Hernias are openings in the abdominal wall that can enable intestines or fat to protrude through. Hernia repair surgery aims to prevent the recurrence of the hernia by closing the defect with little or no tension. Hernias come in a variety of forms, each with unique characteristics. This article will discuss the many hernia types and how they differ from one another.
The Iskandar Complex Hernia Center offers hernia patients a listen-first, non-judgemental approach to treating all types of hernias. Dr. Iskandar, a recognized complex hernia surgeon, provides unparalleled empathy and expertise, so you can enjoy a dramatically improved quality of life. To learn more about the minimally invasive treatment options available for all types of hernias at The Iskandar Complex Hernia Center, call our office to schedule your appointment with Dr. Iskandar. You deserve to experience an improved and healthy lifestyle.
The two main types of groin hernias are inguinal and femoral.
Inguinal hernias, often known as groin hernias, are the most common type of hernia. They occur close to the crease that divides the upper thigh from the lower abdomen. When an inguinal hernia forms, adipose tissue (fat) or the intestine may push through the opening in the abdominal wall and cause a bulge on either the right or left side. A direct inguinal hernia appears as a protrusion from the inguinal canal’s posterior wall, whereas an indirect inguinal hernia passes through the inguinal canal or the groin. The defect in the indirect inguinal canal is hidden by the external oblique muscle fibers, making it difficult to feel.
Inguinal hernia signs and symptoms include:
- Continuous pain
- Discomfort while sitting or when moving around
Inguinal hernias can occasionally go completely unnoticed. Inguinal hernias occur in between 10 and 15 percent of males and 2 percent of women during the course of their lifetimes. The inguinal canal, where the spermatic cord enters the scrotum, is typically where the weak spot in men is located. Hernias can sometimes develop when connective tissue from the uterus joins to tissue surrounding the pubic bone in women because the inguinal canal carries a ligament that aids in holding the uterus in place.
Tension repair of inguinal hernias has a recurrence incidence of 15% or greater, meaning that the hernia may return at a later point in time. Alternative hernia repair methods, such as laparoscopic tension-free surgery, have substantially lower recurrence rates, under 1%.
Femoral hernias are another type of groin hernia. Although they can develop in men, they are significantly more common in women. This kind of hernia develops in the area right below the groin crease. When the lower groin becomes weak, an intestinal sac can slip into the femoral canal, which is a space near the femoral vein that carries blood from the leg up to the body. Compared to inguinal hernias, these hernias are more likely to have incarceration or strangulation as an early complication. Thus, prompt repair of these hernias after diagnosis is strongly suggested to avoid an incarcerated hernia or further complications.
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Diaphragmatic hernias include hiatal hernia, Morgagni hernia, and Bochdalek hernia.
When the top part of your stomach pushes through your diaphragm and into your ribcage, a hiatal hernia forms. Up to 60% of people will develop hiatal hernias by the time they turn 60, making it one of the most prevalent types of hernias.
Heartburn, pain, and esophageal erosion can result from these hernias’ capacity to cause acid reflux from the stomach into the esophagus. Acid reflux, chest pain, and difficulty swallowing are all hiatal hernia symptoms. The procedure to treat this type of hernia is typically more complex and may necessitate a lengthier hospital stay.
Morgagni hernias are a rare type of congenital diaphragmatic hernia through the anterior foramen of morgagni. These types of hernias usually do not cause symptoms and are an anterior defect. Most commonly, fat and the colon herniate through.
Bochdalek hernias are a rare type of diaphragmatic hernia that is usually posterior. Most commonly fat herniates through but can also have the spleen and kidney herniate.
Ventral hernias include epigastric, umbilical, incisional, flank, and Spigelian hernias.
Men experience epigastric hernias more frequently than women. They develop along a line between the breast bone and the navel and are caused by a weakening, opening, or gap in the muscles or tendons of the upper abdominal wall or epigastrium. Epigastric hernias are found below your rib cage and above your belly button in the upper abdomen. The affected area may feel tender, have a small lump, or cause bloating or constipation. However, not all epigastric hernias are symptomatic.
When you cough, sneeze or exert yourself, epigastric hernias may cause pain. There are several types of surgical repair methods for this type of hernia, including laparoscopic surgery and robotic hernia repair surgery.
