What are the different types of hernias?
Inguinal
hernias occur in the groin, which is the area between your abdomen and
thigh. As the most common type of hernia in adults, inguinal hernias are
most common with men although they can also occur in women. With an inguinal
hernia, the contents of the abdomen - namely the intestine - protrude
through a weakness or tear in the abdominal wall muscle creating a visible
bulge and sometimes pain. Pain caused by an inguinal hernia can be a
constant, daily pain or may be sporadic, occurring once in a while. Inguinal
hernias can also be
bilateral, occurring on both sides of the abdomen instead of a single
side.
Umbilical hernias occur in or around the naval, or umbilicus.
This type of hernia may be due to
congenital factors. Umbilical hernias may also result from sudden or
repeated strain or stress on the abdominal muscles. In adults, as with any
hernia, an umbilical hernia will not heal and go away but rather grows
larger with time and often becomes problematic in that
incarceration or
strangulation can occur. With infants, however, an umbilical hernia
may slowly close, delaying surgery until age 3 or
4 unless the hernia causes problems before then.
Incisional hernias can occur in the abdomen in the area of any prior
surgical incision or scar. Hernias of this type are often accompanied by a
swelling or bulge near the area of the prior incision, typically along
straight incisional scars running down from the breastbone to the pubic
area. Incisional hernias can be a result of 1) tension placed on the tissue
from the prior surgical procedure, 2) disruption in the general area of
prior
suturing to the abdominal wall or 3) inadequate healing, which can be
due to obesity, metabolic diseases, infection or poor nutrition. Since
suturing (tension) can be the cause of some incisional hernias, it is highly
advised that incisional hernias be repaired with the
Tension Free Mesh technique to avoid future
recurrence. Pain may be an early warning sign of an incisional hernia,
as there may not be any initial presence of a bulge, though this type of
hernia can develop soon after the original surgery or at any time
thereafter.
Femoral
hernias are almost exactly the same as
inguinal
hernias. The femoral hernia occurs when abdominal contents are forced
through the "femoral canal". Typically, this type of hernia forms near the
crease of leg in the abdominal region, but in an area relatively lower than
the more common inguinal hernia. Females tend to have a slightly larger
femoral canal because of the angle and shape of the pelvis, which is why
they are more prone to these types of hernias as opposed to men, who tend to
have slightly larger
inguinal canals making them more susceptible to the
inguinal
hernia. The two types of hernias are often too difficult to tell apart
in diagnosis, which is why a
hernia specialist
is often required to confirm diagnosis. Femoral hernias are more likely to
become
incarcerated or
strangulated because of their location, which is why repair is strongly
advised upon diagnosis of this type of hernia.
Epigastric hernias occur between the lower part of the breastbone and
the naval and is caused by a weakness or opening in the
fibrous tissue of the abdomen. This type of hernia usually consists of
fatty tissue and rarely contains intestinal tissue. Although generally small
in size (no bigger than a golf ball), epigastric hernias can easily become
pinched in their small area, sometimes causing a great deal of pain.
Will my hernia go away?
Although a hernia may not worsen for months or even years, an
untreated hernia WILL NOT get better on its own. Hernias
which are
reducible, are not generally an urgent danger to your health, though
they can be painful. A
non-reducible hernia can become life-threatening if any part of
the intestine becomes trapped or
strangulated in the opening or weakness and then requires emergency
surgery.
What about complex hernias?
Our state-of-the-art
Tension Free Mesh technique is successful at repairing large,
recurrent and complex hernias, although some of these types of hernias
may require
general anesthesia in order to be repaired effectively. However, even if
the hernia is large or complex, most
inguinal,
umbilical and many
incisional hernias can be repaired with
local anesthesia with sedation.
What is the recovery time?
Rapid recovery after surgery is dependent on the
location of the hernia, the
type of
hernia, the
repair technique used as well as your individual, physical health. With
the advanced
surgical techniques used at the Hernia Center of Southern California,
our patients experience considerably less post-operative pain, have fewer
restrictions after surgery and recover rapidly. We typically see our
patients return to everyday activities within DAYS of surgery and can
return to work
and back to
recreational and sport activities within two weeks.
NOTE: Recovery following
incisional and/or more complex hernias may be slightly longer to some
extent depending on the involvedness and type of the hernia and the general
heath of the patient.
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When can I return to work?
After hernia repair surgery at the Hernia Center of Southern
California you will be able to rapidly return to normal, daily activities as
well as work and athletic activities. We use a "tension free" repair that
results in minimal post operative pain.
This is a guide
to assist you in determining when you can be expected to return to work
after hernia surgery. At the Hernia Center of Southern California you will
be examined by your surgeon after surgery to determine your individual
guideline for returning to work.
Sedentary Work
This work
includes secretarial work, computer work in the office or home. Work
involving sitting, standing and walking with lifting less than 20 pounds.
Patients may
return to unrestricted work 3 to 5 days after surgery. They will experience
minimal pain which can be managed with over-the-counter pain medications
such as Advil®, Motrin® or Tylenol®.
Minimal
to Moderately Physical Work
This work
includes electricians, plumbers, factory workers, mechanics, and workers in
retail stores and laborers who lift 20 to 80 pounds. This does not include
stockers who lift repetitively.
Patients can
return to unrestricted work two weeks after surgery. They may return to work
in one week with a light duty restriction of no lifting over 20 pounds. When
you return to work you will experience minimal pain which can be managed
with over-the-counter pain medications such as Advil®, Motrin® or Tylenol®.
Heavy
Physical Strenuous Work
This work
includes construction workers, road workers, heavy duty mechanics, and
retail or wholesale stockers or order pullers who stock orders and load and
unload pallet jacks throughout their work day.
Patients can
return to unrestricted work four weeks after surgery. They may return to
work in one week with a light duty restriction of no lifting over 20 pounds.
They may return to work in two weeks with a work restriction of no lifting
over 80 pounds and no repetitive lifting. When you return to work you will
experience minimal pain which can be managed with over-the-counter pain
medications such as Advil®, Motrin® or Tylenol®.
When can I return to recreational or athletic
activities?
We typically recommend and promote patients returning to
recreational or athletic activity in stages, as soon as possible, depending
on the type
of hernia and
surgery
performed. Since each patient is a unique individual with their own
needs and abilities, we specifically tailor each patient's progressive
return to recreational and athletic activity to your needs and abilities. We
tend to follow a four week rule for most athletes. Week one consists of
light or easy activities to maintain flexibility. Week two consists of
minimal to moderate activities. Week three consists of moderate activities
and week four consists of strenuous activities. Activities are performed
four times weekly, gradually increasing in intensity.
Disclaimer:
These activities are recommended by Dr. Albin for his
patients who he personally examines after surgery and individually initiates
an exercise program depending on the patients healing and skill level.
