Hernia Surgery
Learn about the hernias we treat at Minnesota Surgical Specialists
What is a hernia?
A hernia refers to a hole in the strong layer of tissue (called the fascia) that envelops and connects muscles. Hernias often times can cause pain or discomfort, largely due to the the tissue "herniating" or protruding through the mouth of the hernia defect. The tissue from below the level of the hernia defect protrudes above the hole and is lined by a thin layer of tissue, referred to the hernia sac. In some cases, tissue from below a hernia can get trapped, referred to an "incarcerated" hernia, and occasionally the tissue can become "strangulated", or lose its blood supply which can lead to an emergency situation where the hernia needs to be fixed very promptly to avoid death of the tissue herniating above the level of the defect.
How is a hernia treated?
The only real treatment for most adults with a hernia is surgery. There are many different surgical options and techniques used to treat a hernia, and this is largely based on individual patient characteristics as well as surgeon experience. It is important to know that outcomes, or results after surgical repair of a hernia, often times are directly correlated with optimizing patients before surgery. ​
What are some things I can do to increase the likelihood of a successful hernia repair?
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Stop smoking, and stop the use of all nicotine and tobacco products for several weeks before and after a surgery is planned. Tobacco and nicotine use is a major risk factor for hernia recurrence. If you actively use these products, your surgeon will likely have you quit using them for at least 8 weeks before surgery is scheduled.
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Lose weight before a hernia repair is planned. Ventral, incisional and hiatal hernias are much more likely to recur, or return, if patients are obese at the time of their surgery. A recurrent hernia is much more difficult to treat and may be more likely to fail if the initial hernia repair is unsuccessful. Reducing your BMI, or body mass index, to a level below 30 is best.
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Start exercising. Hernias can make exercise difficult but studies have shown that patients who can actively exercise their abdominal wall are more likely to have success after a hernia repair. If you struggle with exercise because of your hernia, your surgeon may refer you to a physical therapist who specializes in strengthening your abdominal wall muscles before you are scheduled for a hernia repair.
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​Control your blood sugars (for diabetic patients). Having very high blood glucose/sugar levels significantly increases the likelihood of developing a wound infection after a hernia repair, and wound infections are the number one risk factor for a hernia recurrence. Talk to your surgeon about optimal parameters for your blood sugars if you are diabetic.
What is a hernia mesh and will I need one for my hernia repair?
Mesh is an implant used by your surgeon to improve the chances of a successful hernia repair. It is a sheet of material often used to reinforce a hernia repair. The mesh can be made from various materials, and can be permanent or dissolve over time (absorbable). Decisions about which mesh to use, if any, are made with your surgeon, and depend on the location and size of the hernia, as well as specific details of your case.
There are many hernia repair techniques that can be performed both with and without mesh, and the final decision will be made by you and your surgeon.​
If your surgeon feels the hernia should be treated with use of a mesh, the benefit is that mesh will reduce the chances of the hernia coming back. The risks of using hernia mesh, which are uncommon, include: pain, infection, or damage to nearby structures. The risk of mesh related complications is very low, but unpredictable for any given individual. If a complication arises, it may require treatment with medication and/or surgery to repair any damage the mesh may have caused and to remove part or all of the mesh.
Some patients have pain after hernia surgery with mesh, but pain can also develop after hernia surgery without mesh. Studies have found equal numbers of patients with pain, regardless of whether or not mesh was used for the repair. Talk to your surgeon in consultation about the benefits and risks of mesh repair of your hernia, and develop a strategy together that leads to the most likely optimal result of your hernia repair.
Types of Hernias
There are many different types of hernias. Some people can develop hernias in more than one location. Learn about the different types of hernias below.
Inguinal hernias
An inguinal hernia is one that occurs in the groin. It can occur on the right or left side, and occasionally on both sides.
Umbilical hernias
Umbilical hernias are hernias that occur at the navel, or belly button. These may be congenital (you're born with them) or may develop over the course of one's life. In fact, an "outtie" belly button actually represents an umbilical hernia.
Ventral or Incisional hernias
A ventral hernia is one that occurs anywhere on the abdominal wall outside of the groin (inguinal) or navel (umbilical) region. Some people can develop hernias on their belly at a site of a prior surgery, and these are referred to as "incisional hernias".
