WHAT IS A HERNIA?
A hernia is a weakness or tear in the abdominal wall lining or muscles that allows intraabdominal fatty tissue or organs to protrude into the space beneath the skin. This may cause a noticeable bulge in the surface of the skin and may lead to pain or discomfort from the pressure of the tissues pushing through the torn abdominal lining.

Hernias must be treated when diagnosed, as hernias will not spontaneously heal themselves but will only increase in size over time. The larger the hernia becomes, the more difficult it is to repair. Also, if left untreated, hernias can lead to life-threatening complications such as obstruction of the intestines or loss of blood supply to intraabdominal organs caught in the hernia sac.

HERNIA SYMPTOMS
The signs and symptoms of a hernia are varied. The size of the hernia, its’ location, the patient’s body type and the contents of the hernia sac all play a roll in the different types of symptoms which may be experienced by the hernia patient. There may be a small, firm, painless “lump” which spontaneously goes away when the patient lies down. There may be pain, discomfort, burning or a stretching sensation, with or without an associated “lump” which occur when straining (such as urinating, coughing or trying to have a bowel movement) or even when just standing for prolonged periods. There may be a tender, painful “lump” which occurs when standing and requires lying flat and gently massaging to make it go away. Any of these symptoms may be indicative of a hernia. If you have these symptoms you should call the doctor’s office to schedule an evaluation to determine whether or not a hernia is present and when it should be repaired.

EMERGENCY SYMPTOMS
If left untreated, a hernia can become a medical emergency. This can occur when the tissues inside the hernia sac become trapped outside the body (known as an incarcerated hernia). If this condition is left untreated, these tissues (often intestines) may lose their blood supply. This is known as a strangulated hernia and may result in death of the tissue with the subsequent need for emergency abdominal surgery. If you have been diagnosed with a hernia and have severe, unremitting groin or abdominal pain, a “lump” which is very firm and will not “go back in” with gentle massage while lying flat, abdominal distention, nausea/vomiting and an inability to pass flatus or stool or the passage of rectal blood, you should either call 911 or report to the nearest emergency medical facility.

TYPES OF HERNIAS
Hernias can occur in many locations but by far the most common ones are in the groin (inguinal hernias), at the navel (umbilical hernias) and at the site of prior surgical incisions, especially when they are on the abdomen (epigastric, incisional or ventral hernias).
These areas on the abdominal wall are weaker, either because of natural fetal development or because of a prior incision, and are more subject to wear and tear or strain. Hernias in all of these locations are easily repaired with an outpatient procedure and will allow rapid return to work or normal activity level with a minimum of pain.

TREATMENT OPTIONS
Hernia surgery has evolved tremendously over the past few years. Whereas in the past a hernia repair often involved hospitalization and slow return to work and normal activities, herniorraphy is now performed as an outpatient procedure with rapid recovery, decreased postoperative pain and earlier return to work and activities. Much of this is due to improved surgical techniques, better anesthetic agents and improved knowledge of anatomy and physiology. A lot of this is also due to the development of prosthetic materials (mesh) which is used to patch hernia defects. This mesh can be placed at the hernia defect through either a small incision at the hernia under a local anesthetic, or via a laparoscopic approach with a general anesthetic. Which method is best for you will be discussed more thoroughly at the time of your evaluation.