What kind of doctor should you see for a hernia? Learn about the different types of hernias, their symptoms, and the available treatments including surgery. Get answers to common questions about hernia diagnosis and management.

Understanding Hernias: Types and Symptoms

A hernia is a condition where an organ or tissue pushes through a weak spot or opening in the surrounding muscle or connective tissue. The most common types of hernias include:

• Inguinal hernia – Occurs in the groin area, where the abdomen meets the thigh.
• Umbilical hernia – Appears as a bulge around the belly button, usually present from birth.
• Femoral hernia – Develops in the upper thigh, just below the groin.
• Hiatal hernia – Occurs when part of the stomach pushes up through the diaphragm into the chest cavity.

Hernias can cause a variety of symptoms, including:

• Pain or discomfort – Especially when lifting, coughing, or straining.
• Bulge or lump – That may be visible or palpable, especially when standing or bearing down.
• Difficulty swallowing – In the case of a hiatal hernia.
• Acid reflux – Also associated with hiatal hernias.

Diagnosing a Hernia

How is a hernia diagnosed? A physical examination by a healthcare provider is often sufficient to diagnose a hernia. They may be able to see or feel the bulge, especially when the patient is standing or bearing down. Additional tests that may be used include:

• Ultrasound – To visualize a femoral hernia.
• Abdominal X-rays – To check for bowel obstruction.

Hernia Treatment Options

The main treatment for a hernia is surgery, known as herniorrhaphy. There are several surgical options:

Traditional Hernia Surgery

In this approach, the surgeon makes an incision, pushes the protruding tissue back into place, and repairs the weakened muscle or connective tissue. This may involve the use of synthetic mesh or tissue to strengthen the area.

Laparoscopic Hernia Repair

A less invasive technique that uses a small camera and instruments inserted through tiny incisions to perform the repair. This results in smaller scars and a faster recovery time.

In some cases, particularly with small umbilical hernias in children, the hernia may not require immediate surgery if it is not causing significant symptoms. The doctor may recommend a “wait and see” approach, monitoring the hernia regularly.

Risks and Considerations for Hernia Surgery

Hernia surgery is generally safe, but like any procedure, it carries some risks, including:

• Infection at the incision site
• Bleeding or hematoma formation
• Nerve damage leading to numbness or pain
• Recurrence of the hernia

It’s important to follow your surgeon’s post-operative instructions closely, including avoiding heavy lifting and strenuous activity for several weeks to months, depending on the type of hernia and repair.

When to See a Doctor for a Hernia

If you suspect you have a hernia, it’s important to see a healthcare provider, such as a general surgeon or gastroenterologist, for an evaluation. They can confirm the diagnosis and recommend the appropriate treatment plan. Seek immediate medical attention if you experience sudden, severe pain, nausea, vomiting, or an inability to pass gas or have a bowel movement, as these may be signs of a potentially life-threatening hernia complication.

Preventing Hernia Recurrence

After hernia surgery, there are steps you can take to help prevent the hernia from returning:

• Maintain a healthy weight and avoid activities that put strain on the abdominal muscles, such as heavy lifting.
• Use proper lifting techniques, bending at the knees and keeping your back straight.
• Treat and prevent constipation, which can increase abdominal pressure.
• Quit smoking, as it can weaken the connective tissues and increase the risk of recurrence.

Regular follow-up with your surgeon is also important to monitor for any signs of hernia recurrence.

Key Takeaways

Hernias are a common condition that occur when an organ or tissue protrudes through a weak spot in the surrounding muscle or connective tissue. While some hernias may not require immediate treatment, surgery is the primary treatment option to repair the defect and prevent potentially serious complications. If you suspect you have a hernia, it’s important to see a healthcare provider for an evaluation and appropriate management.

Hernia Tests and Treatments: Truss, Surgery, & More

How Is a Hernia Diagnosed?

A physical exam by your health care provider is often enough to diagnose a hernia. Sometimes hernia swelling is visible when you stand upright; usually, the hernia can be felt if you place your hand directly over it and then bear down. Ultrasound may be used to see a femoral hernia, and abdominal X-rays may be ordered to determine if a bowel obstruction is present.

What Are the Treatments for A Hernia?

In babies, umbilical hernias may heal themselves within four years, making surgery unnecessary. For all others, the standard treatment is conventional hernia-repair surgery (called herniorrhaphy). It is possible to simply live with a hernia and monitor it. The main risk of this approach is that the protruding organ may become strangulated — its blood supply cut off — and infection and tissue death may occur as a result. A strangulated intestinal hernia may result in intestinal obstruction, causing the abdomen to swell. The strangulation can also lead to infection, gangrene, intestinal perforation, shock, or even death.

Conventional Medicine for a Hernia

Hernia surgery is performed under either local or general anesthesia. The surgeon repositions the herniated tissue and, if strangulation has occurred, removes the oxygen-starved part of the organ. The damaged muscle wall will frequently be repaired with synthetic mesh or tissue.

Increasingly, herniorrhaphy is being performed using a laparoscope, a thin, telescope-like instrument that requires smaller incisions and involves a shorter recovery period and less post-operative pain. Hernia repairs are usually performed as an outpatient procedure. There are usually no dietary restrictions, and work and regular activity may usually be resumed in one or two weeks. Complete recovery usually takes three to four weeks, with no heavy lifting for two to three months. Ask your surgeon for specific instructions after your surgery.

Hernias may return after surgery, so preventive measures are especially important to help avoid a recurrence.

Umbilical Hernia: Should I Have Surgery?

You may want to have a say in this decision, or you may simply want to follow your doctor’s recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Umbilical Hernia: Should I Have Surgery?

Get the facts

Your options

• Have surgery now to repair your umbilical hernia, even if you don’t have symptoms.
• Take a “wait and see” approach to surgery because the hernia doesn’t bother you much.

Key points to remember

• Hernias don’t go away on their own. Only surgery can repair a hernia.
• Many people are able to delay surgery for months or even years. And some people may never need surgery for a small hernia. If the hernia is small and you don’t have any symptoms, or if the symptoms don’t bother you much, you and your doctor may simply continue to watch for symptoms to occur.
• Over time, hernias tend to get bigger as the muscle wall of the belly gets weaker and more tissue bulges through.
• Many doctors recommend surgery because it prevents a rare but serious problem called strangulation. This occurs when a part of intestine or a piece of fatty tissue is trapped inside the hernia and is cut off from its blood supply.

FAQs

An umbilical hernia is a bulge near the belly button, or navel. The hernia has a sac that may hold some intestine, fat, or fluid. These tissues may bulge through an opening or a weak spot in the stomach muscles. You may have had this weak spot since you were born, when muscle and other tissue around your umbilical cord didn’t close properly.

In adults, umbilical hernias are more common in women who have been pregnant several times, in people who are overweight, and in people who have had surgery in the belly.

Repairing the hernia can relieve pain and discomfort and make the bulge go away. The hernia won’t heal on its own.

Your doctor may recommend surgery if:

• Your hernia is very large.
• Your hernia bothers you.

Your doctor will recommend surgery right away if:

• You have pain, a swollen belly, or other signs of a rare but major problem called strangulation or incarcerated hernia. This can occur when the intestine gets trapped in the hernia sac and loses its blood supply.

During the surgery, the doctor makes a small cut, or incision, just below the belly button. Any tissue that bulges into the hernia sac is pushed back inside the belly. The muscles and tissues around the belly button are repaired, and the cut is closed with stitches.

Usually there is only a small scar, but if the hernia is very large, the belly button may not look normal. Most of the time, a surgeon can fix this. This surgery has few risks.

A synthetic patch or mesh may be used to repair your hernia. Patch use is becoming widespread in repairing hernias in adults. A patch may strengthen your abdominal wall, reduce your discomfort after surgery, and reduce the chance that your hernia repair will have to be done again.

