What is a Hernia?
Diagram from uptodate.com

Hernias are openings or weaknesses in the abdominal wall that organs, fat or intestines can protrude through and cause a bulge and other associated symptoms. These can occur from age-related wear and tear, strenuous activity such as powerlifting, weight gain, or from previous surgeries which cause holes or tears in the abdominal wall. The most common types of hernias are in the groin, called inguinal hernias, but other hernias include hiatal hernias (in the chest), femoral hernias (similar to inguinal hernias but more dangerous), ventral hernias (in the front of your abdomen), umbilical hernias (through your belly button), flank hernias (on your flanks), or incisional hernias (caused by previous surgery). Most patients with hernias have symptoms, however hernias are inherently dangerous due to the fact that intestines or organs can get caught in the hernia and can be damaged. The inability to reduce hernia contents into your abdomen would label those hernias as incarcerated, and when those contents are damaged, these hernias are labeled strangulated. We try to repair hernias before they get strangulated.

There are many different ways to repair hernias, and more and more techniques are being developed which improve the outcomes of hernia repair and reduce complications. Our surgeons specialize in the latest techniques for hernia repair, from robotic abdominal wall reconstruction, Transversus Abdominis release, and enhanced access surgery which allows for repair of the entire hernia without ever entering your abdominal cavity.

Hernia types:

The following is a list of major and some minor types of hernias that may occur in individuals:

Inguinal hernias:

An inguinal hernia is a hernia in the groin, where a weakness in the abdominal wall allows underlying structures, usually intestine, to push through, creating a bulge. This bulge can have mild symptoms, but in some circumstances can cause debilitating and life limiting pain and discomfort. There are several techniques utilized for the repair of an inguinal hernia. Your repair options should be discussed with your surgeon to determine the best approach for your specific circumstance. Even if you have had previous surgery in your groin such as a previous hernia repair or a prostate removal, minimally invasive surgery is still a possibility.

Femoral hernias:

These hernias are similar to inguinal hernias but occur below the area where regular groin hernias are formed. Femoral hernias more often occur in women and after pregnancy or childbirth. These hernias are more dangerous than an inguinal hernia as they have a high rate of strangulation. If you are concerned for a femoral hernia, please consult with a hernia surgeon right away.

Umbilical hernias:

These hernias are present in all children, as this hernia represents the space in which the umbilical cord goes through. Most of the time this space closes before the age of 5, but may appear in adults as they age. They can come back after pregnancy, childbirth, weight gain, or in instances of increased amounts of heavy lifting. These can most often be repaired with a small incision and a few sutures, but if larger may need to be covered with a mesh. In circumstances where diastasis recti is present (a large gap or bulge between the ab muscles, normally located above the belly button), a more extensive surgery may need to be performed which repairs both at the same time.

Ventral (incisional hernias):

These hernias are on the ventral (front) side of your abdomen. Typically these are caused by previous surgical incisions and are specified as "incisional" hernias. Traditionally these hernias used to be repaired with large incisions and long, complex operations. But The Hernia Institute of New Jersey, which is a part of Shore Minimally Invasive Surgery, specializes in minimally invasive repair of these hernias. Dr. Dupree and Dr. George are experts in their field of incisional hernia repair and have lectured at the local and national level about their techniques.

Hiatal hernias:

These hernias occur through the diaphragm, where the esophagus goes through. These hernias typically do not produce the same bulge as other hernias, but can cause reflux, heartburn, regurgitation, or other gastrointestinal symptoms. Please look at the REFLUX AND FOREGUT SURGERY tab for additional information.

Groin Pain:

Groin pain can affect anyone, even in the absence of previous surgery. Some pain can be caused by neurologic disorders, bone, muscle or tendon disorders. Groin pain also affects those who have had previous hernia repair. Even in the most perfect of scenarios, chronic pain can still occur. Our center offers complex methods of helping you with groin pain such as injections, mesh removal, recurrent hernia repair, as well as nerve excision. We know that groin pain can be a debilitating disease and will help you along every step of the way.

Abdominal Wall Reconstruction:

Abdominal Wall Reconstruction:
Having complicated surgery leaving you with a massive incisional hernia can be emotionally traumatic. We offer minimally invasive approaches to repairing any incisional hernia no matter how large. Our center is one of the only centers in the country performing Transversus Abdominis Release and Rives Stoppa hernia repairs with the robotic platform. Ask us today about how we can bring your abdominal wall, and your life back together.

Epigastric hernias:

These hernias occur in the upper abdomen at or above the belly to the breastbone; they occur more frequently in men than women.

REFERENCES:

'Brooks, David C., et al. "Overview of abdominal hernias." UpToDate. 7 Dec. 2020.'

Brooks, David C., et al. "Classification, clinical features and diagnosis of inguinal and femoral hernias in adults." UpToDate. 25 Jan. 2013.

Brooks, David C., et al. "Overview of abdominal hernias." UpToDate. 9 Oct. 2012.