Treating Hernias at UPMC

A hernia happens when tissue, intestines, or other organs push through an opening between muscles or connective tissue. This will usually cause a bulge you can see under your skin.  Typically, hernias happen in the abdomen or groin, but they can also occur in the thigh or genitals. 

Unfortunately, there is no age-limit on hernias. Hernias are extremely common Your risks of developing a hernia are higher if you are male, have a family history, smoke, are overweight, or have had previous abdominal surgery. 

Types of hernias include: 

• Groin (inguinal) hernia – Often caused by heavy lifting or straining, this type of hernia is most      commonly suffered by men. 
• Upper thigh (femoral) hernia – More common among older women, this a type of hernia in which tissue or part of the intestine protrudes into the groin. 
• Hiatal hernia – This condition results in part of the stomach protruding through an opening in the diaphragm. 
• Navel (umbilical) hernia – Occurs when part of the intestine or other tissue pushes through the bellybutton. In children, this usually disappears by preschool years. 
• Abdominal (ventral) hernias – These develop in various areas of the abdomen. Incisional hernias happen at the site of a previous surgery. 

How is a hernia diagnosed? 

A hernia is most often diagnosed through a medical history and physical examination. Your doctor will ask you questions about your hernia symptoms and a review of your medical history. 

Your physician may recommend a variety of diagnostic imaging tests including; High-resolution computerized tomography (CT) scan, magnetic resonance imaging (MRI) gastrointestinal (GI) contrast study, or ultrasound may be recommended for woman, because it allows doctors to check for other pelvic conditions, such as ovarian cysts or fibroids, that can cause abdominal pain. 

How is a hernia repaired? 

Surgery is often the recommended treatment. Your doctor will refer you to a general surgeon to exam you and determine the type and size of your hernia. What that exam reveals will determine your surgical options—open repair, minimally invasive, or robotic surgery. 

During hernia repair, the surgeon will either suture the opening in the muscle or tissue or insert a mesh material to close the opening. The mesh is a permanent material that supports and strengthens the weakened area where the hernia formed. 

If possible, the surgeon will perform minimally invasive surgery through several small incisions, rather than one large incision. Innovative robotic system is a surgical option that allows for greater precision using small incisions. 

Surgical treatment options 

Several surgical options are available for hernia repair include:

• Open repair: Utilizing traditional surgical incisions, the surgeon reaches the hernia, through a larger incision replaces protruding tissue and sews up torn muscle or tissue. A synthetic mesh may be added to support the area and prevent a reoccurrence of the hernia. 
• Laparoscopic repair: This approach utilizes only a few small incisions. A tiny camera is placed through one incision to guide the surgeon. Small instruments are inserted through another incision to repair the hernia. Laparoscopic surgery generally offers a faster recovery time than open repair but may not be appropriate for all conditions or patients. 
• Robotic surgery repair: Robotic-assisted hernia repair is a minimally invasive surgical option that is performed through small incisions. The surgery allows for a lower rate of recurrence, less pain and faster recovery. 

If a hernia goes untreated, potential complications may include: 

• Increase in size and become more painful. 
• A portion of the intestine becoming trapped in the abdominal wall, causing a bowel obstruction. This can cause severe pain, nausea or constipation. 
• Blood supply to the intestine being compromised, and increase the risk for perforation, which can be life-threatening and require emergency surgery.