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Saint Mary's Hernia Center

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Our highly skilled surgeons have expertise in many different methods of hernia repair.

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What Is a Hernia?

Hernias are holes in muscle that allow organs to protrude and possibly “bulge.” They can be present at birth (congenital) or acquired later in life. Contrary to popular belief, you do not need to feel a “pop” when lifting something heavy to have a hernia; hernias can result from long-term overuse of a muscle, and there frequently is no bulge. While the bulge can cause cosmetic concerns, the real worry with a hernia is that whatever organ is bulging can become stuck or “incarcerated,” which can lead to emergency surgery to avoid choking of the incarcerated organ. “Outie” belly buttons are hernias and should be fixed!

How Can a Hernia Be Fixed?

There are many ways to repair hernias, and the most important decision is to match the proper type of repair with the patient and their hernia. Some hernias can be repaired directly, or simply closed again. Most hernias require some type of “mesh” to reinforce the repair, and some may require rearranging muscle layers to get a strong repair. All these repairs may be done in an open fashion, or laparoscopically or even using an operative robot. Each approach has its pros and cons, and should be discussed with your surgeon. With very few exceptions, all hernias should be repaired before they become emergencies.

Frequently Asked Questions

Q) How do I know if I have a hernia?

A) Hernias can present many ways, including a pain that feels like a muscle pull that won’t go away, or a bulge, or both. Some hernias hurt, some do not. A bulge that comes out and goes back in, in any of the areas discussed below is almost always a hernia. A tender bulge in one of those areas can be an emergency situation. The combination of a painful or tender bulge with vomiting is an absolute emergency and you must go to the emergency room immediately.

Q) How can someone be born with a hernia?

A) Because of the way we are built, internal parts of our bodies must go from place to place, similar to the way water pipes in your house need to go from room to room. Those areas that need to be “open” for a structure to pass through (the belly button must allow the umbilical cord to pass through) represent natural weak spots that can then become hernias. Even a baby crying may generate enough force to push out a hernia.

Q) What is an inguinal (groin) hernia?

Groin Hernia

Figure A - Right side inguinal hernia with incarcerated or "stuck" intestines causing the classic groin / scrotal bulge of a hernia. A hernia can still be present without a bulge being present.

A) An inguinal hernia is a hole in the lower part of the abdomen that in a male, allows the tubes that carry sperm from the testicles to go to the prostate. In a female, the “round ligament” passes through this area and helps to support the uterus. There are several types of inguinal hernias, and together they are the most common types of hernia in men, women and children.

Q) What is an umbilical hernia?

Umbilical Hernia

Figure B – Umbilical Hernia with incarcerated intestine causing a bulge. An “outie” belly button is always a hernia and should be repaired before it becomes a problem. A hernia in an old incision may appear the same and should also be repaired. 

A) The umbilical cord allows blood to flow back and forth from the mother to the fetus. For this to happen, there must be a hole in the abdominal muscles, and this hole must close after the umbilical cord falls off. If the hole does not close, pressure inside the abdomen can push outwards and create an umbilical hernia. Contrary to popular belief, umbilical hernias have nothing to do with “how the doctor cut the cord”! In adults, pressure from being overweight or pregnant can cause a previously closed hole to open and cause a hernia.

Q) What is a ventral hernia?

A) A ventral hernia is any hernia on the front side of the body. Many people use this term to refer to hernias in the midline between the breast bone and bellybutton.

Q) What is an incisional hernia?

A) An incisional hernia is any hernia that occurs in an area of a previous surgical incision. Larger incisions or infections after surgery increase the chances of incisional hernias.

Q) What is a Hiatal Hernia?

A) There is an opening in the diaphragm (the muscle that separates your chest cavity from your abdominal cavity and causes you to breathe when it moves up and down) that allows the esophagus (“food pipe”) to connect to the stomach. Hiatal hernias occur when the stomach slides up through this opening into the chest. They frequently cause pain behind the sternum (breast bone), heartburn, or a sensation that food is “stuck.”

Q) What if I need a mesh?

A) While some small hernias can simply be closed, most hernias require some type of reinforcement in the form of a mesh that surrounds the hernia repair. Some meshes are designed to be permanent and some are designed to be temporary or absorbable. The type of mesh to be used needs to be discussed with your surgeon.

Q) What about my activity / lifestyle afterwards?

A) With very few exceptions, your activity and lifestyle will be back to normal after a period of recuperation. Many people who have their surgeries repaired laparoscopically or robotically only have a recuperation period of a few days.

Q) Can I do anything to avoid getting a hernia in the first place?

A) Keeping your weight in a healthy range and using proper body mechanics while lifting are the two most important things you can do to avoid getting a hernia. Smoking, having diabetes or previous surgical infections may increase the risks of getting a hernia.

Q) Why are some surgeries performed with an incision, and some performed laparoscopically? Can I choose how to have my hernia repaired?

A) The type of anesthesia needed during a surgery is just as important as the surgery itself. All laparoscopic surgeries require general anesthesia (you are completely asleep), which may not be safe for some patients. Sometimes an open surgery with just sedation for anesthesia is a better choice than a laparoscopic surgery with general anesthesia. This is something you need to discuss with your surgeon.