A hernia is defined as a opening that allows protrusion of an organ through the wall of the cavity that normally contains it. Hernias are typically categorized by the area that the bulge is located. Not all hernias need to be fixed, but most hernias cause some symptoms and place you at risk of getting something stuck in the opening which can lead to an emergency as blood supply is cut off from the tissue stuck in the opening.
At Southwest General Surgery we operate on hernias arising with the abdomen a regular basis and are well versed on the current literature and operative techniques used for fixing hernias. The information below is general and every patient is different. We would be happy to talk about your specific case and discuss the appropriate work-up and treatment of your issue.
Groin hernias occur in the lower abdomen on either the left or the right at about the level of the groin crease. They can be congenital or from tears in the connective tissue of the abdominal wall from high pressure created by lifting heavy objects, chronic coughs, etc. Groin hernias can be either inguinal hernias or femoral hernias. Not all of these hernias have to be fixed, but it is generally suggested that repair be performed for all patients that are symptomatic or simply desire repair.
There are a number of repairs described for groin hernias. We generally suggest a repair with a synthetic mesh as the recurrence rates are much lower when mesh is used. Also, laparoscopic and open techniques are both acceptable. We are happy to discuss the pros/cons of each and allow you to make an informed decision.
Umbilical (bellybutton) hernias are very common and are often described as someone having an "outtie" bellybutton. They are especially common after pregnancy as the abdominal wall is stretched with the growing uterus. Most are small, but despite their size they can cause significant discomfort. In this situation referral to a surgeon to discuss repair is warranted.
There are several ways to fix an umbilical hernia including laparoscopic and open. Repairs with and without mesh are also acceptable depending on size, though repairs with mesh clearly have a lower recurrence rate. We would be happy to discuss the options with you and make recommendations after complete evaluation.
Ventral hernias are holes in the connective tissue of anterior abdominal wall. Most of these are due previous abdominal operations and failure of the connective tissue to completely heal after the incision was closed. Some, however, come about after never having had an abdominal operation. These hernias can cause pain, difficulty with GI motility, and self esteem problems.
Repair of some of these large hernias can be complex and it is important to have a surgeon who understands the techniques and technology available. We have a thorough understanding of both. Whether you've had repairs in the past that have failed or other complicating factors, we would be happy to discuss the options with you. We perform both open and laparoscopic repairs when indicated and used both synthetic and biologic meshes where appropriate.
Hiatal and paraesophageal hernias are two names for essentially the same thing. The hiatus is where the esophagus crosses through the diaphragm into the abdominal cavity. When the hiatus is enlarged it can allow the stomach or other organs to bulge through the opening. The most common symptoms are reflux and chest pain, but can also have a feeling like food is getting stuck in the esophagus. Not all of these hernias need to be fixed, but if anything more than just the upper part of the stomach is herniated through the hiatus, repair is indicated to prevent the herniated tissues from dying from no blood flow as twisting is common. Also, even if just the upper part of the stomach is herniated and you are having symptoms that are not controlled with medical treatment, you may be a candidate for surgery.
We prefer to perform most of these repairs laparopscopically, but sometimes size and previous operations dictate an open approach. We would be happy to review your case and discuss specific options with you.