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MIS for Hernia Repair

Abdominal/Pelvic Hernias

Hernia patientVentral/Incisional Hernias

Ventral hernias often develop at the site of a previous surgical incision in the abdomen and are caused by thinning or stretching of the abdominal wall. This results in a bulge or tear of the muscle. Over a patient's lifetime, about 1 in 3 large abdominal incisions will 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 approach to repairing these hernias eliminates the need for a large incision, reducing the chances of the condition reappearing. Additionally, patients often have less post-operative pain, a shorter 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 usually occur spontaneously when soft tissue — usually part of the intestine — protrudes through a weak point or tear in the lower abdominal wall. 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 and of 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 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 can now be successfully repaired with minimally invasive techniques that use small incisions, leading to a faster, less painful recovery.

Hiatal and Paraesophageal Hernias

With giant hiatal and paraesophageal hernias, the stomach bulges up into the chest through an opening in the diaphragm. These hernias are increasingly common for the elderly population.

Depending on the size of these hernias, complications can occur. One of these complications might be incarceration, in which the hernia gets stuck and twists, resulting in a person's inability to swallow solid foods, regurgitation of food into the mouth and chest pain. 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 a minimally invasive surgical approach, surgeons are able to repair the hernia through small holes in the patient's abdomen. The smaller incisions mean less risk of infection, less pain and scarring, and a faster recovery. This safer approach also allows surgeons to recommend surgery before the disease becomes an emergency situation, not only for 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 at Northwest Hospital
21 Crossroads Drive, Suite 360
Owings Mills, MD 21117
410-356-0410

Celine A. Richardson, M.D.
Department of Minimally Invasive & Bariatric Surgery
5401 Old Court Rd
Randallstown, MD 21133
410-601-4486

Gary Hamamoto, M.D.
Gary Hamamoto, M.D.
23 Crossroads Dr, Suite 410
Owings Mills, MD 21117
410-581-0700