Umbilical hernias are a type of ventral hernia that develops in the weak area around the navel caused by the umbilical cord’s blood vessels. Hernias occur when organs or tissue begin pushing through a weak spot around the belly button, causing a noticeable bulge. When you cough or go to the bathroom, it can become worse.
These hernias can develop in newborns at or shortly after delivery and can go away by the time the child is three or four years old. The weakness, nevertheless, can develop at any time in men, women, or children of any age and can last for the rest of one’s life. Umbilical hernias in adults do not go away on their own and may even get worse with time. They can occasionally be brought on by pregnancy, chronic coughing, or abdominal strain brought on by being overweight.
The signs and symptoms of an umbilical hernia are:
- A bulge in the area affected
- Pain, especially while coughing, sneezing, or carrying heavy objects. Pain can range from a subtle ache to severe pain.
- Constipation or bloating
Umbilical hernias can be treated in one of three ways.
Observation. For less severe hernias, your doctor may advise waiting to take further action in order to monitor the hernias’ progression over time.
Elective (non-emergency) surgical repair. Elective surgical repair may be advised by your doctor if your umbilical hernia is causing you a lot of pain or discomfort.
Emergency surgery. Your doctor will advise urgent or emergency surgery if the umbilical hernia poses a risk of strangling a portion of your intestine. A strangulated hernia is a medical emergency and requires immediate treatment.
Incisional hernias are a type of abdominal hernia that develops in the abdomen near the location of prior surgery. This special type of abdominal wall hernia occurs close to previous surgical wounds when the abdominal wall has been weakened by previous surgery or when an infection in a healing surgical incision compromises the wound’s ability to heal. Between 25 to 30 percent of people who have abdominal surgery will experience an incisional hernia.
These hernias can range in size from small to very large and complex, and they can develop weeks, months, or even years following surgery. If you’ve had abdominal surgery, and the incision didn’t heal properly, it can leave a weak place in your abdominal wall. A significant bulge might develop around the incision scar if organs or tissue protrude through the incision. See your doctor as soon as possible if you suspect you have an incisional hernia, as it could become worse and be far more challenging to repair.
Spigelian and Flank Hernia
Spigelian Hernias commonly occur on the right side of the abdomen and involve the protrusion of the intestine or an empty sac through a weakness between the muscle fibers of the abdominal wall. Since there is frequently no apparent bump or swelling, it can be nearly impossible to detect. Instead of sticking out through layers of fatty tissue, it develops in the spaces between the muscles of the abdominal wall. It could be confused for a different type of abdominal ailment. Although it can affect both men and women, this type of hernia is quite uncommon. Spigelian or flank hernias frequently appear as people age, and their abdominal muscles weaken.
Sports (extreme twisting or turning), smoking, being overweight or obese, straining during urination or defecation, lifting heavy objects, and abdominal injuries are some of the causes of Spigelian hernias. Symptoms may include poor bowel function or constipation, a dull ache in the abdomen, pain when bending or straining, and a noticeable small swelling on someone with lean or low body fat (otherwise, it may be difficult to observe). Diagnosing this type of hernia can be difficult. based on the patient’s symptoms, an examination, palpation of the area, and an x-ray, a diagnosis can be made. Open or laparoscopic surgery, utilizing a surgical mesh to repair the area, is often the recommended course of treatment.
Hernias that return after treatment are referred to as recurrent hernias. Due to the nature of the weak abdominal wall, hernias can occur again even under ideal conditions.
Recurrent hernias are more challenging to treat than other forms of hernias because of the presence of surgical scar tissue, previous use of surgical mesh, and inflamed tissue in the area. Recurrent hernias should be examined right away to see if they can be repaired.
A surgeon who specializes in treating complex or recurrent hernias is known as a complex hernia surgeon. While many general surgeons perform hernia surgery, it becomes extremely important to locate a surgeon with extensive experience in dealing with complex hernia surgery and abdominal wall reconstruction as a case becomes more complicated. One of the top complex hernia specialists in the country, Dr. Iskandar, receives frequent referrals from other surgeons for their complex cases.
With renowned expertise and unmatched compassion, the Iskandar Complex Hernia Center offers complex hernia surgery and advanced abdominal procedures to patients with debilitating hernias. These procedures dramatically enhance patient quality of life. Contact our friendly medical team to request an appointment with Dr. Iskandar and regain the quality of life and health you’ve been missing.