Hernias are openings in
the abdominal wall or groin which can occur at birth or be acquired as a
result of abnormally increased intrabdominal pressure. They can also
occur as the result of previous surgery. This could potentially allow
the intestines to become trapped in the opening resulting in a potential
life threatening situation. This could result in emergency surgery. It
is for this reason, all hernias should be repaired. The most common
sites of hernias are inguinal, umbilical, and the abdominal wall.
Inguinal Hernia
These are commonly
referred to as groin hernias. They have been traditionally treated as an
open procedure without the placement of mesh. This has been an
uncomfortable procedure and resulted in a high recurrence rate. These
hernias are now routinely repaired with mesh which has resulted in a
less painful operation with a recurrence rate of 0.2%. Patients can
expect to return to work in about 14 days.
Even better is the
laparoscopic approach which can be done as an outpatient procedure
as well. This is less painful and the recurrence rate is the same.
However, one can expect to return to work with unrestricted activity
much quicker (typically in 3-5 days). This requires only 3 small
puncture sites and no sutures in the muscle. Results have been
excellent.
All of our
surgeons perform laparoscopic inguinal hernia repairs.
Incisional/Ventral
Hernia
Incisional hernias are
common after previous abdominal surgery. They can be very uncomfortable
and unsightly with a considerable bulge in the abdomen. They can also be
dangerous if the intestines were to become stuck in the defect.
Therefore, all of these hernias need to be repaired.
The recurrence rate
approaches 25% so these are usually repaired with mesh. These also can
be repaired with an open or laparoscopic approach.
The laparoscopic
incisional hernia repair is done with only 3 or 4 puncture sites.
Occasionally, this can be done on an outpatient basis. This results in a
less painful procedure with a faster recovery time. Mesh is used
for the repair and recurrence rates are similar to the open repair. Most
patients can return to work with unrestricted activity in about 2 weeks
instead of the 6 weeks typically required by open repairs.
Our surgeons perform
laparoscopic incisional hernia repairs.
Umbilical
Hernia
Umbilical hernias can
be acquired as an adult or as a result of birth. While in children 85%
of umbilical hernias resolve without surgical intervention, in adults
these need to be repaired. They have a high incidence of entrapping the
intestines and smaller ones carry a higher risk than larger ones. These
are repaired on a outpatient basis with low recurrence rates. The
incision is hidden in the navel and return to work usually occurs in
about 2 weeks.