There are two types of hernia repair surgeries:

• Open hernia repair surgery. The hernia is repaired through a cut (incision) in the belly. Open surgery is safe and effective and has been done for many years.
• Laparoscopic hernia repair. A surgeon inserts a thin, lighted scope through a small incision in the belly. Surgical tools to repair the hernia are inserted through other small incisions in the belly. Laparoscopic hernia surgery may have some advantages over open surgery in certain cases. Studies show that people have less pain after this type of surgery and can return to work and other activities more quickly than after open repair. But this surgery costs more than open repair.

It can take up to 4 weeks after open hernia surgery before you can begin normal strenuous activities. If you have laparoscopic surgery, you may recover sooner.

You and your doctor may want to put off surgery if:

• The hernia is small and you don’t have any symptoms, or if the symptoms don’t bother you much.
• The hernia can be pushed back into the belly or it goes away when you lie down. (If it cannot be pushed back, surgery must be done sooner.)

It may also be a good idea to put off surgery if:

• You are pregnant.
• You have other health problems that make surgery dangerous.

Talk with your doctor before wearing a corset or truss for a hernia. These devices aren’t recommended for treating hernias and sometimes can do more harm than good. There may be certain cases when your doctor thinks a truss would work, but these are rare.

Your hernia may get worse, but it may not. Over time, hernias tend to get bigger as the muscle wall of the belly gets weaker and more tissue bulges through. But some small, painless hernias never need repair.

Compare your options

Compare Option 1Have surgery nowWait and see

Compare Option 2Have surgery nowWait and see

Have surgery now Have surgery now

• You may be asleep during the operation. Or the doctor may keep you awake and simply numb the area around your belly button.
• You may have an epidural, which is medicine that numbs your body below the point of the injection. You may remain awake during the operation.
• You don’t need to stay overnight in the hospital.

• Surgery prevents the rare but serious problem called strangulation.
• It relieves the bulge from the hernia and any swelling or feeling of heaviness, tugging, or burning in the area of the hernia.

• The hernia could come back.
• Risks of surgery include:
  • A bad reaction to the anesthesia.
  • Infection and bleeding.
  • Damage to the intestines or bladder if the surgery is a laparoscopic repair.

Wait and see Wait and see

• You will get regular checkups to watch for changes.
• You watch for signs of problems related to the hernia, such as vomiting, pain, or a swollen belly.

• You don’t have the risks or costs of surgery.

• A rare but serious problem called strangulation could occur.

I’m pregnant, and I have a small hernia that doesn’t hurt. I’ve talked with my doctor about it, and she said I could have surgery as long as I have an epidural and not general anesthesia. But she said it may be best to wait until I’m done having kids. There’s a risk I could get another hernia when I get pregnant again. So as long as my hernia doesn’t get worse, I’ll wait.

I’ve had a hernia for a few years now. My doctor said it may have happened because I lost a lot of weight and my stomach muscles were weak. So I started exercising to try to get stronger, and I feel great. The hernia hasn’t ever really bothered me, except for how it looks. So I don’t feel like it’s worth having surgery now.

I’ve had a small umbilical hernia for several years but have basically ignored it. I’m not a big believer in letting people cut on my body, so I wanted to avoid surgery at all costs. But the hernia is really starting to bug me now, and it’s gotten bigger and it looks weird. So I’ve got an appointment to talk to my doctor about surgery.

I’m a nurse, and sometimes I have to lift patients and other heavy things. One day, after helping a patient transfer into a wheelchair, I felt something weird in my abdomen. Later, I noticed a bulge in my belly button. My doctor said it may have happened because I’ve gained quite a bit of weight lately. I’ve decided to go ahead and have it fixed since it’s kind of painful and it could be a problem with my work.

What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to have surgery now

Reasons to wait

My hernia is keeping me from doing daily activities or from returning to work.

My hernia doesn’t bother me at all.

More important

Equally important

More important

I want to have the hernia repaired while my insurance or worker’s compensation will help cover the costs.

I am worried about being able to afford the surgery.

More important

Equally important

More important

I will be traveling to an area where health care may not be available, so I want to take care of this now.

I have no plans to travel to places where health care may not be available.

More important

Equally important

More important

Surgery would be convenient for me at this time.

This is not a good time for me to have surgery.

More important

Equally important

More important

My other important reasons:

My other important reasons:

More important

Equally important

More important

Where are you leaning now?

Now that you’ve thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Having surgery now

Waiting to have surgery

Leaning toward

Undecided

Leaning toward

What else do you need to make your decision?

1. 1, One reason for me to have surgery for my umbilical hernia is to prevent a rare but serious problem called strangulation. 2.2, I need surgery even though my hernia is small and doesn’t bother me. 3.3, I can wait for my hernia to go away on its own. 1.1,Do you understand the options available to you?2.2,Are you clear about which benefits and side effects matter most to you?3.3,Do you have enough support and advice from others to make a choice?

1.
How sure do you feel right now about your decision?

Not sure at all

Somewhat sure

Very sure

2.2, Check what you need to do before you make this decision.

Use the following space to list questions, concerns, and next steps.

Your Summary

Here’s a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

Next steps

Which way you’re leaning

How sure you are

Your comments

Key concepts that you understood

Key concepts that may need review

Credits

Author	Healthwise Staff
Primary Medical Reviewer	E. Gregory Thompson MD – Internal Medicine
Primary Medical Reviewer	Adam Husney MD – Family Medicine
Primary Medical Reviewer	Kathleen Romito MD – Family Medicine
Primary Medical Reviewer	Kenneth Bark MD – General Surgery, Colon and Rectal Surgery

You may want to have a say in this decision, or you may simply want to follow your doctor’s recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Umbilical Hernia: Should I Have Surgery?

Here’s a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

1. Get the facts
2. Compare your options
3. What matters most to you?
4. Where are you leaning now?
5. What else do you need to make your decision?

1.

Get the Facts

Your options

• Have surgery now to repair your umbilical hernia, even if you don’t have symptoms.
• Take a “wait and see” approach to surgery because the hernia doesn’t bother you much.

Key points to remember

• Hernias don’t go away on their own. Only surgery can repair a hernia.
• Many people are able to delay surgery for months or even years. And some people may never need surgery for a small hernia. If the hernia is small and you don’t have any symptoms, or if the symptoms don’t bother you much, you and your doctor may simply continue to watch for symptoms to occur.
• Over time, hernias tend to get bigger as the muscle wall of the belly gets weaker and more tissue bulges through.
• Many doctors recommend surgery because it prevents a rare but serious problem called strangulation. This occurs when a part of intestine or a piece of fatty tissue is trapped inside the hernia and is cut off from its blood supply.

FAQs

What is an umbilical hernia?

An umbilical hernia is a bulge near the belly button, or navel. The hernia has a sac that may hold some intestine, fat, or fluid. These tissues may bulge through an opening or a weak spot in the stomach muscles. You may have had this weak spot since you were born, when muscle and other tissue around your umbilical cord didn’t close properly.

In adults, umbilical hernias are more common in women who have been pregnant several times, in people who are overweight, and in people who have had surgery in the belly.

Why does an umbilical hernia need to be repaired?

Repairing the hernia can relieve pain and discomfort and make the bulge go away. The hernia won’t heal on its own.

Your doctor may recommend surgery if:

• Your hernia is very large.
• Your hernia bothers you.

Your doctor will recommend surgery right away if:

• You have pain, a swollen belly, or other signs of a rare but major problem called strangulation or incarcerated hernia. This can occur when the intestine gets trapped in the hernia sac and loses its blood supply.

What happens in surgery for an umbilical hernia?

During the surgery, the doctor makes a small cut, or incision, just below the belly button. Any tissue that bulges into the hernia sac is pushed back inside the belly. The muscles and tissues around the belly button are repaired, and the cut is closed with stitches.

Usually there is only a small scar, but if the hernia is very large, the belly button may not look normal. Most of the time, a surgeon can fix this. This surgery has few risks.

A synthetic patch or mesh may be used to repair your hernia. Patch use is becoming widespread in repairing hernias in adults. A patch may strengthen your abdominal wall, reduce your discomfort after surgery, and reduce the chance that your hernia repair will have to be done again.

