Hernia Facts
Frequently Asked Questions
General Hernia Questions
What is a hernia?
A hernia is the protrusion of tissue or organs through a hole (defect) in the dense layers (muscle and fascia) of the abdomen and groin. Think of squeezing something in your fist and seeing it squeeze out between your fingers; that is similar to a hernia. These hernia defects can be present from the time of birth (congenital) and others can develop throughout the course of your lifetime. Hernias often present as a bulge that can be seen or felt by the patient. As underlying organs and tissue protrude through the hernia defect, they may get squeezed which commonly leads to pain with activity or straining.
What are the symptoms of a hernia?
A hernia usually causes a visible bulge or lump; pain or discomfort, especially when bending, coughing, or lifting; heaviness or pressure in the abdomen; burning or aching sensation at the site. Hiatal hernias often cause heartburn, acid reflux and chest pain. Occasionally, more serious issues can occur such as a blockage of bowels (obstruction), or loss of blood flow to organs (strangulation). If organs die from lack of blood flow within the body, they can make you very sick and in rare cases lead to death. These uncommon, less likely situations may require emergent medical attention and surgery.
What are the common types of hernias?
Inguinal and femoral hernias are found in the groin area. Umbilical hernias are found at the navel (belly button). Hiatal hernias are where the contents of the abdomen push through the diaphragm into the chest. Incisional hernias are at the site of a previous surgical incision.
I think I have a hernia, but I am not sure. Is it appropriate to see a hernia surgeon?
Hernias commonly occur at the belly button, groin, and sites of surgical scars. The symptoms of a hernia vary from patient to patient, but discomfort and/or a bulge is common. Seeking consultation from your primary care provider is the most appropriate first step in your evaluation. If the presence of a hernia is uncertain, imaging might be obtained prior to seeking additional consultation from a hernia surgeon. Many times, hernias do not require an operation, and your hernia surgeon can help guide you as to whether an operation is advised or whether watchful waiting is appropriate.
Are hernias dangerous?
Some hernias may remain painless and harmless. However, occasionally hernias can become serious if the protruding organ gets trapped (incarcerated) or loses blood supply (strangulated), which is a medical and surgical emergency.
Can a hernia heal on its own?
Hernias do not heal on their own. Surgery is the only definitive way to repair a hernia. In some cases, if the hernia is small and not causing symptoms, a doctor may recommend watchful waiting.
How do I know if my surgeon is a hernia specialist?
Hernia surgery is an essential component of general surgery. Most general surgeons offer hernia repairs. A hernia specialist is a surgeon with a special interest in hernias and with experience treating complex hernias. You can Find a Hernia Surgeon through the American Hernia Society website. A surgeon member of the American Hernia Society has a special interest in caring for patients with hernias, but this does not mean all surgeon members have similar expertise. Take care to research your condition and the individual surgeon's experience by asking questions during your consultation.
How are hernias diagnosed?
Diagnosis is usually made through obtaining information from the patient and physical examination. Imaging tests such as ultrasound, CT scan, or MRI can help in establishing the diagnosis if the diagnosis is unclear or to guide planning for surgery. Hiatal hernias cannot be diagnosed by physical exam and require imaging studies or endoscopy to establish the diagnosis.
What radiologic studies do I need to confirm that I have a hernia?
Oftentimes, the surgeon’s exam alone can determine if you have a hernia and might be all that is needed. In some cases, the surgeon would request additional radiologic studies such as ultrasound, CT scan or MRI to confirm the diagnosis and for surgical planning.
I have an appointment with my surgeon. What questions should I ask?
Prior to your consultation with a hernia surgeon, you should ensure the surgeon is licensed and board certified. You can confirm your surgeon is licensed for free through your state's Medical Board and board certified for free through Osteopathic Board Certification Confirmation for Osteopathic Surgeons (DO) and the American Board of Medical Specialties website for Allopathic Surgeons (MD). During your appointment with your hernia surgeon, come prepared to ask questions about your surgeon's experience in treating your condition. Asking your surgeon about their experience with your type of hernia and their techniques of repair is appropriate. For more information, check out this video “Top 10 Questions to Ask Your Hernia Surgeon.”
Hernia Surgery
My surgeon talked about different ways to repair my hernia. What is the difference between an open, laparoscopic and robotic hernia repair?
An open hernia repair involves making a larger incision directly over or near the site of the hernia, replacing the contents into their original location and commonly closing the hernia defect (hole) with stitches (sutures). Many repairs use mesh to reinforce the repair, but some hernia repairs do not use mesh. Laparoscopic and robotic procedures are minimally-invasive repairs that involve multiple smaller incisions and inflation of the abdomen with gas. This gas allows space for the surgeon to see with a camera that is able to fit through small ports placed into the abdomen using those small incisions. The surgeon will then use small instruments on long sticks to perform the procedure. Open, laparoscopic and robotic surgeries all have different risks and benefits.
