A hernia is a condition that occurs when an organ bulges or pushes through muscle or tissue, most commonly in the abdominal area. Hernias can be painful—and occasionally even may turn into a life-threatening emergency. They are often caused by muscle weakness or strain, or a combination of both.
The most common type of hernia is an inguinal hernia. An inguinal hernia occurs when the muscles of the lower abdominal wall have become weakened or torn and the intestines or fatty tissue push through it. This type of hernia gets its name because it often occurs in the “inguinal canal”, a space to the right and left of the groin at the base of the abdomen.The inguinal canal houses a cord which supports the testicles (the spermatic cord) in men, and contains a ligament supporting the uterus in women.
Inguinal hernias are more common in men, in part because sometimes the inguinal canal doesn’t close properly after the testicles descend through the inguinal canal shortly after birth, leaving the area weakened. There may be a number of other causes for an inguinal hernia, including general weakness of muscles of the groin or abdomen, or sustained pressure on the area.
Without treatment, the portion of the intestines or tissue may not be able to be pushed back into place, and the hernia becomes “incarcerated”. Sometimes, an incarcerated hernia swells cutting off blood supply to the intestines and creating a dangerous strangulated hernia, which requires emergency medical attention.
A ventral hernia occurs when tissue pushes through abdominal muscles. This type of hernia can happen at any location on the abdominal wall, but typically only refer to those that happen above the inguinal area.
A ventral hernia may develop over time from muscle strain, pregnancy (especially multiple pregnancies), or obesity. One commonly occurring type of ventral hernia is known as an incisional hernia, which is the result of surgical scarring that has weakened or thinned the abdominal muscles. Ventral hernias can also become incarcerated and strangulated, leading to the need for emergency surgery.
The risk for ventral hernias can increase with certain risk factors, including older age, congenital defects, pregnancy, obesity, previous hernias or family history of hernias, abdominal surgery, bowel injuries, constipation, and heavy lifting.
Symptoms of Inguinal and Ventral Hernias
Recognizing the symptoms of an inguinal or ventral hernia is usually not difficult. You may see a protruding bulge, which may become less noticeable when you lay down. With an inguinal hernia, you may see a bulge on one or both sides of the groin, and men sometimes experience a swollen or enlarged scrotum.
Sometimes, people don’t experience pain with a hernia until it becomes large. Some people may experience general discomfort, aching, or a burning sensation in the area of the hernia. You may also feel sharp pain—especially with strenuous activity such as exercise, lifting, or straining. The pain may get better with rest. Some people with inguinal hernias may feel pressure or weakness in the groin and men may experience pain in the scrotum.
Minor or No Symptoms
A hernia may cause discomfort only occasionally when lifting, coughing, straining, or during bowel movements. Or, you may only notice sharp or dull aching with prolonged standing or sitting, especially getting worse later in the day.
Occasionally, a person who has a hernia will experience no symptoms, only discovering the hernia during a physical or other medical exam. It’s still important to seek treatment for a hernia so that it doesn’t grow and possibly develop complications.
If you have a strangulated hernia requiring emergency attention, you may notice redness, extreme or sudden pain, fever, rapid heart rate, nausea, vomiting, or inability to have a bowel movement. These are life-threatening symptoms that require emergency surgery.
How are Inguinal and Ventral Hernias Diagnosed?
If you have symptoms of a hernia or a healthcare provider suspects you may have a hernia, it’s a good idea to have a consultation with a qualified general surgeon.
To diagnose an inguinal or ventral hernia, your doctor will perform a physical exam, including feeling along your abdomen or groin area and asking you to stand and cough. The doctor will discuss your medical history and symptoms. Hernias can often be diagnosed with a physical exam, but sometimes imaging tests will be ordered to diagnose an inguinal or ventral hernia. These tests may include abdominal ultrasound, CT scan, or MRI.
Treatment for Inguinal and Ventral Hernias
An untreated hernia will not go away on its own. Hernia repair through surgery is the only effective way to treat a hernia. If left untreated, you run the risk of developing serious complications.
Hernia repair is a very common and highly successful surgery, with the goal of returning the herniated tissue back into the abdominal cavity and repairing the weakness or defect in the abdominal wall, often reinforcing it with a mesh structure.
Many hernia repairs are still performed as open surgeries, which require one large incision in the abdomen near the groin. Both inguinal hernia repair and ventral hernia repair now have laparoscopic options, which are less invasive, using smaller incisions possible with the use of tiny cameras to help guide the surgery.
Benefits of Robotic Surgery
Robotically-assisted surgery with the Da Vinci surgical system may offer many benefits for those who qualify for this option. The Da Vinci system gives surgeons a 3D, high-definition view of the patient’s anatomy. The fine instrumentation gives surgeons precision range of motion that’s not possible with the human hand and traditional scalpel. This refinement in dexterity, visibility, and technical precision makes robotic hernia repair minimally-invasive, and may offer the following benefits, compared to traditional surgery:
- Less blood loss
- Less surgical trauma
- Smaller surgical incisions
- Less scarring
- Low risk of complications
- Shorter hospital stay
- Faster recovery time
Dr. Abtin Khosravi can advise what surgical option may be right for you, based on the location of your hernia, medical history, and other factors. Learn more about laparoscopic hernia repair and ventral hernia repair with Dr. Abtin Khosravi.
About Our Practice
Dr. Abtin Khosravi, MD, is a board-certified general surgeon leading Orange County Robotic General Surgery. He specializes in traditional open, as well as minimally invasive laparoscopic and robotic general surgery. Learn more about our practice.