What kinds of surgeries are used to repair umbilical hernias?

There are two types of hernia repair surgeries:

• Open hernia repair surgery. The hernia is repaired through a cut (incision) in the belly. Open surgery is safe and effective and has been done for many years.
• Laparoscopic hernia repair. A surgeon inserts a thin, lighted scope through a small incision in the belly. Surgical tools to repair the hernia are inserted through other small incisions in the belly. Laparoscopic hernia surgery may have some advantages over open surgery in certain cases. Studies show that people have less pain after this type of surgery and can return to work and other activities more quickly than after open repair. But this surgery costs more than open repair.

It can take up to 4 weeks after open hernia surgery before you can begin normal strenuous activities. If you have laparoscopic surgery, you may recover sooner.

When is it safe to delay surgery?

You and your doctor may want to put off surgery if:

• The hernia is small and you don’t have any symptoms, or if the symptoms don’t bother you much.
• The hernia can be pushed back into the belly or it goes away when you lie down. (If it cannot be pushed back, surgery must be done sooner.)

It may also be a good idea to put off surgery if:

• You are pregnant.
• You have other health problems that make surgery dangerous.

Talk with your doctor before wearing a corset or truss for a hernia. These devices aren’t recommended for treating hernias and sometimes can do more harm than good. There may be certain cases when your doctor thinks a truss would work, but these are rare.

Your hernia may get worse, but it may not. Over time, hernias tend to get bigger as the muscle wall of the belly gets weaker and more tissue bulges through. But some small, painless hernias never need repair.

2. Compare your options

Personal stories

Personal stories about considering umbilical hernia surgery

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

“I’m pregnant, and I have a small hernia that doesn’t hurt. I’ve talked with my doctor about it, and she said I could have surgery as long as I have an epidural and not general anesthesia. But she said it may be best to wait until I’m done having kids. There’s a risk I could get another hernia when I get pregnant again. So as long as my hernia doesn’t get worse, I’ll wait.”

“I’ve had a hernia for a few years now. My doctor said it may have happened because I lost a lot of weight and my stomach muscles were weak. So I started exercising to try to get stronger, and I feel great. The hernia hasn’t ever really bothered me, except for how it looks. So I don’t feel like it’s worth having surgery now.”

“I’ve had a small umbilical hernia for several years but have basically ignored it. I’m not a big believer in letting people cut on my body, so I wanted to avoid surgery at all costs. But the hernia is really starting to bug me now, and it’s gotten bigger and it looks weird. So I’ve got an appointment to talk to my doctor about surgery.”

“I’m a nurse, and sometimes I have to lift patients and other heavy things. One day, after helping a patient transfer into a wheelchair, I felt something weird in my abdomen. Later, I noticed a bulge in my belly button. My doctor said it may have happened because I’ve gained quite a bit of weight lately. I’ve decided to go ahead and have it fixed since it’s kind of painful and it could be a problem with my work.”

3. What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to have surgery now

Reasons to wait

My hernia is keeping me from doing daily activities or from returning to work.

My hernia doesn’t bother me at all.

More important

Equally important

More important

I want to have the hernia repaired while my insurance or worker’s compensation will help cover the costs.

I am worried about being able to afford the surgery.

More important

Equally important

More important

I will be traveling to an area where health care may not be available, so I want to take care of this now.

I have no plans to travel to places where health care may not be available.

More important

Equally important

More important

Surgery would be convenient for me at this time.

This is not a good time for me to have surgery.

More important

Equally important

More important

My other important reasons:

My other important reasons:

More important

Equally important

More important

4.

Where are you leaning now?

Now that you’ve thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Having surgery now

Waiting to have surgery

Leaning toward

Undecided

Leaning toward

5. What else do you need to make your decision?

Check the facts

1.
One reason for me to have surgery for my umbilical hernia is to prevent a rare but serious problem called strangulation.

You’re right. Many doctors recommend surgery because it prevents strangulation, which happens when a piece of tissue gets trapped inside the hernia and is cut off from its blood supply.

2.
I need surgery even though my hernia is small and doesn’t bother me.

You’re right. If your hernia is small and your symptoms don’t bother you, you can delay surgery. Some people never need surgery.

3.
I can wait for my hernia to go away on its own.

You’re right. An umbilical hernia won’t go away on its own. Only surgery can repair it.

Decide what’s next

1.
Do you understand the options available to you?

2.
Are you clear about which benefits and side effects matter most to you?

3.
Do you have enough support and advice from others to make a choice?

Certainty

1.
How sure do you feel right now about your decision?

Not sure at all

Somewhat sure

Very sure

2.
Check what you need to do before you make this decision.

Use the following space to list questions, concerns, and next steps.

Credits

Note: The “printer friendly” document will not contain all the information available in the online document some Information (e.g. cross-references to other topics, definitions or medical illustrations) is only available in the online version.

Current as of: April 15, 2020

Author:
Healthwise Staff

Medical Review:E. Gregory Thompson MD – Internal Medicine & Adam Husney MD – Family Medicine & Kathleen Romito MD – Family Medicine & Kenneth Bark MD – General Surgery, Colon and Rectal Surgery

Inguinal Hernia Care & Treatment | Mount Sinai

If you’re experiencing the discomfort caused by an inguinal hernia, surgery is your best option for achieving relief. At Mount Sinai, our expert surgical team has extensive experience in the newest procedures for treating inguinal hernias, including laparoscopic techniques.

About Inguinal Hernias

An inguinal hernia is a weakness or defect in the abdominal wall occurring in the groin, near the opening of the inguinal canal. This is a common type of hernia that may be present since birth, or may develop over several years. More common in men, inguinal hernias can occur on one side or both sides. Most patients first notice a bulge in the groin, sometimes accompanied by discomfort. Occasionally, patients will report a strong, sharp pain in the groin, especially after heavy lifting or strenuous exercise. These hernias grow larger over time, as the pressure inside the abdomen pushes on the area of weakness.

As with all hernias, inguinal hernias may become incarcerated, or trapped, often causing significant pain that is sometimes accompanied by nausea, vomiting, or the inability to pass gas from the rectum. This is an emergency, and if this occurs, you should contact your doctor or go to the emergency room.

Hernias can be diagnosed by your doctor after listening to your history and performing a thorough physical examination. Occasionally, radiographic testing is needed to confirm the presence of a hernia.

Treatments for Inguinal Hernias

Surgical repair of an inguinal hernia is the best available treatment. At Mount Sinai, surgery for inguinal hernias can be performed laparoscopically or using the traditional open surgery method.

Open Inguinal Hernia Repair

Often referred to as the “traditional method,” this repair involves an incision being made over the site of the hernia. A surgical mesh, or patch, is usually placed over the site of the hernia within the muscle in order to provide long-term strength to the area to help prevent the hernia from recurring. As in any operation, complications such as bleeding, infection, injury to the intestines, blood clots, or heart or lung problems may occur. Before surgery, your surgeon will recommend testing to determine if it is safe for you to have surgery.

After surgery, pain, discomfort, and swelling in the groin are expected. Pain is controlled by pain medications prescribed to you upon discharge from the hospital. Patients may need to ice the site of the area for approximately four days after surgery to help relieve the swelling and bruising. After an open inguinal hernia repair, patients are usually released from the hospital on the same day as the surgery.

Laparoscopic Inguinal Hernia Repair

At Mount Sinai, our surgeons are highly skilled in laparoscopic surgery to repair inguinal hernias. In this procedure, small incisions (about ½ – 1 inch long) are made, through which the laparoscope (a tiny telescope attached to a video camera) and several instruments are inserted. A mesh, or patch, is also inserted though one of these incisions to be placed over the hernia. The mesh is secured in place using very small tacks. For patients who have two inguinal hernias (bilateral), our surgeons can repair both at the same time. Patients undergoing this procedure receive general anesthesia.

