What Is A Hernia?
Imagine a steak. You know, a good steak is when a steak knife isn't needed, but rather you can just use a fork. This happens because the muscle splits easily apart. If you have ever eaten a steak and chewed the gristle in the steak, you understand what fascia is. The fascia is the wrapper around the muscle that keeps the muscle together as it contracts and relaxes. When the fascia develops a hole in it, the muscle thins at that area and whatever is pushing from the inside to the outside on the muscle bulges through. This could be bowel within the hernia sac or it could be intra abdominal fat, or even other organs.
Where Do Hernias Occur?
Hernias can develop in many different areas of the body. Most often, the hernias we see and repair are located in the diaphragm, which can be a hiatal hernia or a hernia on the left or the right side of the diaphragm, an abdominal wall hernia which could be as simple as a small umbilical hernia, or a ventral or an incisional hernia located away from the umbilicus but at the site of an old surgical incision or perhaps originating from a weak site of the fascia.
The groin houses the fascia’s weakest site; herniation at this site leads to an inguinal hernia. While this area is a weak spot for both genders, men develop inguinal hernias more commonly due to anatomic differences.
Often people question herniorrhaphy mesh. Many people have a negative view of herniorrhaphy mesh as there are numerous commercials and even lawsuits regarding the use of a mesh utilized for vaginal repairs. Obviously, gynecologists perform vaginal repairs, we don't in our practice. But, mesh is a tool we have at our disposal. It improves lives, without it we wouldn't be able to repair some hernias. There is the right and wrong tool for each particular type of hernia or patient. You need an experienced surgeon who understands anatomy, the types of mesh products available on the market for any particular hernia, and how those products behave in certain patients. Similar to an artificial hip or knee joint, or a pacemaker, mesh is a foreign body, it may get infected or have other complications. The goal of any hernia operation should not be just to fix the hole that is the hernia operation should not be just to fix the hole that is the hernia, but to return the patient back to full form and function without residual pain or loss of motion.
Different hernias happen, depending on the location. The most common types of hernias form in the groin, while other types form in the abdomen. Other common hernias form around the navel (umbilical hernias). They may also occur at the site of a previous surgery. Hernias often recur in the same location (recurrent hernias). In some cases, patients may have multiple types of hernias.
The Abdominal Wall
The abdominal wall is strengthened by layers of muscle, fat, and other tissues. Hernia surgery repairs the weakness in the muscle and connective tissue. This prevents the intestines or other tissue from bulging out again.