Hernia Surgery | Laparoscopic.MD

A hernia is a surgical condition that develops when a part of an organ, most commonly in the abdomen, pushes through an abnormally large opening in the muscle and membranous organ wall. Genetic predispositions undoubtedly exist and a family history of hernias is a contributing factor that increases the chance that a hernia may develop or enlarge with physical activity.

Most hernias that are NOT accompanied by extreme pain are not surgical emergencies. When a hernia occurs, however, the only cure is surgical. Surgery is required to place the part of body back into its place and close the hole it went through. The condition becomes serious when the blood supply becomes cut off to the portion of the organ that has pushed its way through the abdominal wall.

Uncomplicated hernias are performed as outpatient procedures, while more complicated operations may require a hospital stay for a few days. A successful surgery may reduce the risk of having a recurring hernia, but recurrence will ultimately come down to genetics and lifestyle choices.

Laparoscopic Inguinal Hernia Repair

Hernias that occur in the groin are known as inguinal hernias. These are characterized by small balloon-like pouches protruding from the groin region. These form at a natural point of weakness at the intersection of abdominal muscles. The protrusions occurs when a loop of intestine or fat passes through this weak point and either enters the inguinal canal or pushes out just medial (more in the middle) to the inguinal canal. Men usually suffer from inguinal hernias developing in the groin, and may notice an ambiguous discomfort or even a bulge in the scrotum. Infants and children also suffer from inguinal hernias when a part of the lining of the abdominal cavity called the peritoneum does not close properly. This leads to a bulge in the groin because the intestine or other abdominal contents may push into the opening when the pressures inside the abdomen rise.

Hernia

A hernia is a condition in which a part of an organ pushes through the opening of the organ wall made up of muscle tissue or membranous material. The most common site for hernias to develop is the abdomen. Hernias may or may not display any outward symptoms. Hernias are usually treated surgically. If the blood supply at the herniated portion is cut off then it becomes a medical emergency. Muscle weakness and straining too hard at an activity can cause hernias. A person born with weak abdominal muscles is more likely to acquire the condition, particularly if he leads a sedentary lifestyle without any form of exercise.

How do I know if my hernia is incarcerated?

An incarcerated hernia is painful and sometimes dangerous

How common is hiatal hernia?

The incidence of hiatal hernia increases with age and occurs in approximately 10% of the adult population. In patients undergoing upper gastrointestinal x-ray examination, with abdominal compression hiatus hernia was diagnosed in half of the patients undergoing the study. Approximately 95-99% of all hiatal hernias are type I (sliding) are either asymptomatic or cause symptoms of reflux that are treated by medicines.

¿Es peligrosa una hernia hiatal?

Las hernias hiatales de tipo I, el tipo deslizante, típicamente no se consideran peligrosas y las hernias hiatales deslizantes aisladas generalmente no requieren reparación quirúrgica. Aunque estas hernias pueden causar enfermedad por reflujo gastroesofágico y los síntomas relacionados de ardor y malestar epigástrico, por lo general no se considera que sean peligrosas.

Paraesophageal

The hiatus is a normal opening in the muscle that separates the chest cavity from the abdomen which moves up and down with breathing. Although the hiatus is a normal opening, there are occasions when this opening enlarges and the stomach or other organs can slip up inside the chest. This occasion of an abnormally large opening of the hiatus is called a hiatal hernia. Paraesophageal hernias account for only 5% of all hiatal hernias. A paraesophageal hernia is a type of hiatal hernia where the junction of the stomach and the esophagus remains in place, but part of the stomach is squeezed up into the chest beside the esophagus.

Diaphragmatic hernia being laparoscopic sutured

Ventral Hernia Repair Combined with Abdominoplasty

While it is important to keep in mind that ventral hernia surgery and abdominoplasty are two distinct operations, they are performed in the same area (lower abdomen) and address problems that often have a common origin. While the need for an operation may be driven by the hernia repair, performing it together with abdominoplasty is usually a safe and practical combination. In addition to having a diagnosed ventral hernia from whatever cause, two conditions account for about 95% of patients interested in combining hernia surgery with abdominoplasty. One condition is associated with women who have had one or more children, which left them with stretch marks and an abdominal wall musculature permanently deformed by carrying a baby. The other is the result of massive weight loss, where the patient develops folds of overhanging skin. In either case, abdominoplasty is required to correct for substantial and unsightly tissue and skin.

Parastomal

Parastomal hernia occurs when a weakness in the muscles of the abdominal wall allows a loop of bowel or other tissue to protrude out, resulting in a bulge or swelling around the stoma. Other symptoms include discomfort at the stoma site, abdominal distention, back pain, intermittent cramping, changes in stoma function and an increase in leakage due to poor fit of stomal appliances.

Ventral Hernia

A hernia might develop at a point of weakness caused by a previous surgical incision. A small out pouching that occurs months to years at a previous incision may be a sign of a hernia. Patients may witness a small soft balloon-like sac protrusion due to slackening of the muscular wall of the abdomen or at the site of the previous operation. These balloon-like protrusions may change in size according to position and may disappear when the abdominal wall is completely relaxed such as when you are lying down. This defect in the layer surrounding the muscles of your abdominal wall is called a ventral or incisional hernia. Sometimes, internal organs or a loop of the intestine may get trapped in this sac and cause a dangerous condition heralded by severe pain and discomfort.

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