Hernias

What is a Hernia?

  • A hernia is an abnormal protrusion of the contents of a cavity through its walls. Hernias are most commonly seen in the abdominal cavity and hence the term hernia is often used synonymously with an abdominal hernia

General Hernia Facts

  • 75% of all abdominal-wall hernias are Inguinal Hernias

  • Umbilical Hernias developed due to a weakened opening in the abdominal wall, which should normally close before birth but fails to close completely.

  • Incisional Hernias develop through a weak abdominal wall after abdominal surgery

  • Ventral Hernia is a hernia that surfaces on any part of the anterior (or ventral)  surface of the abdominal area.

  • The two types of procedures used to treat hernias are: traditional (open) hernia repair and laparoscopic or robotic hernia repair

Epigastric Hernia
Right Inguinal Hernia female
Right Inguinal Hernia male
Large Inguinal-scrotal Hernia
Epigastric Hernia
Large Scrotal Inguinal Hernia
Femoral Hernia Incarcerated
Umbilical Hernia
Bilateral Inguinal Hernias
Incisional Hernia

Predisposing Factors

  • Obesity

  • Chronic obstructive pulmonary disease

  • Smoking

  • Pregnancy

  • Straining

  • Family history of hernia

  • Heavy lifting

  • Connective tissue disorders

  • Prostatism

  • Coughing

  • Advanced age

  • Previous surgeries

WHAT IS A HERNIA?

A hernia is an abnormal protrusion of the contents of a cavity through its walls. Hernias are most commonly seen in the abdominal cavity and hence the term hernia is often used synonymously with an abdominal hernia.  75% of all abdominal-wall hernias are inguinal hernias (groin hernias). An inguinal hernia occurs when part of the abdominal cavity, sometimes fat or intestines, bulges through an opening in the groin muscles. This bulge sometimes stays limited to the groin or goes down to the scrotal area in men, depending on the type of inguinal hernia.

Umbilical hernias develop due to a weakened opening in the abdominal wall (the area where the umbilical cord enters the fetus in uterus), which should normally close before birth but fails to close completely. Incisional hernias develop through a weak abdominal wall after abdominal surgery (in the area of a previous operation). Another type, Ventral hernias, are hernias that surface on any part of the anterior (or ventral) surface of the abdominal area.

 

The prevalence of hernias in the world is between 5-10% and the most common one is the inguinal hernia, followed by incisional and umbilical hernias. 75% occur in men and it is estimated that 1 in 30 adults will eventually develop a hernia.

 

A hernia surgery is one of the most common operations a general surgeon will do and in the United States alone, there are nearly 1,000,000 hernia surgeries performed every year. 

Risk factors for hernias include obesity, chronic obstructive pulmonary disease, smoking, pregnancy, straining, family history of hernia, heavy lifting, connective tissue disorders, prostatism, excessive coughing, advanced age and previous surgeries.

 

The normal intra-abdominal pressure is around 8 cmH20 when you are laying down. It increases to around 35 in the lower abdomen just by standing up. During defecation, urination or giving birth, it could increase to 150-180 cm H20. Anything that increases the intra-abdominal pressure is a risk factor for hernias or it worsens existing hernias.

 

5 Important things to consider when choosing your Hernia Surgeon or Hernia Specialist:

  • 1. Does your surgeon perform routine and complex hernia procedures? Surgeons who perform complex hernia procedures in general have more experience in the treatment of hernias

  • 2. Consider having your surgery done by a hernia surgeon with a practice focused only on hernias and a high volume of cases per year

  • 3. You want to know all the different treatment options. Your surgeon should perform all types of hernia repair: open, laparoscopic, mesh and no mesh

  • 4. Ask about outcomes, recurrence rates, types of mesh used and where is the mesh going to be located

  • 5. When given a choice most patients will rather have a surgeon with extensive experience in a specific field do their surgery

How long can a hernia go untreated?

With the exception of some small umbilical hernias in children less than 5 years old, hernias usually don’t get better with time. The only way to fix them is with surgery. With time, most untreated hernias become painful and tend to enlarge. The bigger the hernia, the more difficult the hernia surgery to fix it. Larger hernias also tend to have a higher chance of recurrence in the future. 

 

A hernia is called a “reducible hernia” when the bulge can be pushed back into the abdomen. An incarcerated or a “non-reducible hernia” occurs when the contents inside the hernia sac cannot be pushed back into their normal anatomic position inside the abdomen. Incarcerated hernias can sometimes become “strangulated” when the blood supply to the organs that are entrapped (intestines or fat or other organs) becomes compromised and the tissue dies. This is a surgical emergency that requires immediate operation with a higher morbidity and mortality. 

To avoid major complications, if you feel a bulge that might be a hernia come to the Miami Hernia Center for a full examination with one of the Top Hernia Specialist in South Florida.

Tummy tucks and Hernias

Tummy tucks are a very popular way to contour the abdomen. It is not uncommon to perform a tummy tuck at the same time of an umbilical or ventral hernia repair. Most of the time, the insurance will cover the hernia repair and the patient would pay the extra fee for the tummy tuck. You should contact your insurance provider to verify your specific plan benefits. They will normally give you recommendations on how to proceed. At the Miami Hernia Center we coordinate with many Plastic Surgeons in order to provide the best possible treatment for our patients. One of the main advantages is that you will have to go only through one anesthetic and one post-operative recovery period for both procedures.

 

Additionally, if the the hernia is big enough that requires mesh, many times we place the mesh in the pre-peritoneal space covered by the muscle. The risks, benefits and alternative treatment options will be discussed with each patient prior to any procedure. For more information, come and visit us at The Miami Hernia Center.

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