What is a Hernia?

Abdominal hernias are very common, particularly among men. Various hernias receive their name for the area of the body where they occur. Each year in the U.S. around 700,000 hernia surgeries are performed. We perform surgeries to correct various hernias at HAR Surgical. We specialize in the treatment of hernias, even if you have had previous hernia surgery.

A hernia is a bulge that occurs through the muscles of the abdominal wall – it can be a bulging intestine or other organ, or even fat. Weakness in the muscle wall allows these bulges to push through. In adults, the most common types of hernia are inguinal and hiatal.

  • Inguinal hernia – An inguinal hernia is a common defect in the groin. Though there are direct, indirect, and femoral types within the inguinal hernia class, they are often repaired the same way. These are especially common in men as the canal the testicles previously took to migrate into the scrotum prior to birth is a natural area of weakness.
  • Hiatal hernia – A hiatal hernia is different from other hernias because it results in weakness of a natural and necessary defect in the diaphragm where the esophagus exits the chest and enters the abdomen. It is a condition in which part of the stomach pushes up into the chest cavity through an opening in the diaphragm called the hiatus. The hiatus is the place where the stomach and esophagus connect. When the stomach pushes through this opening due to a weakness in the diaphragm, a hiatal hernia results.Hiatal hernias may cause reflux, or back flow, of acid from the stomach into the esophagus, resulting in varying degrees of discomfort or distress. This back flow of acid is called gastroesophageal reflux disease, commonly known as GERD. Surgical repair is necessary if nonsurgical treatments are ineffective or symptoms exacerbate. A hiatal hernia, like any hernia, can become serious if it becomes incarcerated (trapped) or strangulated, where blood flow is cut off and tissue dies. In either of these cases, emergency surgery is necessary.

Symptoms of a Hernia

When a Hiatal Hernia is too large, you may experience reflux or heartburn. Sometimes the stomach bulges up into the chest and can also cause regurgitation of food, difficulty swallowing, shortness of breath, or vomiting.

Inguinal hernias can cause the sensation of pressure or a dull ache that worsens over the course of the day or with strenuous activity. There may or may not be a visible bulge. Rarely, patient may notice more intense pain or even obstructive symptoms such as nausea, emesis, or new constipation.

Treatment for Hernias

Hiatal hernias are usually repaired with minimally invasive surgery, either laparoscopic or robotic. Using small incisions and long instruments, any hernia content in the chest is brought back into the abdomen and defect is closed to a more appropriate size. Occasionally, a fundoplication (a wrap of the stomach around itself) is done to prevent reflux. Alternatively, a magnetic bead augmentation (LINX) device can be placed to minimize reflux after the repair. Occasionally, a type of weight loss surgery (gastric bypass) is the best procedure for reflux. A number of factors weigh into the best procedure for the individual patient. A discussion with Dr. Harmouch, and some studies/procedures are needed to help determine which procedure is best for you.

Laparoscopic Hernia Repair Surgery

This method uses three or four small incisions, through which a small camera and surgical devices enter to secure a mesh-like patch over the affected area. Using the laparoscope’s thin, flexible, tube-like fiber optic camera, Dr. Maamoun Harmouch can guide instruments directly to the area of the abdomen that needs repair. This minimally invasive approach benefits the patient with minimum disruption to healthy tissue and the tiny incisions can generally be closed with just one or two stitches.

Robotic-assisted Hernia Repair Surgery

This method uses the da Vinci Xi Surgical System’s magnified 3D HD vision system and tiny wristed instruments that bend and rotate far greater than the human wrist. This allows Dr. Maamoun Harmouch to repair the hernia with even more precision and smaller incisions than traditional surgery.

In both laparoscopic and robotic-assisted procedures, patients can benefit from the following:

  • Less pain
  • Less scarring
  • Shorter recovery time
  • Lower risk of infection
  • Shorter hospital stay