After surgery, pain, discomfort, and swelling in the groin are expected. Pain is controlled by pain medications, and you may need to ice the area for approximately four days after surgery to help relieve the swelling and bruising. Following laparoscopic inguinal hernia repair, patients are usually able to leave the hospital the same day.

Hernia Center | High-Quality Care

About Hernias | Our Team | Your Experience | Contact

The Columbia Hernia Center brings together a group of world-class surgeons focused on delivering the highest-quality hernia care possible. We are adept in using all of the newest techniques and materials in hernia repair. Our surgeons are experienced in treating primary and recurrent hernias using both open and laparoscopic methods. 

Pioneering treatments

Abdominal wall and groin hernia repair has made major advances in recent years, leading to smoother recovery, minimizing recurrence, eliminating tension on muscle layers, and making treatment possible for hernias previously considered not repairable.

New prosthetic materials strengthen the abdominal wall and groin without need for the surgeon to cut into adjacent muscles. These “tension-free” procedures come with less pain and involve minimal recurrence. Advances in laparoscopic surgery often mean a more rapid return to normal activity, with reduced discomfort and hospital stay for the patient.

Availability

Abdominal and groin hernias can be painful, may compromise lifestyle, and in some cases can be dangerous if left untreated. Our center is always available to patients for consultation, surgical treatment, follow-up, or just for questions, and we can provide appointments within a week.

One of our surgeons is always on call for emergency situations.

Convenience

We have offices throughout Manhattan, at Columbia University Irving Medical Center, Columbia’s Midtown offices and Columbia’s Allen Hospital. Coming from out of town? We have special services for out of state and international patients.

If you would like to set up a consultation, please call us at (212) 305-5947 or use our online appointment request form. We look forward to answering your questions and meeting your hernia care needs.

Stories & Perspectives

State of the Union: Hernia Care in 2021

An interview with Yuri Novitsky, MD, Director of the Columbia Hernia Center, and Dina Podolsky, MD, hernia surgeon.

ABOUT HERNIAS

What is a Hernia?

A hernia is a weakness or opening in the abdominal wall, which often results in soft tissue such as fat or intestine protruding through the abdominal muscles and occupying space under the skin. The mechanism of the hernia is similar to what happens with a bulge in a damaged tire, where the inner tube, normally contained by the hard rubber of the tire, extends through a thin or weakened place. The opening in the abdominal wall that leads to the hernia is also known as a hernia defect.

Types of Hernias

Inguinal hernias are the most common of all hernias, and are sometimes referred to as groin hernias. They occur near the crease between the lower abdomen and the upper thigh. When an inguinal hernia develops, intestine may protrude through the defect in the abdominal wall, creating a bulge on the right or left side. Inguinal hernia bulges are frequently, though not always, painful. Between 10 and 15 percent of males and two percent of females will develop inguinal hernias in their lifetime.

Ventral hernias are less common than inguinal hernias, with some 10 percent of both males and females expected to develop one during their lifetime. These hernias occur outside the inguinal area of the abdomen, in the epigastrium, the part of the abdominal wall above the umbilicus (belly button) and/or within the umbilicus itself. The Spigelian hernia, another more rare type of ventral hernia, occurs in the mid-abdomen.

Inguinal and ventral hernias may develop due to a number of factors, including obesity, aging, and strenuous physical activity requiring heavy lifting, such as construction work. Certain rare conditions such as collagen vascular disease or genetic defects involving connective tissue may also cause abdominal hernias.

Incisional hernias are a special kind of ventral hernia that occur where prior abdominal surgery has weakened the abdominal wall, or where infection in a healing surgical incision causes breakdown of the wound closure. Incisional hernias are common in patients who have had intestinal surgery complicated by wound infections. About 25 to 30 percent of both males and females will develop an incisional hernia when a wound infection occurs after abdominal surgery.

Surgical Treatment

Surgical Hernia Repair

Anyone who has the symptoms of a hernia, such as pain or a bulge, should consider having a hernia repair. All candidates for hernia repair are evaluated to identify factors that can be modified to minimize the risk of complications.

Hernia repair is conducted using one of two surgical approaches, both of which utilize a piece of synthetic, or prosthetic, mesh to reinforce the weakness in the abdominal wall. When expertly performed, both approaches result in a successful hernia repair.

Open Surgical Repair

The surgeon makes an incision directly over the hernia defect and sews the prosthetic mesh to the abdominal wall. The surgery is done on an outpatient basis, usually under local anesthesia with conscious sedation. This approach is very successful in the repair of small hernias.

Laparoscopic Surgery

Alternatively, a hernia may be repaired using a minimally invasive, or laparoscopic, approach performed while the patient is under general anesthesia. The surgeon inserts small tubes called cannulas through the abdominal wall at some distance from the hernia defect. A mesh prosthesis is then passed through one of the tubes into the abdomen and fixed to the undersurface of the abdominal wall with stitches and staples. This technique is used for both small and large hernias of the abdomen.

OUR TEAM

Yuri W. Novitsky, MD

Phone: (212) 305-5947
Fax: (212) 305-0755

Dr. Novitsky is a Professor of Surgery at the Columbia University College of Physicians and Surgeons and the Director of the Columbia Comprehensive Hernia Center. He is a member of the Board of Governors of the Americas Hernia Society and a Chair of its Practice Advisory Committee. 

He has extensive expertise in advanced laparoscopic and robotic surgery as well complex inguinal and ventral hernia repairs. Dr. Novitsky has published over 130 peer-reviewed papers and numerous book chapters in the field of Minimally-Invasive and Hernia Surgery. He has edited the State-of-the-art textbook on Current Principles of Hernia Surgery. He is an Associate Executive Editor of the World Journal of Hernias and Abdominal Wall Reconstruction.

Dr. Novitsky has successfully developed and applied pioneering techniques for minimally-invasive ventral hernia repair and open abdominal wall reconstructions. Those procedures have been widely adopted around the world. He has been a Faculty and a Visiting Professor at numerous National and International Congresses and Symposia in Europe, Asia, Central and South Americas. 

Dr. Novitsky was trained in General Surgery at the Mount Sinai Medical Center in New York City and the University of Massachusetts Medical Center and then completed his research and clinical fellowships in minimally-invasive and hernia surgery at the Carolinas Medical Center in Charlotte, North Carolina.

Dina Podolsky, MD

Phone: (212) 305-5947
Fax: (212) 305-0755

Dr. Podolsky specializes in all aspects of hernia surgery, including inguinal, ventral, and complex abdominal wall reconstruction, employing minimally invasive techniques with laparoscopic and robotic surgery. Dr. Podolsky completed fellowship training in complex abdominal wall reconstruction and robotic surgery with the Division of General Surgery, working closely with Yuri Novitsky, MD. She is a member of several national organizations, including the Americas Hernia Society and the Society of American Gastrointestinal and Endoscopic Surgeons. Dr. Podolsky currently sees patients in midtown Manhattan, Washington Heights, and in Westchester at NYP/Lawrence Hospital.

Zachary L. Gleit, MD, FACS

Phone: (212) 305-0319
Fax: (212) 932-4328

Zachary L. Gleit, MD, has served as Director of Surgery at the Allen Hospital since 2008 and has practiced surgery at NewYork-Presbyterian/Columbia University Medical Center since 2001. After completing his undergraduate education at Harvard College, he received his medical degree at Harvard Medical School/Harvard-MIT Division of Health Sciences and Technology, followed by surgical training at NewYork-Presbyterian/Columbia. He traveled to Ethiopia in 1998 as part of a humanitarian mission with Doctors Without Borders. Dr. Gleit’s surgical practice in the Hernia Center and in the Division of General Surgery includes hernia repair, gall bladder surgery, colorectal surgery, appendectomy, and splenectomy.  He has a special interest in abdominal wall reconstruction and complicated abdominal wall and groin hernias.

