One of the key issues our site visitors have communicated with us is their confusion in the various medical terms that doctors and surgeons use when it comes to hernia repair. We aim to address the terminology and procedures more commonly used within and throughout the hernia repair process.
The hernia repair and treatment process is almost always dependent on the type of hernia. The solution recommended by the surgeon would be determined by the hernia itself. The most common types of hernias include inguinal, femoral, umbilical, incisional, ventral and hiatal hernias.
Types of hernia
“Groin: a femoral hernia creates a bulge just below the groin. This is more common in women. An inguinal hernia is more common in men. It is a bulge in the groin that may reach the scrotum.
Upper part of the stomach: a or hiatus hernia is caused by the upper part of the stomach pushing out of the abdominal cavity and into the chest cavity through an opening in the diaphragm.
Belly button: a bulge in this region is produced by an umbilical or periumbilical hernia.
Surgical scar: past abdominal surgery can lead to an incisional hernia through the scar.” Medical News
This is the most common type of hernia. An inguinal hernia is one that is in the groin area. This is one the two types of hernias that are in the groin. When a patient has this type of hernia, the tissue or an organ pokes through a weakness in the muscle. This results in a protrusion and a hole in the muscle. A patient will typically have a pain in the groin area and will have discomfort when standing up or coughing. There are two types of inguinal hernias. The first is a direct hernia, which is one that enters the inguinal canal. An indirect hernia does not enter the canal. This is not a life-threatening condition, but it must be treated because the pain will negatively impact the patient’s quality of life.
“An inguinal hernia occurs when tissue, such as part of the intestine, protrudes through a weak spot in the abdominal muscles. The resulting bulge can be painful, especially when you cough, bend over or lift a heavy object.
An inguinal hernia isn’t necessarily dangerous. It doesn’t improve on its own, however, and can lead to life-threatening complications. Your doctor is likely to recommend surgery to fix an inguinal hernia that’s painful or enlarging.Inguinal hernia repair is a common surgical procedure.
Signs and symptoms of an inguinal hernia include:
- A bulge in the area on either side of your pubic bone, which becomes more obvious when you’re upright, especially if you cough or strain
- A burning or aching sensation at the bulge
- Pain or discomfort in your groin, especially when bending over, coughing or lifting
- A heavy or dragging sensation in your groin
- Weakness or pressure in your groin
- Occasionally, pain and swelling around the testicles when the protruding intestine descends into the scrotum” Quote from Mayo Clinic
This is another hernia in the groin area, but is not as common as an inguinal hernia. This also involves a protruding tissue, but instead of entering the inguinal canal, this type of hernia enters the femoral canal. Patients with a femoral hernia will have a protruding lump that will appear and disappear based on the body position. While men are more likely to have an inguinal hernia, women are more likely to have a femoral hernia. This hernia is typically caused by some kind of straining. These hernias are not life threatening, but can cause grave danger if it obstructs the intestines.
“If a portion of tissue pushes through the wall of the femoral canal, it’s called a femoral hernia. A femoral hernia will appear as a bulge near the groin or thigh. The femoral canal houses the femoral artery, smaller veins, and nerves. It’s located just below the inguinal ligament in the groin.”
This type of hernia occurs when the stomach breaks through and bulges into the chest cavity. Here, the stomach pushes through an opening in the diaphragm. Usually, this type of hernia occurs in people who are either smokers or overweight. One symptom of a hiatal hernia is heartburn. Oftentimes, people can mistake the pain and effects of a hiatal hernia with a heart attack. Lifestyle changes may be enough to fix this hernia on its own. However, more severe cases will require surgery to relive the pressure on the chest cavity.
“A hiatal hernia is a condition in which the upper part of your stomach bulges through an opening in your diaphragm. Your diaphragm is the thin muscle that separates your chest from your abdomen. Your diaphragm helps keep acid from coming up into your esophagus. When you have a hiatal hernia, it’s easier for the acid to come up.” Medline
This hernia is swelling or a bulge that is at or near the navel. The intestines protrude through the abdomen in the area of the belly button. This type of hernia can be relatively minor and is not even always painful. It is when the bulge becomes painful or tender that care is necessary. This is a relatively common type of hernia with approximately 200,000 occurrences per year. For adults, this is caused by too much pressure on the abdomen for various reasons including obesity or previous surgeries.
