By Alvaro H. Devia, MD

Hernias are common problems that affect people of all ages. A hernia is a protrusion of body contents through the lining of the body that is designed to contain them. Hernias can occur in many different areas of the body, but the most common location is the inguinal, or groin, area.

Even though inguinal hernias occur much more frequently in men than women, they are the most common type of hernias in women. Other common areas include the anterior abdominal wall, as well as hernias that occur at the site of previous operations, known as incisional hernias. An estimated four million to five million Americans have some type of hernia.

A serious threat
A hernia does have the potential to cause serious health problems. If the intestines pass through the hernia out of the body cavity where they belong, they can become trapped, or incarcerated. This can lead to compromise of the blood supply to the intestines, strangulation and death of that part of the intestine, and possibly, death of the patient from the effects of the dead intestine.

Patients who have incarcerated hernias with strangulated contents usually require emergency surgery. Preventing this type of emergency is one reason for hernia repair. Although they may not create such dramatic situations, hernias often cause significant pain, particularly when patients lift objects. Over time, hernias tend to become larger with increasing symptoms. For these reasons, most healthcare providers recommend repairing hernias when they are present.

Doctors usually can diagnose hernias with a careful history and physical examination. On occasion, it may be difficult to determine whether someone has a hernia, and further imaging may be required to make the diagnosis.

Alvaro H. Devia, MD

Improved treatments

As with most areas in medicine and surgery, the science and technology of hernia repair is always in evolution. The way the same hernia is fixed has changed significantly. One of the most dramatic changes in the past 15 years has been the shift to mesh repairs as the standard for most types of hernia repairs. By using mesh, essentially a plastic screen, to repair hernias, lower recurrence rates and stronger repairs have resulted. The mesh is designed to stay in the body permanently and has lowered the recurrence rate in inguinal hernia repair to one percent or less. Many different types of mesh are available, each with design features that theoretically can make the repair better, the recurrence rate lower or the recovery easier.

More recently, the use of laparoscopy, a tube with a tiny video camera inserted into a small incision, has become more prevalent in hernia repair. In properly selected patients, laparoscopic hernia repairs can result in a shorter and less painful recovery, which can mean a quicker return to work and normal activity.

Most hernia repairs performed today are done on an outpatient basis. Most patients will be restricted from heavy lifting for three to six weeks. Exercise usually can be increased sooner on a gradual basis, and many patients are back at work in about a week.

Today's surgical expertise offers many options to treat hernias and allows for a relatively rapid recovery and return to work and normal activity. It also decreases the chances of a recurrence.

Alvaro H. Devia, MD, is a general surgeon with Premiere Surgical Specialists in Reno. For an appointment or more information, please call 324-0288.

Northern Nevada Medical Center 2375 E. Prater Way, Sparks, NV 89434 775-331-7000