A hernia is a rupture commonly found in the abdomen or groin region. It is often first noticed as a lump that appears when part of the tissue lining the abdominal cavity breaks through a weak abdominal wall. This can be uncomfortable when the hernia becomes enlarged and can be life-threatening if a portion of the intestine gets trapped inside. The best hernia treatment is surgery. The type of surgery depends on the location of the hernia.
Inguinal (Groin) Hernia
Inguinal hernias develop when tissue from the intestine breaks through a tear or weak area in the lower abdominal wall. The bulge that results may be painful, especially when you lift something heavy or when you cough. An inguinal hernia itself is not dangerous, but it can lead to dangerous complications. Surgical repair of the hernia is usually recommended. This can be accomplished with one of two surgeries.
With a herniorrhaphy, the surgeon makes an incision in the groin and pushes the intestine back into the abdomen. He then repairs the torn or weakened muscle by stitching it together.
With a hernioplasty, the surgeon inserts a piece of synthetic mesh over the complete inguinal area. The patch is secured with stitches, staples or clips. Hernioplasty is sometimes performed with one long incision cut over the hernia. More often it is performed laparoscopically with a few small incisions instead of a single large one.
Umbilical (Navel) Hernia
An umbilical hernia develops when a portion of the intestine protrudes in a weak area of the abdominal muscles. A common umbilical hernia is a baby's protruding navel. They are found most often in infants, but adults can develop them as well. Umbilical hernias usually close by themselves by the time an infant is 1 year old. Umbilical hernias that have not disappeared by age 4, or adult onset umbilical hernia, may require surgery.
With an umbilical hernia, the surgeon makes a small incision at the base of the navel. The protruding tissue is put back into the abdominal cavity, and the abdominal wall opening is sutured closed.
Hiatal Hernia
A hiatal hernia develops at the opening of the diaphragm where the esophagus joins the stomach. A portion of the stomach breaks through the opening. A small hiatal hernia usually will not cause problems and may not even be discovered. A larger hiatal hernia may allow food and acid to slip back up into the esophagus, which can lead to chest pain and heartburn. Very large hernias may need to be repaired surgically.
With a hiatal hernia, the surgeon makes an incision in the mid-abdominal section. He tightens the esophageal hiatus with stitches to prevent herniation. He then pulls the upper part of the stomach behind the esophagus and wraps it around the lower part of the esophagus to create a valve which will prevent any stomach acid from being able to reflux into the esophagus.
