Let's Talk About Hernias

By Andrew J. Shapiro, MD, FACS

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Approximately 5 million men and women of all ages develop hernias annually. A hernia is an opening or weakness in the muscular structure of the abdominal wall, which can occur naturally or from excessive strain. The inner lining of the abdomen pushes through the weakened area to form a balloon-like sac. This can cause a loop of intestine or abdominal tissue to slip into the sac and become trapped or strangulated, causing pain or other potentially serious health problems.

Where Are Hernias Located?
Any part of the abdominal wall can develop a hernia. 80% of all hernias occur in the groin (or inguinal). Hernias may also occur below the groin (femoral), through the navel (umbilical), along the abdominal midline (ventral/epigastric) and along a previous incision (incisional).

What Causes Hernias?
Most inguinal hernias in adults result from strain on the abdominal muscles, which have been weakened by age or by congenital factors. Heavy lifting, pulls or muscle strains, sudden twists, excess weight, chronic constipation and repeated coughing attacks can force the soft tissue to push through, resulting in a hernia.

Do I Have a Hernia?
The onset can be gradual, with no symptoms other than the development of a bulge. Other times, the hernia will occur suddenly with a feeling that something has "given way," which can be accompanied by pain or discomfort. Things to look for include: visible bulges in the scrotum, groin or abdominal wall; a feeling of pain, weakness or pressure; a burning feeling at the bulge; or a dull, aching sensation.

Should My Hernia Be Repaired?
In general, hernias should be repaired to prevent possible complications of restricted blood flow or blocked intestines requiring a future emergency procedure. Only you can decide whether to proceed with repair; however, please realize that:

• A hernia doesn't heal by itself.
• Pain may increase in the area of the hernia.
• Over time, the hernia may increase in size.

How Will the Surgeon Repair My Hernia?
Open vs. Laparoscopic Surgery
There are two types of hernia repair:

• Open surgery -- The surgeon makes an incision over the hernia, which may be repaired either using sutures or a mesh material.
• Laparoscopic surgery -- Mesh is inserted to repair the hernia using several small incisions with the aid of a lighted scope.

After a thorough examination, your surgeon will determine which repair is right for you.

What Should I Expect After Surgery?
Following surgery, most patients go home the same day and feel fine within a few days. Strenuous activity and exercise are restricted for a few weeks. Allowing for proper recovery is an important factor to ensure that the repair takes hold. The recurrence rate over many years is small, estimated to be about only 1 to 5%.

Andrew J. Shapiro, MD, FACS, is a board-certified general surgeon with extensive experience in both open and laparoscopic surgical procedures. He has relocated to the Wellington area and has joined Drs. John Corbitt and Andrew Larson for the practice of general surgery. Dr. Shapiro is available for consultation on hernia repair or any surgical need. His offi ce is conveniently located on the campus of Wellington Regional Medical Center. To schedule an appointment, please call 561-439-1500.

Wellington Regional Medical Center, 10101 Forest Hill Blvd. Wellington, FL 33414 (561) 798-8500