Hernia Types – Pasadena Robotic Hernia Specialist

What is a Hernia?

A hernia occurs when an organ pushes out of a weakened portion of muscle in which it normally resides. Typically caused by the combination of pressure and a weakened portion of the surrounding muscle. For example, the most common is the inguinal hernia, where the intestines may protrude through the abdominal wall.

Most commonly, hernias develop in the abdomen. Though they also appear in the upper thigh, belly button, and groin area. Most hernias are not immediate life-threatening complications, however they will not go away on their own and require surgical correction to prevent it from potentially becoming one.

Common Hernia Types

Inguinal Hernia

Inguinal Hernia

Inguinal hernias occur when tissue squeezes its way through a weak spot in the groin muscle, causing a bulge in the groin or scrotum that may cause pain or a burning sensation. The bulge may develop over a timeframe of weeks or months, however can appear suddenly after lifting heavy weights, coughing, straining, or even laughing.

The bulge may develop over a timeframe of weeks or months; however, they can also appear suddenly after lifting heavy weights, coughing, straining, or even laughing.

Inguinal hernias are the most common type of hernia and make up almost 3/4 of all hernias treated. Many people often do not seek treatment for this specific hernia because no symptoms may be seen. However, if you suspect an inguinal hernia, prompt medical attention can prevent it from becoming a discomfort.

The inguinal canal is found at the base of the abdomen in the groin area. In men, it is the area where the spermatic cord passes from the abdomen to the scrotum, holding up the testicles. In women, the inguinal canal contains a ligament that helps to hold the uterus in place. While the inguinal canal is present in both men and women, this hernia is more common in men. This is because after the man’s testicles descend through the inguinal canal shortly after birth, the canal is supposed to close almost completely behind them. Unfortunately, the canal does not always close properly, thus leaving a weakened spot prone to hernias.

Hiatal Hernia

Hiatal Hernia

A hiatal hernia occurs when the upper part of your stomach bulges through your diaphragm into your chest cavity.

A hiatal hernia occurs when the upper portion of the stomach bulges through the diaphragm into the chest cavity. Since the diaphragm has a small opening to allow access to the esophagus to connect to the stomach, the stomach will often push up through this opening. Most hiatal hernias will not be discovered, causing no problems. However if the hiatal hernia is large, it can cause food and acid to back up in the esophagus. Patients over 50 years old will often be diagnosed with hiatal hernias. If a child has the condition, it is typically caused by a congenital (birth) defect.

Umbilical Hernia

An umbilical hernia when a portion of the intestine pushes through the umbilical opening in the abdominal muscles and navel. Most umbilical hernias are common and typically harmless, though you should seek medical advice if you find a bulge near your navel as immediate diagnosis and treatment will help prevent any avoidable complications. Emergency care is highly recommended as soon as the bulge becomes painful or tender.

Being overweight or having multiple pregnancies may increase the risk of developing an umbilical hernia. More commonly found in women, the umbilical hernia will grow bigger over time. Leaving the hernia untreated can lead to it becoming a strangulated hernia, which is when the intestine or fat is trapped and the blood supply to the tissue is cut off. Strangulated hernias are very painful and require emergency surgery.

Incisional Hernia

Incisional hernias can occur months or even years after a previous abdominal surgery. The intestines may push through the incision scar or the surrounding, weakened tissue. Usual incisions made are to get an internal organ such as the appendix, or a caesarian section. The incisional hernia is the next most common hernia, behind the inguinal hernia.


What Causes a Hernia?

Hernias are developed from increased pressure and strain of a weakness in the muscles and or connective tissues. A hernia can develop quickly or over a long period of time, depending on its cause.

Common causes of muscle weakness include:

  • Failure of the abdominal wall to close properly in the womb (congenital defect)
  • Age
  • Chronic coughing
  • Damage from injury or surgery

Factors that strain your body and may cause a hernia (especially if your muscles are weak) include:

  • Being pregnant (puts pressure on your abdomen)
  • Being constipated (causes you to strain when having a bowel movement)
  • Heavy weight lifting
  • Fluid in the abdomen (ascites)
  • Suddenly gaining weight
  • Persistent coughing or sneezing

Am I at Risk for a Hernia?

