If you’ve experienced the pain of a hernia, you know it’s no laughing matter. A hernia occurs when tissue, such as part of the intestine, protrudes through a weak spot in the muscles. The resulting bulge can be painful, especially when you cough, bend over or lift a heavy object. As a surgeon specializing in hernia repair, I’ve found that hernias are no respecter of persons: men and women, heavy and thin, young and old, all fall prey to this common medical condition.
According to the National Institutes of Health, more than 700,000 hernia repairs are carried out in the United States yearly. Groin hernias occur in approximately two percent of the adult population and four percent of infants. Congenital weakness is to blame for most cases of childhood hernias, while those in adults are often triggered by repetitive straining and lifting. Less common forms are incisional hernias (resulting from prior surgeries) and traumatic hernias, which may follow blunt trauma.
Hernia symptoms include bulging and discomfort, both of which can be gradual in onset as muscle weakness progresses and the hole expands. That’s why it’s not uncommon for patients to experience symptoms for weeks or even months before talking to their doctor.
When patients land in a surgeon’s office, they’re often surprised to learn that surgery isn’t always imminent. Many smaller hernias are safe to live with short-term, allowing patients time to plan surgeries around their own schedule. Hernia repairs are typically performed in same-day surgery, and can take anywhere from 30 minutes to several hours depending on complexity. Fortunately, advances in laparoscopic medicine allow most hernias to be repaired through very small incisions, as opposed to traditional open surgeries of decades past. That means less pain and down time for the patient, who typically is on lifting restrictions for one to six weeks post-op. Robotic-assisted technology is also revolutionizing hernia surgery, as flexible cameras and instrumentation allow for greater precision and better access to the surgical site.
Small hernias, such as those around the belly button, are often repaired by a simple suture. Larger hernias often require a non-absorbable mesh implant, which remains in the body indefinitely to provide permanent reinforcement. While mesh occasionally gets recalled, the technology itself is very safe. In fact, repairs made without mesh may have a one-third chance of reoccurrence, compared to a single digit risk in those who receive the implant.
While delaying surgery is common and safe, it’s not without risks. One of the greatest threats of hernia damage is intestinal strangulation, in which a section of the intestines pushes through a weakened area of the abdominal muscle. The surrounding muscle then clamps down around the tissue, cutting off blood supply to the intestine. This can lead to intestinal perforation or shock, which can prove fatal in severe cases. It can happen suddenly and is extremely painful. Patients often experience fever, nausea or vomiting, and sometimes bloody stools, constipation or other gastrointestinal complaints. If you have a hernia and experience these symptoms, seek medical attention immediately.
If you experience hernia symptoms, talk to your doctor about diagnosis and treatment options. And if you’ve chosen to delay treatment, be cognizant of sudden changes or increased pain. Hernia repair can be a welcome, life-changing procedure for those who are tired of living with the pain and discomfort.
Dustin Smith, M.D., F.A.C.S., is a board-certified general surgeon at Williamson Medical Group and is a member of the American College of Surgeons and an active member of the Society of American Gastrointestinal and Endoscopic Surgeons. Dr. Smith lives in Franklin with his wife and three children. To schedule an appointment with Dr. Smith, call (615) 794-8900.Share this Article