Spencer E. Amory, MD, FACS

Phone: (212) 305-5221
Fax: (212) 932-5425

Dr. Amory received his medical training from Johns Hopkins and Columbia Universities. He developed techniques in laparoscopic cholecystectomy that enabled his group to have the lowest open cholecystectomy rates in the state. In addition, Dr. Amory has earned a reputation for his diagnostic acumen in complex surgical problems and for highly individualized and personalized care. In recognition of his exceptional care of patients, collegiality with peers, and outstanding outcomes, Dr. Amory was awarded the the 2014 Jerry Gliklich Award for Exemplary Clinical Care, formerly “Practitioner of the Year” award, by the NewYork-Presbyterian/Columbia University Medical Center Society of Practitioners.

Stories & Perspectives

A Minimally Invasive Hernia Repair Then Back to Golf

At 74, Larry Grunfeld was having a wonderful retirement, with plenty of time on the Connecticut golf course, hiking, and swimming to his heart’s content. Then in early 2018, he had pain in his side while walking, and while lying down. The discomfort was so intense, he couldn’t sleep. After his local physician found a hernia in his groin, Larry came to Columbia’s Comprehensive Hernia Center because he wanted the best possible care. He was treated by Dr. Yuri Novitsky, the Center’s director, and a pioneer in minimally-invasive repair that leaves patients with less pain and little down time.

YOUR EXPERIENCE WITH US

Prospective patients are seen at the Columbia Hernia Center for a consultation, which includes a comprehensive medical history, physical examination, and detailed discussion with the doctor. If patients have had prior abdominal or hernia surgery, they are asked to bring their operative reports and copies of any abdominal CT scans that were performed prior to their consultation. If the doctor recommends a hernia repair and the patient wishes to proceed with scheduling surgery, a date is chosen and pre-operative testing is ordered (blood, EKG, and chest x-ray when appropriate). Testing is usually accomplished in about 1 hour at the Hernia Center, but it may also be done near the patient’s residence if that is more convenient. Instructions are given regarding management of standing medications, diet, and bowel preparation, when necessary.

Day of Surgery

Surgery is performed at one of Columbia University Irving Medical Center’s sites in Manhattan — either at the main 165th Street location or at the Allen Hospital at 220th Street. Patients are asked to report to the facility 90 minutes prior to the anticipated time of their procedure, in order to check in and be seen by their anesthesiologist. The anesthesiologist will examine the patient and review the patient’s medical history, focusing on prior surgery and any anesthetic concerns that the patient may have. Most ambulatory surgery operations, such as inguinal and umbilical hernia repairs, are performed under local anesthesia with additional relaxing and pain-relieving medication provided by the anesthesiologist to assure complete patient comfort. Ambulatory surgery patients who do not need general anesthesia are usually discharged from the recovery room within one hour of completion of their surgery. Prescriptions for pain medication are given and a follow-up appointment with the surgeon is scheduled.

After Surgery

Patients are advised that they should expect to experience some pain after hernia surgery, although it frequently proves to be less than they anticipate. Avoidance of certain movements, particularly contraction of the abdominal muscles when sitting up, helps to minimize pain. Strategies for reducing pain are discussed and medications are prescribed. Patients are encouraged to resume all normal activities as soon as they feel confident that they can do so without causing unreasonable pain. Normal diets can be resumed immediately. Most patients are able to return to work in 1 week or less, and to return to exercise regimens after 2 weeks. Patients may travel safely at any time after surgery provided they have checked-in with their surgeon and confirmed the stability of their health. Suture removal is not required as wound closures are performed with absorbable sutures.

Prepare for your visit by downloading our New Patient Forms ( English | Spanish).

Stories & Perspectives

After Hernia Surgery, Daniel Has a Larger Life

When he was only 4 years old, Daniel Borg was diagnosed with Crohn’s disease, a debilitating condition that causes weight loss, fatigue, diarrhea, pain and cramping and bleeding from the rectum. For Daniel this meant a pretty challenging childhood—one marked by several operations, home schooling and a restricted social life.

CONTACT US

Columbia Hernia Center

NewYork-Presbyterian/Columbia University Irving Medical Center

The Herbert Irving Pavilion
161 Fort Washington Avenue (at West 165th Street), 5th Floor
New York, NY 10032
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Columbia Doctors Midtown

51 West 51st Street
New York, NY 10019
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The Allen Hospital

5141 Broadway (at West 220th Street), 3rd Floor
New York, NY 10034
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To make an appointment with the Hernia Center, please call (212) 305-5947, or use our online appointment request form.

Spencer E. Amory, MD, FACS — (212) 305-5221
Zachary L. Gleit, MD, FACS — (212) 305-0319
Yuri W. Novitsky, MD — (212) 305-5947
Dina Podolsky, MD — (212) 305-5947 

For international patients, please contact the Global Services office at our partner hospital, NewYork Presbyterian. Call (212) 746-9100 or email [email protected].

Hernia: Symptoms & Treatment | Houston Methodist

A hernia is when tissue inside your body pushes through a weak section in the muscle of your abdomen or groin.

There are several types of hernias:

• Inguinal hernia – occurs on the inside of the groin
• Ventral (abdominal) hernia – includes lumbar, spigelian and epigastric hernias
• Incisional hernia – occurs after abdominal surgery at the site of the incision
• Umbilical hernia – occurs at the belly button, most commonly in infants
• Hiatal hernia – occurs when the stomach bulges into the chest
• Femoral hernia – rare, occurs on the inside of the groin near the thigh

Some hernias cause only mild or uncomfortable symptoms, while others can be life-threatening.

In most instances, hernias do not improve on their own and need to be surgically repaired to reduce the risk of serious complications.

Our Approach to Treating Hernias

At Houston Methodist, our surgeons specializing in general surgery are experts in diagnosing and treating all types of hernias — from ones that are common to those that are rare.

When hernias are complex, our surgeons leverage their extensive experience, the latest surgical techniques and advanced imaging to perform open hernia surgery.

In addition to being experts in open hernia surgery, our specialists are skilled at performing laparoscopic hernia repairs. This minimally invasive surgical technique can be used to treat most hernias, and it may result in reduced post-operative discomfort and shorten the duration of recovery.

About Hernias

How Can You Tell If You Have a Hernia?

Most hernias cause pain and discomfort, but the signs and symptoms of a hernia can differ slightly depending on the type of hernia.

While hernias often result in a visible bulge under the skin, this isn’t always the case.

Inguinal hernia symptoms include:

• A bulge on one side of your groin area, often accompanied by burning or aching
• Discomfort, weakness, pressure or pain in your upper groin, particularly while bending
• In some men, swelling and discomfort around the testicles

Ventral hernia symptoms include:

• A bulge in your abdomen, often accompanied by pain
• Changes in bowel habits, including constipation, diarrhea or narrow stool
• Signs of infection, including nausea or vomiting, fever and increased heart rate

Incisional hernia symptoms include:

• A visible bulge at the incision site of an abdominal surgery, often accompanied by burning or aching
• Discomfort, weakness, pressure or pain in your abdomen
• Changes in bowel habits, including constipation, diarrhea or narrow stool
• Signs of infection, including nausea or vomiting, fever and increased heart rate

Umbilical hernia symptoms include:

• A bulge near or inside the belly button, which, in infants, may only be apparent when crying or coughing
• Tenderness, swelling or pain at the site of the bulge
• Abdominal discomfort (in adults)
• Signs of infection, including nausea or vomiting, fever and increased heart rate

Hiatal hernia symptoms include:

• Abdominal pain
• Heartburn
• Belching
• Chest pain
• Nausea

Femoral hernia symptoms include:

• A bulge on one side of your upper groin near the thigh, often accompanied by burning or aching
• Discomfort, weakness, pressure or pain in your groin, particularly while bending

How is a Hernia Diagnosed?

Some hernias are easily diagnosed during a physical exam, especially if a bulge is visible.

However, whether a bulge is present or not and depending on the type of hernia suspected, diagnosis is confirmed via one or more of the following tests:

• X-ray
• Abdominal ultrasound
• Endoscopy
• CT scan
• MRI

When Is Hernia Repair Surgery Needed?