My surgeon plans to fix my hernia robotically. Does that mean my surgeon will not be there?
The robotic platform is a minimally invasive tool surgeons may use to help them provide safe and effective hernia repairs. The surgeon performs the procedure while controlling the robot from within the operating room. Your surgeon will remain with you for the entire procedure. The robot machine does not act without the surgeon’s control and direction. Think of it as replacing the surgeon’s hands with miniature hands that can fit inside you.
My hernia surgeon plans to use mesh in the repair. Is mesh safe?
The general reason behind using a mesh is to decrease your risk of the hernia coming back (recurrence). Depending on your unique hernia and situation, this is a good conversation to have with your surgeon. While there are many places that provide information on mesh, not all of them are reliable. The best source of information is your surgeon, who can discuss the risks and benefits of having mesh for a hernia repair.
What are the risks of hernia surgery?
Some of the risks of surgery depend on which type of hernia is being repaired and the approach the surgeon chooses to perform the surgery, such as an open or minimally invasive repair (laparoscopic/ robotic). General risks for any procedure include bleeding, infection, hernia recurrence (meaning the hernia returns), injury to surrounding structures at the site of the repair, risks to the heart and lungs from general anesthesia, chronic pain, need for additional procedures and poor healing wounds leaving unsightly scars. For a more specific list of risks, ask your surgeon at your preoperative (before surgery) appointment. Your surgeon may also be familiar with risk calculators that can identify your specific risk of many of the general complications.
What is one thing I can do to help my hernia surgery be successful?
Stay healthy! There are a few well-known risk factors such as diabetes, smoking and obesity. All these risk factors substantially increase your risk of complications related to hernia repair surgery, such as wound infection, non-healing wounds and the hernia coming back (recurrence). Do what you can to prevent complications by stopping smoking at least 1 month prior to your surgery and continuing to refrain from all smoking following surgery to greatly reduce risk to you and your repair. It is also important to maintain normal glucose levels with good diabetes control as well as maintain a healthy weight prior to surgery. Your surgeon and medical doctors can help set goals to reduce risk and optimize outcomes following hernia repair. Visit our YouTube channel, specially designed for patients, for tips to prepare and optimize your procedure.
How much does a hernia repair cost?
Hernia surgery costs vary by location, insurance coverage and provider. Most hernia repairs are covered by federal and private insurance providers. Contact your insurance company prior to scheduling your hernia surgery to ensure coverage of both the hospital expenses and those of the surgeon to perform the repair. Most surgical practices have a billing department who will be able to help you with individualized questions on financing and cost of your hernia surgery, as well as obtaining pre-authorization from insurance.
Hernia Surgery Recovery & Possible Complications
I had my hernia repaired. What do I need to do after surgery?
In the postoperative period (after surgery), it is important to avoid strenuous activity. Your surgeon will tell you how long to wait until you are able to return to various activities as part of their postoperative care instructions. Some restrictions may be as long as 2-3 months after surgery (for example, heavy lifting or straining), while others may be resumed shortly after surgery (such as walking, running and other select cardiovascular exercises). The wait time will depend on the surgery you have and your unique characteristics, with your surgeon determining the optimal timeframe for you. It is also important to listen to your body. If a specific action or activity hurts, your body is telling you to stop and it would be best to refrain until speaking with your surgeon for more instruction. “If it hurts, don’t do it” may be a useful guide.
What is a seroma or hematoma and will I get one after hernia repair?
A seroma or hematoma is a collection of fluid at the site of a prior hernia where the bulging tissue used to be. Seromas are filled with thin, watery, clear yellowish fluid while hematomas are filled with bloody looking fluid. Both are common after hernia surgery and it is likely one may occur following your surgery. This is normal and is not a complication of the repair. After hernia surgery, the space that was created by the protrusion of the tissues or organs through the hernia defect becomes empty. The body then fills the space with fluid. This is a natural response to the hernia surgery. Seromas and hematomas can be felt as a bulge at the site of hernia surgery and usually occur within the first few weeks of surgery. If you feel a bulge at the site of your hernia surgery, contact your surgeon who would be able to differentiate seromas and hematomas from a recurrent hernia.
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What is a hernia recurrence?
A hernia recurrence is when a hernia that was previously repaired comes back. This can happen due to many reasons, and it can occur without fault. Hernia recurrence is not an emergency by itself. If you feel a new bulge or pain at a previous hernia repair site after full recovery, contact your hernia surgeon for a follow up appointment to discuss next steps.