Hernias are a very common problem affecting 5% of the population at some point in their life. 75% of hernias are groin (inguinal) hernias, being by far the most common. A hernia is essentially a split in the muscles of your belly allowing the lining to bulge through. This bulge can contain fat or your intestines or bladder. Because they are an actual split in the muscle, hernias do not get better on their own and so hernias are often fixed with surgery. Common areas where people get hernias are the groin, the bellybutton, above the bellybutton and sometimes in the same location of a previous operation.
Inguinal (Groin) Hernias
Your abdominal wall is made up of several layers of muscle travelling in different directions. In your lower abdomen there is a natural weak area with only layer of muscle. Travelling through this area is the spermatic cord and testicular blood supply in men, and the round ligament of the uterus in women. A tear in this one muscle layer can easily result in a bulge (a hernia) that can be painful and even extend into the scrotum in men. It is very important that if an inguinal hernia becomes firm and very painful it should be assessed urgently by a physician as the intestines may be trapped in the hernia which can make you very sick. Not at all groin hernias need to be fixed, and so it is important that you discuss the pros and cons of repair with your surgeon.
Incisional hernias can be among the most challenging to treat. These hernias can potentially occur at any point after prior abdominal surgery and are reported to occur 10-20% of the time after an abdominal incision. Risk factors include smoking, obesity and emergency surgery. There are many options in repairing incisional hernias ranging from a simple suture repair of a small defect to a complete abdominal reconstruction. Our group has expertise in all of these methods.
Umbilical (belly button) Hernias
Umbilical hernias are very common and can easily be repaired. The recovery time is typically two to four weeks. Small hernias (under 1 cm) are often repaired with a simple suture, whereas a piece of polyester mesh will be used to reinforce larger repairs.
Is laparoscopic hernia repair an option?
All of our surgeons offer both laparoscopic and open hernia repairs. It is very important you have a discussion with your surgeon about which surgery is right for you.
Do I need to worry about the mesh?
The use of mesh to repair a hernia is safe. There has been some bad press regarding "mesh" in the media, which has largely centred on using a variety of mesh products on organs which has lead to longterm problems in some people. When used in the abdominal wall it is perfectly safe and is in fact the gold-standard method of ensuring a hernia does not recur. 95% of hernia repairs in North America use mesh safely.
Is this a hernia?
Many people will develop a separation between the "six-pack" muscles of the abdominal wall (the rectus sheath). This is referred to as a diastasis recti. It is not actually a hernia and is not dangerous. People often don't notice this at all until they do a sit-up motion and notice a ridge between their rib cage and bellybutton. This does not require surgery but strengthening the core abdominal muscles may help.