Ventral/Incisional Hernias
Ventral hernias often develop at the site of a previous surgical incision in the abdomen and are caused by the thinning or stretching of the abdominal wall. This results in a bulge or tear of the muscle. Over patients' lifetimes, about one in three large abdominal incisions will eventually result in a hernia. Left untreated, these hernias can cause inflammation, obstruction or strangulation of the intestine. The belly button is another common place for ventral hernias to develop.
Using a minimally invasive surgery (MIS) approach to repairing these hernias eliminates the need for another large incision, reducing the chances of the condition reappearing. Additionally, patients often have less post-operative pain, a shortened hospital stay (most patients are discharged on the day of surgery), and a faster return to a regular diet and normal activity.
Inguinal, Femoral and Umbilical Hernias
Inguinal hernias are the most common type of hernia and occur when soft tissue-usually part of the intestine-protrudes through a weak point or tear in the lower abdominal wall and almost always occur spontaneously. The resulting bulge of this common condition can be painful, especially when coughing, bending over or lifting a heavy object. Although far more men than women have inguinal hernias, no one is immune-including infants, pregnant women and older adults.
In many people, the abdominal wall weakness can be present from birth; however, many inguinal hernias develop later in life when muscles weaken or deteriorate due to factors such as aging, strenuous physical activity or coughing that accompanies smoking. In women, inguinal hernias may be associated with pregnancy.
Not necessarily dangerous in themselves, inguinal hernias can lead to life-threatening complications-including incarceration and strangulation of the intestine-and surgery may be required to repair a hernia that is painful or becoming larger.
Femoral hernias are more common in women, usually in the elderly and frail (although they can happen in children). In a femoral hernia, a bulge is usually present in the upper part of the thigh, just below the groin and may or may not be painful.
An umbilical hernia, another spontaneous hernia, occurs when part of the intestine protrudes through a weak spot in the abdominal muscles. Umbilical hernias are most common in infants, but they can affect adults as well. Most umbilical hernias close on their own by age 2. To prevent complications, umbilical hernias that do not disappear by age 4 or 5, or those that appear during adulthood, should usually be repaired surgically.
The good news is that the operations to repair these hernias no longer require a large abdominal incision, a lengthy hospital stay or weeks of immobility. Instead, many inguinal, femoral and umbilical hernias now can be successfully repaired with MIS techniques that use several small incisions, leading to a faster, less painful recovery.
Flank Hernias: Hiatal and Paraesophageal Hernias
Giant hiatal and paraesophageal hernias are where the stomach bulges up into the chest through an opening in the diaphragm and are increasingly becoming a common diagnosis in the elderly population.
Depending on the size of theses types of hernias, complications can occur. One of these complications might be incarceration, where the hernia gets stuck and twists, resulting in an inability to swallow solid foods, regurgitation of food into the mouth, and even chest pain. Even worse, the twisting of the stomach can cause a lack of blood supply, leading to stomach tissue death and posing a life-threatening emergency.
With the use of an MIS approach, surgeons are able to repair the hernia through several small holes in the patient's abdomen. The advantage of this surgical option are small incisions, which in turn means less risk of infection, less pain and scarring, and resulting in a faster recovery time. The safety provided by MIS also allows surgeons to recommend surgery prior to the disease resulting in an emergency not only to the baby boomer generation, but also to those who are in their 80s and 90s.
Other hernia repair procedures include those for diaphragmatic, bilateral, giant and recurrent hernias.
Physicians
Alan S. Davis, M.D.
Chief of Surgery - Northwest Hospital
21 Crossroads Drive, Suite 360
Owings Mills, MD 21117
410-356-0410
W. Peter Geis, M.D.
21 Crossroads Drive, Suite 360
Owings Mills, MD 21117
410-356-3346