If a hernia is small, is not causing serious pain or discomfort and there are no signs of infection, your doctor may recommend watchful waiting.

However, hernia repair surgery is often ultimately needed, as hernias don’t heal on their own, instead growing and becoming mor painful over time.

Depending on your specific condition and type of hernia, your doctor may be able to perform laparoscopic hernia repair. This minimally invasive procedure uses small abdominal incisions and special tools to place stitches and a synthetic, supportive mesh that reinforce the weakened muscle after the tissue is pushed back in.

In more complex cases, hernia repair requires open hernia surgery rather than laparoscopic techniques.

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Hernia and Abdominal Wall Repair | Conditions & Treatments

Diagnosing Hernias

Patients usually come in for an assessment by the entire team in a coordinated visit, with all testing and imaging services performed in a centralized location during the same appointment, reducing unnecessary visits.

Our doctors begin with a physical exam to determine whether patients have a hernia and, if so, where it is located. In some cases, patients need additional imaging, such as:

• Computed tomography (CT) scan, using specialized X-ray technology that takes cross-sectional images to produce 3D images of the abdomen to pinpoint a hernia
• Ultrasound, using sound waves to produce images of the abdomen to locate a hernia
• X-ray, to produce images of the abdomen to assess blockages in the bowel

Options for Hernia Repair

In recommending the best surgical approach for each patient, our surgeons consider multiple factors, such as overall health, any previous surgeries, ability to heal, and the size of the hernia.

UT Southwestern surgeons have experience with all main surgical approaches:

• Primary repair: Sutures placed in the abdomen to close the hernia opening for simple and small defects
• Safe mesh repair: Prosthetic or biologic mesh to repair openings that are too large for a primary technique; mesh is placed in such a way that complications are rare
• Complex hernia and abdominal wall repair: Combination of primary and mesh repair techniques, which can include muscle flaps for complete coverage of the abdomen

Our surgeons are also experienced in minimally invasive surgical techniques for hernia and abdominal wall repair, such as:

• Laparoscopic surgery: The surgeon uses a laparoscope (thin, flexible tube with a lighted camera) inserted through a small incision and miniature instruments inserted through other small incisions to perform the surgery.
• Robotic surgery: Using a computerized system, the surgeon controls mechanical arms that hold a camera and surgical instruments to perform laparoscopic surgery. The surgeon commands a console that provides a high-definition, magnified 3D view of the surgical site. The robotic arms have a greater range of motion than human hands and wrists, providing greater flexibility for complex, delicate procedures.

At UT Southwestern, our surgeons also:

• Correct genetic and inherited abdominal wall defects in infants and children, make cosmetic repairs, and fix unsuccessful procedures done elsewhere
• Treat abdominal walls weakened by injury, accident, prior surgery, pregnancy, or other causes
• Provide coordinated rehabilitation, follow-up care, and support for each patient
• Communicate and coordinate care with each patient’s referring physician
• In some cases, treat the hernia with temporary, noninvasive slings or with medical management    

How Do I Know If I Have A Hernia? Experts Explain

Are you experiencing pain when coughing, straining or lifting, or do you have a noticeable protrusion in your groin, abdomen or near a scar? You may have a hernia.

A hernia occurs when an organ, intestine or fatty tissue protrudes through something it shouldn’t, such as muscle or tissue. While symptoms can vary from patient to patient, hernias can cause damage to internal organs if left untreated. So, how do you know for sure if you have one?

James Wiseman, MD, a general surgeon with Banner – University Medical Center Tucson, explained the most common types of hernias, their causes and how to best treat them.

Most Common Types of Hernias

• Inguinal and Femoral (groin hernias)
• Umbilical (near the navel/belly button)
• Ventral (abdomen/ventral wall)

“While there are many different types of hernias, the most common we see are groin hernias.” Dr. Wiseman said.

Possible Causes

In most cases, hernias can occur for any reason and to anyone, although men are more susceptible to groin hernias than women. “However, most of these have been present from birth or are associated with aging or repetitive strain on the abdomen or groin area,” Dr. Wiseman said.

Some general activities that can increase your risk of getting a hernia include:

• Smoking
• Any straining due to constipation
• Persistent cough
• Lifting heavy weights
• Being overweight or obese

Symptoms

“Usually they are obvious,” Dr. Wiseman said. In many cases, hernias present as painless swelling in an area. Most often people notice the swelling and see their doctor. Even if it isn’t causing you pain, Dr. Wiseman recommends you still schedule an appointment with your doctor because of the possible risk of organ strangulation.

“It used to be that, unless hernias were symptomatic or causing the patient pain, we didn’t do anything,” Dr. Wiseman said. “New guidance suggests that we fix on diagnosis before it becomes symptomatic. Hernias don’t go away and can continue to grow and become more painful. In fact, in the age group 75 or older, the odds of developing pain associated with the hernia exceeds 75%.”

If you are experiencing pain, nausea or vomiting, seek immediate medical attention.

Treatment Options

When it comes to hernia repairs, there are three surgical approaches: traditional, laparoscopic or robotic.

Traditional surgery: The surgeon makes an incision near the hernia, and the weak muscle is repaired. It can be done with or without surgical mesh.

Laparoscopic surgery: The surgeon makes several small incisions in the abdomen that allows surgical tools into the openings to repair the hernia. This can be done with or without mesh.

Robotic surgery: It is a newer technique for repairing hernias, a surgical technique Dr. Wiseman has perfected and uses quite often for this type of procedure. It uses small cameras just as in laparoscopic surgery, but the surgeon is seated at a console in the operating room and guides the surgical tools from the console.

“Each type of surgery has its advantages and disadvantages,” Dr. Wiseman said. “The best approach should be decided between the patient and surgeon taking into account the age and health of the patient and preferences for using mesh or not.”

Do you think you may have a hernia? Don’t wait. Schedule an appointment with one of our specialized Banner Health experts at bannerhealth.com to be evaluated.

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90,000 Hernia of the spine which doctor should I go to in case of severe, acute pain? | Healthy lifestyle.

Intervertebral hernia – displacement of discs. How and where to be treated for protrusion, hernia.

Intervertebral hernia – displacement of discs. How and where to be treated for protrusion, hernia.

A chiropractor treats hernia of the cervical, thoracic or lumbar spine. He is also chiropractor .

This specialist literally saves your back, neck or joint from displacement of the intervertebral discs to the side or inward.

With skillful hands, he corrects-shifts the protrusion or protruding disc by a few mm, returning it to its normal anatomical position.

What happens with a hernia of the spine?

Hernia and its effect on pinched nerve and back pain.

Hernia and its effect on pinched nerve and back pain.

When displaced, the roots of the spinal cord are pinched and the patient feels a pulling or sharp pain in the back, radiating to the limbs, arms or legs.

The back pain is so severe that it is impossible to straighten up.He literally knocks down. A person begins to run to neurologists and orthopedists in the hope of a speedy recovery.

However, not everything is so simple. Medicines harm your stomach, liver, the health of your entire body. Besides, when you stop taking chemotherapy, the pain returns.

It turns out a vicious circle. Not many people decide to have an operation because of the risks of damage to the nervous system as well as long recovery, return to working condition.

Attack of sciatica of the lumbar spine with hernia and osteochondrosis.

Attack of sciatica of the lumbar spine with hernia and osteochondrosis.

Why do you need a chiropractor or chiropractor?

Since the displacement of the back is a problem, mechanical help should be the same – correction of the displacement and normalization of the position of the cartilage. (Discs)

The manual operator is able to correct the mechanical injury of the displaced disc with his magic ones for a year, two or more. As a rule, until the next breakdown back or injury.

Reduction of intervertebral hernia in the lumbar spine for back pain.

Reduction of intervertebral hernia in the lumbar spine for back pain.

Turning to a good chiropractor, you will receive quick help and relieve pain and inflammation in the spine without the use of drugs, injections, droppers, etc.

The specialist will rebalance the correct position of the soft tissues of your back and neck.

