As a general surgeon accredited by the American Board of Surgery, I have practiced all types of general surgery for over 30 years. I have extensive experience with hernia repair, including complex incisional and multiple abdominal-wall defects. I am joined by a colleague, Ahmed Zihni, MD, FACS, at Prowers Medical Center. In addition to abdominal hernias, Dr. Zihni also treats hiatal hernias of the diaphragm.

In this article, I will explain the signs and symptoms of abdominal hernias and the need for surgical repair.

First, hernias are a common health issue affecting both men and women. Approximately five million people in the United States suffer from a hernia, but only about 1.6 million hernia repairs are performed each year, according to the National Center for Health Statistics and the American College of Surgeons. This discrepancy exists because not all hernias require immediate surgical intervention.

Inguinal hernias are the most common type. Others include incisional, midline or ventral, umbilical, peristomal and a small contingent of other infrequent types of abdominal wall defects.

Inguinal hernias are those that occur in the groin, in an area called the inguinal canal. The National Institutes of Health estimates that 27% of all men in the United States will at some point develop an inguinal hernia, while just 3% of women will.

Surgical Services at Prowers Medical Center

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• Highly experienced, board-certified surgeons

• Most procedures are minimally invasive

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For appointments, call 719-336-7005.

Hernia Symptoms

Common symptoms of an inguinal hernia include an obvious bulge, which may or may not be painful. Certainly, any enlarging bulge of the abdominal wall should be evaluated for possible hernia. Any asymmetry of the body from one side to the other might also be a sign of a hernia. Many times, the hernia manifests without an obvious injury or event to have caused it, but injury or trauma can also cause a hernia to develop.

Enlargement is a sign that a provider should examine the hernia. Any increasing pain, or a mass or lump that cannot be pushed back into the abdominal cavity, warrants immediate attention in the emergency department if symptoms are severe.

The best time to repair a hernia is when it is small and mostly asymptomatic. This is because the hernia has not yet become significantly inflamed. A hernia that is not inflamed at the time of the repair will provide for a quick and far less painful recovery.

Hernia Repair

The only treatment for a hernia is surgical. No noninvasive, physical therapy techniques or strengthening exercises exist that will treat the problem of hernias. Hernia repairs are done either with open surgery or, more frequently today, with minimally invasive surgical techniques, otherwise known as MIS surgery. Open repairs, of necessity, require a much longer incision, as opposed to MIS techniques, which use small incisions and access points called trocars. It is well-documented in most surgical studies that MIS techniques are associated with similar outcomes to open techniques but with a quicker recovery and less discomfort. I completed over 95% of hernia cases using MIS techniques.

In 95% of cases, hernia repair requires the surgeon to use some form of reinforcement to ensure the hernia will not reoccur. If it does reoccur, the hernia becomes much more complex and the surgery more difficult.

Next week, in Part Two of this article, I will explain the surgical mesh options and why I prefer a newer type of biologic material.

Dr. DeLine and Dr. Zihni are available for hernia consultations and, if needed, surgery at Prowers Medical Center. To make an appointment, call 719-336-7005.