DR. MASTRANGELO ANSWERS YOUR QUESTIONS ABOUT HERNIAS

What is a hernia? 

A hernia is a defect or hole between two anatomic areas that allows tissue to move from one area into another when pressure is applied on either side. Hernias can be congenital (you are born with them) or they can appear suddenly from wear and tear over time. A hernia can also become incarcerated (stuck out) or strangulated (choked off), resulting in a potentially life-threatening condition requiring emergency medical care.

Will I feel a bulge if I have a hernia?

Most hernias come with a bulge, but smaller or developing ones may present with pain or discomfort but no bulge. Some hernias are internal such as hiatal hernias where the stomach migrates up into the chest through a hole in the diaphragm.

What is a sports hernia?

Sometimes called a dancer’s hernia, soccer hernia, or athletic pubalgia, it’s a small tear in a ligament in the groin that causes severe pain without a bulge and requires an ultrasound or MRI to detect.

There are many types of hernias and I get confused | Do I need a hernia specialist?

You’re right, there are many types of hernias and variations plus each patient is unique. Most general surgeons specialize in one or two types of hernia repairs. This one-size-fits all approach is not always optimal. A hernia specialist routinely performs many different types of repairs including open and minimally invasive and robotic repairs, and performs repairs using synthetic mesh, biomesh and mesh-free repairs. The specialist is up-to-date on the most recent advances in hernia repair, participates in national education, and reports their outcomes to a national quality database to monitor results and get feedback.

What’s the recovery like from a hernia surgery?

Most of my patients are back to their active lives very quickly, especially when we are using a minimally invasive technique. Your recovery times are based on factors ranging from the severity of the hernia to the chosen treatment plan. In order to allow adequate time for healing, strenuous activity is avoided for 4-6 weeks.

Will the surgery be painful?

Everyone is different.  Patients report anywhere from no pain and no use of pain medicine to significant discomfort in the first week following surgery.  Carefully placed local anesthetic significantly decreases discomfort after surgery for up to 3 days. Careful technique and use of absorbable materials can help to mitigate post-operative pain.

I hear a lot about mesh.  Is it safe?

Many hernias do not require mesh. When appropriate, mesh reinforces the body’s own tissues and can decrease the risk for reoccurrence especially in patients whose lifestyle activities will put large pressures or tension on the area of the repair, or patients with medical conditions that inhibit healing.

When you consider the number of types of repairs available and the number of mesh materials available for repair, and the different suture and fixation devices, there are several thousand combinations possible for any given hernia repair. The key to a successful hernia repair is to consider each patient’s needs and expectations and when necessary, use appropriate mesh materials in a proven and safe manner.

Do I have to get my hernia fixed | Will I need surgery?

Your options range from watchful waiting and use of a truss or pad to hold the hernia in place, to open surgical and laparoscopic or robotic-assisted repairs. The hernia will not be cured without surgical repair since it’s a physical hole or defect in most cases.