At the same time, the chiropractor will advise and show you exercises to strengthen the muscle corset and support the vertebrae of the problem area of ​​the spine.

how to recognize, where to go and is it necessary to operate?

Why does my back hurt?

There is no such person who has never complained of back pain in his life, and this is partly natural. The spine is the most important support system of our body, flexible and dynamic. Perhaps thanks to her, we managed to survive in the process of evolution: the movable spine allowed us to easily dodge danger, maneuver, group the body.

In addition, nature decided that the spinal canal is the most reliable place where a complex and delicate nervous structure can be placed: the spinal cord and nerve roots. The spinal cord is the main information cable of our body. It is not surprising that when the support function of the spine is impaired, the resulting compression of the spinal cord and nerve roots can cause serious problems.

So, we are the owners of a flexible spine.Thanks to this, we can go in for sports, take different poses, dance, stretch – and, unfortunately, sooner or later you have to pay for all these opportunities. Our spine is a chain of vertebrae, between which there are elastic elastic intervertebral discs that act as shock absorbers. As you know, there is a weak link in any chain: over time, some of the intervertebral discs cease to withstand the load, and a pathology of the spine arises.

Although a lot of people complain of back pain, it is unlikely that this will be considered the norm.Back pain can significantly reduce a person’s quality of life. This is pain that cannot be ignored – although it does not die from it, like from a heart attack.

Intervertebral hernia: the essence of the disease

What is this disease? Inside the intervertebral disc is the nucleus pulposus – a gel-like substance that provides shock absorption. With a hernia, the disc membrane – the annulus fibrosus – is damaged: a crack or rupture appears, as a result, part of the nucleus pulposus is squeezed into the spinal canal.The resulting protrusion (protrusion of the cartilage) compresses the spinal nerves, pain occurs, and sometimes sensitivity and movement in the limbs is impaired.

In which parts of the spine does a hernia usually occur? The systematic adoption of uncomfortable postures, sleeping in the wrong position, excessive lifting and carrying weights are the main factors that determine the development of pathology. A hernia occurs in the most mobile parts of the spine, namely in the cervical and lumbosacral.

How common is it? About three thousand people a year come to the consultative and diagnostic department of our hospital with back pain. Of these, a little more than 700 people are operated on in our spinal center for intervertebral hernia. It can be said that this is a very common cause of back pain.

A complicated case of an intervertebral hernia is stenosis: a pathology in which changes in the spine are so extensive that they begin to narrow the spinal canal.Multifactorial compression occurs, ultimately this can lead to dysfunction of the spinal cord and nerve roots. This situation is really dangerous for the patient’s health and, as a rule, requires mandatory surgical intervention.

Symptoms, diagnosis and treatment of intervertebral hernia

What are the symptoms to recognize an intervertebral hernia? Almost always, a hernia is accompanied by pain. As soon as the change in the spine begins to grow, a conflict arises between the aggressive fragment of the cartilage and the delicate nerve structures.A person begins to systematically experience back pain, he has a feeling of stiffness and movement. Most often, the pain with a hernia in the lower parts of the spine increases with walking, radiates to the legs, hips. If the hernia is in the upper sections, dizziness, headaches, pain in the neck with a shot in the arm or shoulder are possible.

How is an intervertebral hernia diagnosed? Spinal surgery is a field in which modern diagnostic methods are especially important. The main diagnostic tool is magnetic resonance imaging: it allows you to accurately identify the presence of a hernia.However, other studies are usually required to determine the next course of treatment.

Spiral computed tomography allows you to scan the condition of all joints of the spine, to assess the density of bone structures. Together with MRI, this study provides irreplaceable information. Much less often we carry out radiography – however, in some cases it is also a good source of information. For example, when we need to check if a patient has excessive spinal mobility, we use dynamic stress radiography.

How is it treated? Most often, treatment begins with conservative methods: physiotherapy procedures, massages, exercise therapy. Inflammation is relieved with non-steroidal anti-inflammatory drugs. If conservative treatment does not bring the desired result, the question of a surgical operation is considered.

Surgical operation of intervertebral hernia

How dangerous are surgical operations? Naturally, any spinal surgery is very responsible and in rare cases can have serious consequences.That is why every operation must be carried out reasonably.

Are there ways to mitigate the risks? Fortunately, modern medicine has a number of ways to manage the risks of spinal surgery.

Firstly, during spinal surgeries, it is very important to localize the affected area with maximum accuracy and control every millimeter of it. This problem is perfectly solved by modern surgical equipment: a high-tech 3D microscope and microsurgical instruments that allow the operation to be performed using a minimally invasive method.

Secondly, an important criterion for success is the availability of modern visualization methods, and not only during the operation, but also at the stage of preparation for it. It is important to visualize the hernia in every detail, to see it in every detail, to understand exactly how it presses on the nerve structures. To do this, you need to use 3D modeling methods. And the entire course of the operation in a modern operating room is visualized on a large monitor. Operating nurses are monitoring the progress of the operation.

Thirdly, modern methods of control over the course of operation significantly reduce the risks. In our spinal center, the intraoperative neuromonitoring system is actively used. We constantly check how certain nervous structures of the patient feel. There is a CT scanner right in the operating room: if necessary, we do a CT scan to the patient right during the operation. This allows you to quickly adjust your actions and in the future to avoid a relapse of the disease.

Finally, a well-trained, well-coordinated team operates with minimal risks. The assistant must understand the surgeon very well, the operating nurse must have sufficient experience to follow the progress of the operation and anticipate the surgeon’s thoughts. The operation goes smoothly if the team has a lot of experience, which is why specialized centers and clinics are better at coping with the task.

How and who makes the decision about what to do? First of all, we note that no universal algorithms and indicators work in this matter.Each case is unique, each decision is made based on the entire body of data. Therefore, get ready for the fact that even if someone of your acquaintances has “all the same”, the decision regarding your particular case may be different.

The first thought that a good surgeon has when he sees pictures with changes in the spine is obvious: “We will operate!” This is natural, because this is the surgeon’s vocation, his strong point. At the same time, no good surgeon will blindly act on first impressions.If there is the slightest chance of dispensing with the operation, it should be used.

There is a formula thanks to which a neurosurgeon can determine as accurately as possible whether it is necessary to resort to surgery. If, in the presence of an intervertebral hernia, the patient’s quality of life, despite the ongoing conservative treatment, does not bring relief for a certain period of time, the operation is necessary. If, within a month, intensive conservative treatment can reduce symptoms and achieve a certain quality of life that suits the patient, there is no need to operate.

How long will the patient have to recover from hernia repair?

Spine surgeries are now becoming less invasive and more technologically advanced. As a rule, if the operation was successful, the patient is active already on the second day, gets on his feet, and can serve himself. Theoretically, the patient can already be discharged home at this stage – but in our spinal center a lot of attention is paid to rehabilitation, so patients go home either on the third, or on the eighth day, or on the tenth day, depending on the individual rehabilitation program that accompanied by our instructors.

In order to fully recover, the patient will need to adhere to a certain discipline: to complete the tasks given by the instructors-rehabilitation therapists, to adjust the lifestyle. If the doctors’ instructions are followed closely, within two to six months after surgery, the patient is likely to recover completely and enjoy a high level of quality of life.

Food for thought

Who is at risk for herniated discs? It is difficult to identify risk groups: the cause of hernia development may be, for example, improper performance of certain physical exercises, a passive, sedentary lifestyle.

At what age can this disease be suspected? Intervertebral hernia is most often diagnosed in people aged 30-45 years. They are quite active, spend a lot of time driving, their spine is under serious daily stress. Nevertheless, in my lifetime there have been 14-year-old patients with intervertebral hernia.

In fact, I would advise everyone not to consider themselves to be in any low or high risk groups, but simply see a doctor at the first sign of the disease and undergo the necessary tests.

How to understand that you need to seriously deal with your back? As soon as back pain occurs, an urgent need to stop self-medication sessions and consult a specialist.

