A hernia is a tear or hole in a muscle that allows the tissue and organs that should stay on the inside slide out through the hole. Hernias are typically identified as bulges that often appear and then disappear throughout the day as the tissue slides in and out. There are several different locations that hernias develop.
Inguinal Hernias: These are hernias in the groin that most people think about first when they hear the term “hernia.” A tear can develop after lifting something heavy, or it can be present when you are born, just very, very small. Over time, this tiny opening can expand slowly, resulting in a hole large enough for your intestines or the fat inside your abdomen to protrude through. Typically these hernias require a minor surgery for repair, without requiring an overnight stay.
Umbilical Henias: These hernias develop in your belly button and start as a very small hole that expands over decades to allow for the tissues inside your abdomen to protrude through. Although these are usually small, they can become quite large, particularly in the obese. If they are not uncomfortable, they are typically left alone, however if they cause pain or become tender, we usually recommend repair.
Incisional Hernias: Hernias that occur through previous incisions can become very difficult problems because, in some cases, they can become quite large. These hernias are the most challenging problems, both for the surgeon and the patient since they can become painful and even interfere with your ability to remain mobile. We usually recommend repair of all incisional hernias unless a patient has lots of medical problems or the surgery is particularly risky.
Hiatal Hernias: Hiatal hernias can’t be seen from the outside or identified on physical exam, they can only be found through specialized x-rays or endoscopies. They are extremely common and are usually small. Small hiatal hernias often do not cause any symptoms, however they can result in heartburn. The typical treatment is acid blocking medication. Rarely, hiatal hernias can become very large and cause significant heartburn and abdominal pain. In this situation, repair is usually indicated.
Dr. Weiner typically approaches most hernias using a laparoscopic technique allowing for a faster patient recovery and often a better long term result. He typically uses mesh to repair inguinal hernias, large umbilical hernias and incisional hernias. He does not use mesh to repair hiatal hernias.