Are you wondering if that ache you feel in the lower belly area is a hernia?
Hernias are very common in women and men and symptoms can vary. Typically, they cause a lingering pain and discomfort that doesn’t go away. They are not usually dangerous or life threatening, but they can cause complications. Most hernias can be surgically repaired and care is straightforward and manageable.
In this Q&A, Jenny Zhang, MD, an expert in hernia, bariatric, and minimally invasive surgery at Mount Sinai Doctors-Brooklyn, and Assistant Professor of Surgery, Icahn School of Medicine at Mount Sinai, explains how to recognize the signs of a hernia, your treatment options, and why minimally invasive surgery may be a good option.
What is a hernia?
A hernia is a defect or weakness in the abdominal wall or diaphragm. You can think of the abdomen as a bag filled with pebbles. When there is a hole or weak spot in the bag, the pebbles can push through. Similarly, when a hernia is present, internal organs or fat can protrude through that defect. This can lead to discomfort and potential complications.
What causes a hernia?
There is no clear answer but in general, lifting heavy objects, standing for many hours, chronic coughing, severe vomiting, or doing strenuous activities that strain the abdomen can cause a hernia.
What are the most common types of hernias?
There are many kinds of hernias, but there are two general categories, abdominal wall hernias and diaphragmatic hernias.
Abdominal wall hernias present as bulges in the abdomen or the groin areas. They include:
- Umbilical hernia: A weakness that forms in the abdominal wall through and around the belly button. Most people with this hernia first notice discomfort or a bulge around the belly button.
- Inguinal hernia: Occurs in the groin near the opening of the inguinal canal, and it may grow larger over time.
- Ventral hernia: Develops when a weak spot in the abdomen enables abdominal tissue or an organ to protrude through it.
- Femoral hernia: Develops in the upper thigh and groin. It is due to weakness in the femoral canal.
- Incisional hernia: A protrusion of tissue at the site of a healing surgical scar.
- Diaphragmatic hernias, such as hiatal hernias, do not typically cause a bulge but are associated with symptoms of heartburn, difficulty eating, or swallowing. There is a weakness in the diaphragm, and a portion of the stomach or intestine protrude up through it.
What are signs of a hernia?
That can depend on the type of hernia.
- Abdominal wall hernias usually present as a bulge in the abdomen. They are often smaller in the morning and get bigger at the end of the day. They become more noticeable when someone is standing for a prolonged period, lifting heavy objects, or straining their abdomen.
- Diaphragmatic hiatal hernias are associated with eating problems, such as constant heartburn, regurgitation, or feeling like food is stuck in the chest.
When is it time to see a doctor?
In general, it’s important to see a doctor immediately if you are experiencing any of the following symptoms:
- A bulge or lump in the abdomen or groin area
- Sudden or severe pain by the bulge area; aching, pressure, burning, or a dull, nagging pain, or a burning sensation when coughing
- Heartburn or reflux type of symptoms
- Nausea or vomiting that’s not from food poisoning or a related virus
How do you diagnose a hernia?
Abdominal wall hernias are usually diagnosed with a physical exam. In some cases, imaging studies such as an ultrasound or CT scan may be used to confirm the diagnosis. Diaphragmatic hiatal hernias cannot be diagnosed by physical exam alone and require additional testing, such as endoscopy, manometry, or CT imaging.
What is the treatment for hernias?
The definitive treatment for a hernia is surgery. The defect is not going to close on its own and may increase in size over time. There are two main surgical approaches that I offer:
- Open repair is a traditional approach where a single larger incision is made for direct access to push the protruding tissue back into the abdomen. It‘s often used for larger complex surgeries. The recovery time is longer with typically more pain.
- Minimally invasive approach
- Laparoscopic repair is a minimally invasive repair method where small incisions are made with use of a camera, and specialized tools. The recovery time is faster with less pain and fewer infections.
- Robotic-assisted repair is a variation of laparoscopic surgery where a robotic system is used to enhance precision, control, and visualization during complex repairs.
What are the benefits of robotic surgery for hernias?
I perform robotic surgery for hernias often and this option is becoming more popular because of its unique benefits for patients.
Some key benefits include:
- Faster, more comfortable recovery, less pain and discomfort, and quicker return to normal activities.
- Minimal scarring because the procedure uses small incisions.
- Hospital stay is shorter, most patients go home the same day of surgery.
- Less risk of complications because advanced technology and imaging pinpoint the precise location.
- Lower recurrence of hernias because the robotic technology provides excellent dissection and suturing capabilities that allow us to make secure repairs.
What is recovery like after hernia surgery?
Most of my patients go home the same day within a few hours after surgery. Recovery involves managing mild to moderate soreness or pain, returning to normal diet in one to two days, and resuming light activity within one to two weeks. Patients can go resume their normal activities within four to six weeks. A full recovery typically takes four weeks.
What distinguishes hernia treatment at Mount Sinai?
Mount Sinai is a recognized leader in hernia care. We specialize in minimally invasive, robotic, and complex abdominal hernia surgeries. With advanced technology and extensive surgical expertise, we can repair a range of hernia types with minimal scarring, quicker recovery, and positive outcomes. As a premier research hospital and academic health system, we are always looking to improve the patient experience by applying scientific discoveries to the clinic.
Beyond that, what stands out is our comprehensive, personalized, and holistic care approach. When a patient visits us, they will feel comfortable, listened to, and have clear communication with our team of experts. We listen to their concerns and together we formulate the best individualized treatment plan. Patients can trust our team, and feel safe, supported, and confident in our care. With coordination across specialties, patients will have a seamless and stress-free journey from diagnosis and through recovery.
Please call 718-951-9661 to schedule an appointment.