JOSE ERBELLA, M.D., FACS
General, Oncologic & Minimally Invasive Surgeries
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Hernia surgery is one of my most common surgeries. I prefer to repair these laparoscopically when possible because it causes less pain and recovery and is just as strong.
WHAT IS A HERNIA?
A hernia is basically a hole in the muscle layer of the abdomen. It occurs when the inner layers of the abdominal wall muscle are weak and result in a bulge or tear in the lining. This could be caused by heavy strain, aging, or injury. A hernia can be present at birth or develop over time. Intestine or abdominal tissue can push through this opening in the abdominal wall and cause severe pain and further health complications. When this happens, you may see a bulge like a ball under the skin at the location.
The most common locations for hernias are:
• Inguinal hernia – in the groin area
• Umbilical hernia – in the belly button area
• Incisional hernia – near the incision site scar of a previous operation
• Hiatal hernia – in the diaphragm between the abdominal and chest cavities (this presents as heart burn or difficulty swallowing and cannot be seen by the outside of the body).
HOW HERNIA SURGERY WORKS
I like to perform hernia surgery using a minimally invasive laparoscopic approach. This involves making several small incisions in the abdomen and inserting specialized surgical instruments and a lighted video camera. The hernia opening is then sutured closed and sometimes a prosthetic mesh is placed over the weak part of the abdomen wall to close the opening and reduce tension on the area to prevent future hernias from occurring in the same place.
Laparoscopic hernia repair provides several benefits to the patient over open surgery, including:
• less risk of infection
• shorter recovery time
• less post-op pain
WHAT IS MESH?
The mesh I use to help repair hernias is basically woven suture into a sheet. It helps to patch the hole and make the repair stronger so the hernia does not recur. Think of it like repairing a tire, garment or even a concrete wall with a patch or when you first build a wall using rebarb. The rebarb is like the mesh. It serves as a underlying frame to strengthen the wall or repair. Not all hernia surgeries require mesh but many do, especially if they have existed for many years or their is thinning of the surrounding muscle. There are many types of mesh available and some dissolve and some are permanent. Different conditions require different mesh. Here are some close up photos of mesh.
Here is an instructional video I made to teach other surgeons how to perform laparoscopic inguinal hernia repairs with a special mesh.
DO YOU NEED HERNIA SURGERY?
The only treatment for a hernia is surgery. A hernia can often be recognized by a bulge under the skin or pain when lifting heavy objects, coughing, straining during bowel movements or standing for long periods of time. If it's starting to bother you in any way, then it's time to consider surgery.