care nationally.