Several factors increase your risk of developing a hernia, including:

  • A personal or family history of hernias
  • Being overweight or obese
  • A chronic cough
  • Chronic constipation
  • Smoking (which can trigger a chronic cough)

Conditions such as cystic fibrosis can also indirectly increase your risk of developing a hernia. Cystic fibrosis impairs the function of the lungs, causing a chronic cough which can contribute to hernias.

What Are the Symptoms of a Hernia?

In most cases, the hernia causes no more than painless swelling in the abdominal area. There are times when the hernia will cause discomfort and pain, often worsening when standing, straining, or lifting heavy objects.

Other common symptoms of an inguinal hernia include:

  • Pain or discomfort in the affected area (usually the lower abdomen), especially when bending over, coughing, or lifting
  • Weakness, pressure, or a feeling of heaviness in the abdomen
  • A burning, gurgling, or aching sensation at the site of the bulge

Other symptoms of a hiatal hernia include:

  • Acid reflux (when stomach acid moves backwards into the esophagus causing a burning sensation)
  • Chest pain
  • Difficulty swallowing

How Is a Hernia Diagnosed?

Doctors can correctly diagnose a hernia through a physical examination. They may feel for a bulge in your abdomen or groin that gets larger when you stand, cough, or strain.
A hiatal hernia may be diagnosed with a barium X-ray or an endoscopy. A barium X-ray is a series of X-ray pictures of your digestive tract that are recorded after drinking a barium-containing liquid solution, which shows up well on X-ray images. An endoscopy involves threading a small camera attached to a tube down the throat and into the esophagus and stomach.


Surgery and Treatment Options for Hernias

Depending on the size of the hernia and severity of the symptoms, surgery may be required. The doctor may simply monitor the hernia for possible complications.

Symptoms of a hiatal hernia can often be treated by simply changing diet. Avoid large or heavy meals, do not lie down or bend over after a meal, and keep body weight in a healthy range. If these changes in diet do not eliminate discomfort, surgery might be required to correct the hernia.

A doctor will only operate if the hernia grows larger and causes pain. Remember, not all hernias are painful. Repairing a hernia through means of surgery can be completed by sewing the hole in the abdominal wall closed. However, the more common treatment for hernias is to patch the hole with surgical mesh. Both methods of surgical treatment of hernias can be repaired with laparoscopic or robotic surgery.

Laparoscopic Surgery

Laparoscopic surgery implements a tiny camera and miniaturized surgical equipment to repair the hernia using only a few small incisions. This minimally invasive procedure produces less damage to the surrounding tissues compared to traditional open surgery. Open surgery also requires a longer recovery process, typically being unable to move for up to six weeks. Laparoscopic surgery has a much shorter recovery time; however, the risk of the hernia recurrence is higher. In addition, not all hernias are suitable for laparoscopic repair, including those in which a portion of your intestines has moved down into the scrotum.

Robotic Surgery

Although Dr. Alexander has decades of experience with laparoscopic hernia repair, he prefers to use advanced robotic surgery for the treatment and repair of inguinal (groin) hernias in both men and women. While robotic surgery provides the same benefits as laparoscopic surgery, it also improves the surgeon’s visualization, dexterity, and precision. As the most advanced, minimally invasive procedure available, robotic surgery can be performed in patients who are not candidates for laparoscopic repair and would have otherwise required an open hernia repair. Inquire with Dr. Alexander today to see if you are a candidate for a da Vinci robotic hernia repair.


Potential Complications of a Hernia

While most hernias are painless, if left untreated for too long, it will probably grow larger and more painful. “Incarceration” of a portion of the intestine in the abdominal wall can obstruct bowel movements, causing severe pain, nausea, and constipation.

“Strangulation” occurs if the trapped section of intestine cannot receive enough blood flow. This can cause the intestinal tissue to become infected or die and is a life threatening medical emergency.

Preventing a Hernia

Muscle weakness that allows a hernia to occur cannot be completely avoided. However, by reducing the amount of strain in place on the body, it may help prevent a hernia or keep an existing hernia from getting worse.

Tips to help prevent hernias include:

  • Not smoking
  • Seeing your doctor when you are sick to avoid developing a persistent cough
  • Maintaining a healthy body weight
  • Avoiding straining during bowel movements or urination
  • Not lifting weights that are too heavy for you and lifting with your knees, not your back.

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pasadena hernia specialist doctor magdi alexander md

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