“An umbilical hernia occurs when part of your intestine sticks out through the opening in your abdominal muscles through which your umbilical cord passed before you were born. Umbilical hernias are common and typically harmless. They are most common in infants, but they can affect adults as well.” Mayo Clinic
This hernia occurs in the abdomen, but does not incur naturally or in response to straining. Instead, an incisional hernia happens when there is some type of cut in the abdomen that results in scar tissue. When the tissue is healing, it results in a protrusion at the sire of the scar. This hernia more closely resembles an infection as the patient will often have fever and burning at the area of inflammation. While surgery is not always a necessity, this type of hernia has the potential to be extremely dangerous so it can be an emergency in certain circumstances.
“An incisional hernia is a protrusion of tissue that forms at the site of a healing surgical scar. This type of hernia accounts for 15-20 percent of all abdominal hernias.” Mount Sinai
This hernia is also caused by bulging tissue, but the site of the hernia is the abdomen as opposed to the groin. An incisional hernia is a type of ventral hernia, but there are also other kinds of ventral hernias. This hernia can be caused by straining and heavy lifting. Ventral hernias will always require surgery to fix because, if left untreated, they can cause serious complications. Surgery is necessary even if the ventral hernia is not causing any pain.
“A ventral hernia is a bulge of tissues through an opening of weakness within your abdominal wall muscles. It can occur at any location on your abdominal wall. Many are called incisional hernias because they form at the healed site of past surgical incisions.” Healthline
A herniorrhaphy is defined as a procedure where a hernia is repaired by stitching the muscle tissue together, where the hernia has developed or occurred and without the use of prosthetic products. Various studies have been conducted in terms hernia recurrence on a post-operative basis including both the herniorrhaphy and the hernioplasty options.
One of which include “Factors Affecting Recurrence following Incisional Herniorrhaphy” – Anthony et al. (2000) where it was found that “the recurrence rate for those patients undergoing a tissue repair (herniorrhaphy) was 54%, compared to that of 29% “recurrence rate following prosthetic repair”, which refers to the hernioplasty procedure (see below). The resultant finding, or data supported conclusions, of the study published by Anthony et. al provides that the use of prosthetics, such as hernia mesh, is supported for incisional hernia repairs, particularly for patients that are in fact overweight.
The use of prosthetic materials for the repair of a hernia is commonly referred to as a hernioplasty. Although hernioplasty has shown to be a more effective treatment, it does not come without a fair share of criticism, and perhaps even more importantly defective products that have been withdrawn and recalled from the marketplace.
In the past, the prevalent way of fixing a hernia was to sow the hole shut. This required an invasive surgery and a longer hospital stay. Starting from 1958, hernia mesh began to become a part of many hernia surgeries. Now, an overwhelming majority of these procedures involve the implantation of a mesh in the patient as a means for fixing the hernia.
A hernia mesh is most often made of some sort of synthetic material. It is woven into a sheet and is placed over the muscle weakness or hole. The surgeon will then sew the mesh into the surrounding muscle so that the mesh fully covers the area. Over time, the mesh will strengthen around the mesh as the hernia continues to heal.
Meshes can be made of a variety of materials. The initial type of hernia mesh which was first used was made out of plastic-type material. The most common type of mesh is called polypropylene. This is also a material that is like plastic. In addition, there are meshes that are made out of polyester. The next generation mesh is made out of biological material, including parts from pigs and cows. These meshes are safer, but cost more money than the standard synthetic type mesh.
The synthetic meshes have caused a variety of complications. Some of these meshes have caused allergic reactions in the patients. In other instances, the mesh can become infected, leading to more severe complications. Finally, the mesh can fail or contract, leading to the requirement of an additional surgical procedure. In each of these instances, the patient is subjected to additional pain, suffering and expense. If you have had a hernia surgery that has involved mesh and have suffered from any complications, it is vital that you immediately contact a lawyer to discuss your legal rights.