South Florida Hospital News
Tuesday August 4, 2020
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August 2020 - Volume 17 - Issue 2
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Hernias are more common than you think

According to the U.S. Food & Drug Administration (FDA), at least one million surgical hernia repairs are performed each year in the U.S. alone. The FDA reports about 800,000 of those hernia repairs are inguinal hernias. 
 
What is an inguinal hernia? 
 
An inguinal hernia occurs when internal organs within the abdomen, most commonly a part of the small intestine or fat, protrude outward through a vulnerable area in the lower portion of the body’s abdominal wall. Inguinal hernias can bulge outward from the inguinal canals located on either side of the groin or via deeper passageways known as femoral canals. During the occurrence, a part of the abdominal cavity, known as the peritoneum, swells and a sac forms around the actual hernia. 
 
Inguinal hernias are common, especially in men. Only about two out of every ten cases occur in women. About one out of every four males will develop an inguinal hernia during their lifetime. Chances of developing an inguinal hernia are most common in people ages 75 to 80. A trained general surgeon can explain the type of hernia ailment and whether it’s an indirect inguinal hernia or direct inguinal hernia. 
A direct inguinal hernia is primarily due to a weak portion of the inguinal canal wall where contents of the abdomen bulge out causing a hernia. An indirect inguinal hernia, which is congenital, presents at birth due to an opening in the inguinal canal and can develop later in life. 
 
Do inguinal hernias have signs and symptoms?
 
In men, inguinal hernias can appear as a bulge in the scrotum. Inguinal hernia symptoms may include feelings of discomfort, pain, heaviness or a burning sensation in the groin area. Symptoms associated with an inguinal hernia may worsen when the individual strains, lifts, coughs or stands for a long period of time. Some inguinal hernia symptoms may lessen when resting or lying down. 
The most dangerous aspect of inguinal hernias arise if the contents of the hernia project through the abdominal wall and cannot be massaged back in by a trained physician and becomes strangulated, possibly losing blood flow. If intestinal obstruction occurs at this time, part of the intestine could die. Other strangulated hernia symptoms include fever, redness, severe pain in the hernia area, abdominal pain, bloating, nausea and vomiting. If symptoms of a strangulated hernia occur, go to the emergency room right away. 
 
For the above mentioned complications, hernia repair should be done, once diagnosed.
 
Does a past history make some people more vulnerable to inguinal hernias?
 
Inguinal hernias are also more common in males with a history of prostatectomy or surgical removal of the prostate gland. Also, a family history of inguinal hernias, lower body mass index (BMI) or connective tissue disorder increases the incidence.
 
Doctors use various criteria to diagnose an inguinal hernia which may include medical history, symptoms and possibly imaging tests. During a physical exam, the doctor may attempt to massage the hernia back into the abdomen. 
How does a trained general surgeon treat an inguinal hernia? 
 
In most cases, treatment of an inguinal hernia will require surgery. Open and minimally invasive robotic or laparoscopic hernia repair surgeries are available today. The doctor will provide recommendation of the type of hernia repair surgery based on a variety of factors including size of the hernia, age of the individual as well as past medical history. 
 
During a minimally invasive hernia repair surgery, a surgeon makes small incisions in the abdomen to insert specialized scopes and tools to view and repair the hernia. The hernia repair may include insertion of a surgical mesh sutured or glued over the open hernia to strengthen and fortify the abdominal wall. In most cases, patients do receive general anesthesia for minimally invasive hernia repair surgery. One of the main benefits of minimally-invasive surgery is a shorter recovery time, in most cases, than open surgery. 
 
After hernia surgery, pain or discomfort may present. Pain from a hernia repair surgery is, in general, mild and shouldn’t last for more than one to two weeks. A doctor can prescribe certain medications in an effort to ease pain. After the hernia procedure, most people can resume normal daily activities including going back to work within three to five days post-surgery. Talk with your doctor about when it’s safe to resume normal activities. 
Any individual with a suspected hernia or any type of ailment, disease or disorder should seek medical attention from a trained, experienced doctor who will determine a plan of care. 
 
Dr. Alexis Abril | Dr. Alexis Abril is an experienced general surgeon specializing in general surgery, stereotactic breast biopsy, hernia repair, vascular surgery and peripheral noninvasive surgery. He is a member of the American Society of Breast Surgeons and the Society of Laparoendoscopic Surgeons. Dr. Abril’s Tenet Florida Physician Services office is located in Coral Gables, FL and he is on-staff at Coral Gables Hospital. 
 
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