Hernia

Yale New Haven Hospital offers comprehensive Digestive Health Services comprised of a team of expert clinicians who diagnose, treat, and help patients manage a range of gastrointestinal symptoms and conditions, including all kinds of hernias.

A hernia is a hole or weakness in the body’s tissues. It can develop between the muscles of the abdominal wall, in the groin or even in the diaphragm. This allows parts of organs to push through this area of weakness. This can cause a noticeable bulge, pain, and can occasionally be dangerous. Hernias are very common. In many cases, small hernias may have been present since birth, and they can enlarge over time. Other hernias can develop as we age from repetitive strain, heavy lifting or at sites of previous abdominal surgeries. Hernias do seem to run in families.

Implanted materials like hernia mesh are sometimes used in hernia repairs. In rare cases, these cause problems of their own. We can evaluate and treat these problems.

Other contributing factors for hernias are:

  • Physical exertion
  • Obesity
  • Pregnancy
  • Frequent, heavy coughing
  • Straining due to constipation
  • Prostatism (prostate disorder)
  • Smoking
  • Prior hernia surgery

Types of Hernias We Treat

There are a number of common types of hernias:

  • Ventral hernia: a bulge of tissue through an opening, or defect, in the abdominal muscle wall. This type of hernia is usually umbilical hernias (belly button) and epigastric hernias (just under the breast bone).
  • Incisional hernias: happen at the site of a previous surgery that weakened the abdominal wall. These hernias vary in size and can be small, or occasionally quite large.
  • Inguinal hernia: fatty or intestinal tissue bulges through the inguinal canal or groin and is most common in men, but can occur in women too.
  • Hiatal or para-esophageal hernia: part of the stomach or other organs from the abdomen protrude into the chest cavity. This can often be a cause of heartburn, chest pains and trouble swallowing.
  • Recurrent hernias: Any hernia that was previously repaired, that has now returned.

Less common hernias include:

  • Flank hernias: on the side of that abdomen or even between ribs. These often result from spine or kidney surgery incisions and sometimes from old injuries.
  • Lumbar hernias: can cause a bulge on one side at the lower back.
  • Spigelian hernias: occur on the lower side of the abdomen that push into, not through the abdominal wall and can be hard to detect, but cause pain in that area.

Symptoms of a Hernia

When a hernia becomes present in the abdomen or groin, a noticeable lump or bulge usually appears.

Other symptoms of a hernia include:

  • Swelling or bulging in groin or scrotum
  • Pain at the site of the bulge
  • Pain when lifting
  • Bulge increasing in size over time
  • Dull aching sensation
  • Signs of bowel obstruction

A doctor is normally able to see or feel a bulge from a hernia during a physical exam, but some cases might require a CT scan, ultrasound or other imaging to accurately diagnose the condition and plan the repair. If you have had any of these studies, let us know so we can review them.

Treatment For Hernias

If left untreated, a hernia can worsen and require surgery. They can occasionally be dangerous and symptoms shouldn’t be ignored. Pain from a hernia, especially in the groin, can increase with both regular and strenuous activity.

Treatments vary, depending on the type and size of the hernia. We offer minimally invasive approaches to most hernias, including robotic surgery and laparoscopic surgery. Our approach focuses on repairing the hole and stabilizing and, in some cases, reconstructing the abdominal wall to enable unrestricted activity, including work and exercise. In any type of hernia in adults, surgery is typically the best remedy in treating the condition and provides a durable repair.