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Hernias
What is a hernia?
A hernia occurs when an internal organ or other part of the body pushes through the muscle or tissue wall that normally contains it. Most hernias appear within the abdominal cavity, in the space between the ribcage and the hips.
The most common types of hernia are:
- Inguinal hernia: In men, the inguinal canal is a passageway for the spermatic cord and blood vessels leading to the testicles. In women, the inguinal canal contains the ligament that supports the uterus. In inguinal hernia, adipose tissue, or part of the intestine pushes into the groin at the top of the inner thigh. This is the most common type of hernia and affects men more often than women.
- Femoral hernia: Femoral hernias occur when a portion of tissue bulges through the wall of the femoral canal, a passage for the femoral artery as well as smaller veins and nerves, located below the inguinal ligament. They appear as a bulge near the thigh. Femoral hernias are much less common than inguinal hernias and mostly affect older women.
- Umbilical hernia: When tissue a part of the intestine pushes through an opening in the abdominal muscles near the navel, it’s called an umbilical hernia. This type of hernia is quite common, especially in infants, and generally harmless.
- Hiatal hernia: Part of the stomach pushes up into the chest cavity through an opening in the diaphragm (the muscle that separates the chest from the abdomen).
- Incisional hernia: Tissue bulging through the site of a healing abdominal scar from an operation on the abdomen or pelvis.
- Epigastric hernia: A protrusion of tissue through the abdominal area between the navel and the lower part of the sternum (breastbone).
- Sports hernia (athletic pubalgia): It is an injury (usually a tear) to the muscles and/or tendons in the lower abdomen or groin that causes chronic pain.
What causes hernias?
Inguinal and femoral hernias occur due to weakened muscles either congenital or related to aging as well as repetitive pressure on the abdominal and groin area, caused by physical strain, obesity, pregnancy, chronic cough, or hard stool due to constipation.
Umbilical hernias in adults may occur in cases of obesity and heavy chronic cough or after giving birth.
The cause of hiatal hernia is not fully understood but weakening of the diaphragm with age or pressure in the abdomen is thought to play a role.
What are the symptoms of a hernia?
A swelling or bulge in the groin, the size of which may increase over time, is the main symptom of an abdominal or inguinal hernia. Other hernia symptoms include:
- Increased pain at the site of the swelling
- Pain when standing up
- A feeling of fullness or signs of bowel obstruction
In the case of hiatal hernia, there is no externally visible swelling. Instead, symptoms may include heartburn, indigestion, difficulty swallowing, frequent reflux, and chest pain.
How is a hernia diagnosed?
Usually, a lump may be seen or felt in the area where a hernia has occurred. As part of a standard physical examination, the doctor palpates the area around the testicles and groin while the patient is asked to cough. In some cases, soft tissue imaging such as a CT scan will accurately diagnose the condition.
How are hernias treated?
The treatment of a hernia usually requires surgery, ideally performed by a specialized surgeon.
A hernia can be repaired with:
- Open surgery, which requires a long incision at the site of the hernia. During the procedure, the protruding tissue is repositioned and the weakened muscle wall is sutured back together. A mesh may be implanted in the area to provide extra support.
- Laparoscopic surgery involves the same type of reconstruction, but instead of a long incision on the abdomen or groin, tiny incisions are made through thin surgical instruments are inserted.
- Robotic hernia repair, like laparoscopic surgery, uses is also performed through small incisions, but with the levels of precision, stability and accessibility only a robotic surgical system can provide. While robotic surgery has until recently been used mainly for smaller hernias or weak areas, it can now also be applied to completely reconstruct the abdominal wall.
In case any of any type of hernia its immediate repair by a specialized surgeon is essential. Dr. Chrysocheris is fully specialized in hernia surgery and is the most suitable for the repair of any hernia. Contact him and book your appointment for a personalized and immediate surgical treatment.
