Surgical Associates of Central New Jersey

We Provide Surgical Treatment for...

Appendicitis

Breast Disease

Gallbladder Disease

Hernia

Hiatal Hernia (Gastro-Esophageal Reflux Disease)

Thyroid Conditions

Vascular Disease

DISCLAIMER

Hernia

Men, women and children of all ages can have hernias, which are weaknesses or tears in the wall of the abdomen. Acquired hernias are caused by wear and tear over the years. Congenital hernias result from a weakness in the abdominal wall that is present at birth. Hernias may get worse or grow larger with time or physical stress. The hernia sac may fill with intestine or fat, which causes pain. Surgery simply removes the weakened or torn area from the abdomen and reinforces the surrounding area so there will be no future problems.

Hernias can cause bulges under your skin or pain when you lift, cough or strain during urination or bowel movements. The pain may get worse near the end of the day or after you stand for a long time. Your doctor may suggest surgery to relieve your pain. It's usually better to have surgery before the hernia gets bigger and complications arise. Hernias do not go away on their own and if the intestine becomes trapped inside the hernia, serious intestinal and digestive problems can occur. At that point, emergency surgery would be required to relieve the intestinal blockage and repair the hernia.

Ventral Hernia Repairs operation repairs a hernia of the abdominal wall. It usually occurs in the site of an old surgical incision. Laparoscopic repair results in a much less painful and shorter recovery. The results of the repair appear to be at least as good as repair with traditional surgery.

Laparoscopic Inguinal Hernia Repair
This operation repairs a groin hernia. Groin hernias have traditionally been repaired with an incision just above the groin. Now the hernia can be repaired laparoscopically using 3 small incisions. This results in a quicker recovery and a quicker return to work compared to the recovery after a traditional repair

Hernia Surgery

There are five locations where you could develop a hernia and surgery for each is a bit different. They include:

• Indirect inguinal hernias: The most common type of hernia, these are weaknesses at the internal ring in the groin and can be present at birth or occur later in life. An incision is usually made on an angle just above the crease where the abdomen meets the thigh. The hernia sac is lifted and opened and the intestine or other tissue is placed back into the abdominal cavity. The excess sac may be tied off and removed. The opening at the internal ring may be tightened and the abdominal wall made stronger with sutures or synthetic mesh. The skin incision may be sutured or stapled.

• Direct inguinal hernias: These hernias are more common in men and after the age of 40. They result from a weakness that develops in the groin near the internal ring. An incision is usually made on an angle just above the crease where the abdomen meets the thigh. The sac containing intestine or other tissue is placed back into the abdominal cavity. The weakened area of the abdominal wall is reinforced with either synthetic mesh or by suturing the abdominal tissue. The incision may be sutured or stapled.

• Femoral hernia: These hernias are more common in women and result from a weakness below the groin. They are often small but cannot be reduced. They can cause serious complications, such as strangulation of the intestine. An incision is made above the crease where the abdomen and thigh meet. Then, either a classic repair or mesh plug repair is performed. In a classic repair, the hernia sac is lifted out of the femoral canal and opened. Intestine or other tissue is then placed back into the abdominal cavity. The excess sac may be tied off and removed. the femoral canal is closed with sutures or made stronger with a sheet of synthetic mesh. The skin incision may be sutured or stapled. During mesh plug repair, the intestine or other tissue is pushed up the femoral cavity into the abdominal cavity. A plug of synthetic mesh is used to fill the canal.

• Incisional hernia: These hernias bulge through scars from past surgical incisions, occurring months or even years after the surgery. They need prompt treatment because they may widen and become even harder to repair and they may cause such complications as obstruction or strangulation of the intestine. The incision from the earlier surgery is reopened at the site of the hernia. The intestine or other tissue in the hernia sac is placed back into the abdominal cavity. The opening is sutured or made stronger either with a sheet of synthetic mesh or by suturing the abdominal wall. The skin incision may be stapled or sutured.

• Umbilical hernia: This looks like an inflated or bulging navel. It is caused by a defect that you may have at birth or acquire over time. They can occur in children and adults. A semicircular incision is made above or below the navel. The intestine or tissue in the hernia sac is placed back into the abdominal cavity. The umbilical weakness is tightened with sutures or made stronger with synthetic mesh. The skin incision may be closed with sutures or staples.

All of these hernias may also be repaired laparoscopically.   With this minimally invasive procedure a small incision is made at a site away from the hernia and using a laparoscope to visualize the hernia a plastic mesh is placed under the muscle, repairing the hernia from the inside.  Surgery usually takes less than one hour and you will go home the same day.

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Somerset Medical Center