A hernia is a weakness in the abdominal wall that allows abdominal organs to bulge out. The bulge may be more noticeable when sneezing, coughing, lifting or other exertion.
The natural course of a hernia is for it to slowly enlarge and worsen over time. Doctors sometimes provide a truss or belt for hernias to support the abdominal wall and alleviate some of the symptoms. But this is not a cure.
The only way to “fix” a hernia is by surgery. We recommend that the majority of people with hernias have surgery to repair them, even if they do not have symptoms. This is because hernias have the potential for strangulation, a serious problem that occurs when part of your intestine gets trapped inside the hernia. If strangulation occurs, emergency surgery is necessary to prevent life-threatening complications, such as gangrene.
Once hernia surgery is performed, trusses (supportive braces worn around the abdomen or groin) are no longer needed, and people may resume normal activities.
Types of Hernias
Inguinal or Groin Hernias
- Inguinal or groin hernias are the most common type of hernia to occur.
- Inguinal hernias are much more common in men.
- Symptoms include a bulge in the groin area that may be accompanied by pain or a dull ache when standing for prolonged periods of time, when doing heavy lifting, coughing or straining.
- Umbilical hernias result from a weakness in the abdominal wall at the site of your belly button.
- People at higher risk for umbilical hernias are those who have had prior surgery at the site of their belly button, women who have had children and obese people.
- Symptoms include a bulge in the area that may be accompanied by pain or a dull ache when standing for prolonged periods of time, when doing heavy lifting, coughing or straining.
- A ventral/incisional hernia can occur anywhere on the abdominal wall. If you have had prior surgery on your abdomen this type of hernia may occur at the site of your scar.
- Symptoms can include a bulge in the area that may be accompanied by pain or a dull ache when standing for prolonged periods of time, when doing heavy lifting, coughing or straining.
Hiatal and Paraesophageal Hiatal Hernias
- A hiatal hernia occurs when the stomach slides though the opening in the diaphragm – the muscular wall separating the chest cavity from the abdomen. The opening is called the hiatus. Normally, the esophagus goes through the hiatus and attaches to the stomach.
- A paraesophageal hernia is a hiatal hernia where a portion of the stomach squeezes up through the hiatus so that part of the stomach is sitting next to the esophagus. This is a less common and more dangerous form of hiatal hernia. UC San Diego Health’s esophageal surgeons treat Hiatal and Paraesophageal Hiatal Hernias.
Types of Surgery for Hernias
The two basic types of hernia surgery are open and laparoscopic.
- Open surgery is performed with a single long incision over the hernia.
- Laparoscopic surgery is performed using several small incisions rather than one large one. A fine tube with a tiny camera is inserted into the body through one incision, and miniature instruments are inserted through the other incisions. Your surgeon then performs the operation using the video camera as a guide.
During the hernia repair, your surgeon will either push the affected tissue back into place or remove it, and then use a piece of mesh to cover the weakened area. The mesh is usually secured with sutures or staples. This technique helps to strengthen the repair and decreases the lifelong recurrence rate.
In some cases, mesh is not used and the healthy tissue is simply stitched back together with sutures after the hernia repair. This procedure is called herniorrhaphy.
We offer hernia repairs that may involve local anesthesia, light sedation, spinal anesthesia and general anesthesia. Depending on your individual case, your surgeon may choose to use regional anesthesia, a technique that uses local nerve blocks rather than general anesthesia. The benefits of regional anesthesia include less pain, fewer side effects, a faster recovery time and less time spent in the hospital.
We will help you understand your surgical options depending on your condition and the type of hernia you are experiencing.