Unfortunately, the patient’s journey to a competent specialist is sometimes too long. To shorten this path, I advise you to immediately contact a medical organization that specializes in degenerative diseases of the spine.

90,000 Evgeny Ivanov, author on Spine Command

Hello! I have a question – is it possible to cure – to correct the bulging of the 7th vertebra, when passing from the neck to the back, like a small step, it is very ugly.Is it possible to straighten the vertebra? There is no excess tissue, no fat at the bulging site.

I express my deep gratitude to Ekaterina Pavlovna Kosareva for the professional treatment of my shoulder, for the sensitive and attentive attitude. Finally, my constant pains stopped and my hand began to move. Thank you very much. Be healthy and happy!

Dear employees of the “Spine Team” clinic (with whom I had to communicate)! Thank you for your kindness, attention and understanding. Thank you very much to the head physician Yevgeny Borisovich for the competent diagnosis and treatment.And, of course, special words of gratitude and gratitude to the attending physician Kosareva Ekaterina Pavlovna – the doctor from …

I applied to your center on July 2, 2016 with severe headaches that tormented me for 3 years and pain in the spine. Having visited the doctor-neurologist Kosareva Ekaterina Pavlovna, I realized that they would help me here. …

Many thanks to all the doctors and staff who worked with me. A sensitive attitude, punctuality, professional qualities, there would be more of this in all medical institutions! During a week of treatment, you have relieved my suffering, stopped my pain.If something, God forbid, is repeated, then only to you! …

Good afternoon, doctor. Can cervical osteochondrosis go down the throat? And what kind of doctor should you see if you have neck pain with a blow-back to the throat?

Good day! Sincerely I want to express my deep gratitude to EVERYONE who helps me cope with my illness: Syunikova Albina Amirovna Nevolin Vladimir Vladimirovich Shirokovskikh Marina Viktorovna Shukshina Tatyana Sergeevna Mashyanova Elena Yurievna Solovarov Vyacheslav Sergeevich Aniskina Marina Vladimirov.To the person who, …

I have been observing and undergoing treatment with Evgeny Borisovich for several years, now I have already begun to be observed in the clinic “Spine Team”, I come from another city, the clinic is very conveniently located next to the metro. Attentive staff, the clinic is very comfortable, they are received almost always on time, …

I liked the physiotherapist Kayukov Alexey Vasilievich. Very attentive during the laser therapy procedure. Each point on the back was palpated and emphasized on sore points.

Hello, can you please tell me how many blockages can be done per year for back pain?

Although the clinic is small, it is good! She underwent a course of treatment at the end of winter. Then my back was very painful. I want to note the staff, very attentive and friendly staff. I wish you and your business health and prosperity. I recommend you to my friends.

Hello. Does it make sense to stretch out on a horizontal bar with a hernia of the spine?

I have been working as a driver all my life, in recent years I could not fully drive cars, my back ached, I had to rub myself with anesthetic ointment in the morning.I underwent a course of treatment in your medical center, did a laser, VTES, blockades, now the pain has disappeared, I hope for good. Thanks to all doctors and nurses …

Good evening, this spring my hand often gets numb at night, I have to wake up and shake my hand to reduce the numbness. Is it dangerous?

Hello! My back has been hurting for a year and a half. Can You Get Rid Of Back Pain With The Gym By Doing Back Exercises?

Hello, my question is: can a hernia disappear after traction or laser?

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Translated as “kinesio” – movement and “tape” – tape, literally this is the imposition of special tapes on the skin. The essence of this rehabilitation method is that stretch tapes (kinesio tapes) on a hypoallergenic adhesive base are glued to the skin. Under the influence of the heat of the human body, glue …

Hello. How much does spinal hernia treatment cost in your clinic?

Which doctor should I see if I have sciatica? – Questions

Herniated disc – treatment and symptoms, diagnosis of herniated disc in Moscow, Clinical Hospital on Yauza

03.11.2021

The article was checked by a chiropractor, neurologist, reflexologist, vertebrologist Gudel R.S. is for general informational purposes only and does not replace specialist advice.
For recommendations on diagnosis and treatment, consultation with a physician is required.

Recently, a herniated disc has become a fairly common disease that can seriously affect a person’s viability. Very often, the disease is accompanied by a pinched nerve connecting one of the internal organs with the spine, which leads to a violation of its functions. The treatment of herniated discs should be entrusted to a highly specialized specialist in the field of neurology.

Symptoms of intervertebral hernia

The symptomatology of the spine disease has rather striking manifestations. A hernia leads to a thinning of the intervertebral discs, which causes characteristic friction between the vertebrae. Such changes cause unbearable pain to a person.

The resulting hernia begins to press on the nerve endings, leading to spasms and numbness of body parts. Symptoms, as a rule, vary depending on the zone of localization of the formation:

• thoracic region – difficulty breathing, pain in the heart;
• cervical spine – headaches, dizziness, numbness of the upper extremities, changes in blood pressure;
• lumbosacral region – lumbar pain, numbness in the groin and fingers of the lower extremities.

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“The hernia itself does not dissolve.” It is imperative to be treated. If therapy takes place under the supervision of an experienced doctor in a specialized center, then the pain syndrome is quickly removed, and degenerative-dystrophic changes stop. In the initial stages of the disease, it will take 1-2 years for a complete cure.
We do our best to ensure that patients cope with the disease without surgery.But if the pain does not subside for several days, then surgical intervention is indispensable. ”

Akopdzhanov Georgy Levonovich,
neurosurgeon, doctor of the highest qualification category

Causes of the disease

When the position of the body changes, the intervertebral discs contract and push the ring outward. If the discs are healthy, no structural changes are observed. With the development of an intervertebral hernia, the nucleus pulposus of the disc is displaced and the annulus fibrosus is stretched (protrusion).

This is the first stage of herniated disc development. If you do not see a doctor in time, further stress leads to rupture of the annulus fibrosus and prolapse of the nucleus. After this, the disease enters its destructive phase. Severe pain begins, sometimes there are neurological complications in the limb area, paralysis is possible.

Reasons influencing the development of pathology:

• characteristic back injuries;
• extra pounds;
• osteochondrosis;
• unsuccessful sudden movement;
• excessive stress on the spine;
• diseases associated with the destruction of bone or cartilage tissue;
• curved spine.

There are certain groups of people who have a doubled risk of developing a herniated disc in any part of the spine, in particular, the sacral spine. This is the age category from 25 to 50 years old, truck drivers who have to spend a lot of time behind the wheel, office workers, with prolonged work at the computer.

The pressure on the discs of the spine in a sitting position is much stronger than when walking. With limited mobility, blood circulation in the muscular system is impeded, and this leads to a loss of fluid reserves in the nucleus.

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Making a diagnosis

Diagnosis of intervertebral hernia is of leading importance for choosing a treatment regimen and is carried out using the following methods:

• MRI of the spine. The “gold standard” for detecting pathological changes in muscles, ligaments and nerve structures.
• CT of the spine. Allows you to assess the condition of bones and soft tissues.

Ultrasound for intervertebral hernias is not the main way to diagnose spinal diseases.X-rays are prescribed only to determine the traumatic or non-traumatic nature of the existing disorders.

Treatment at the Clinical Hospital on Yauza

A hernia of the intervertebral spine is usually treated surgically. At the initial stages of disease progression, conservative (non-surgical) therapy is used. Drug treatment can last for several months, but the whole course gives good results. Timely measures will eliminate irreversible destruction of the structure of the spine and avoid complications (urinary and stool incontinence, sensitivity disorder of body parts, paralysis).

Treatment of herniated disc with drug therapy involves the use of non-steroidal anti-inflammatory drugs. Necessarily in the treatment should be prescribed muscle relaxants, chondroprotectors and a number of vitamins. With a sharp exacerbation of the pathology process, which is characterized by acute pain, the doctor prescribes blockades (hormonal anti-inflammatory and analgesic drugs).

In conjunction with the medication course, physiotherapeutic procedures, massage, acupuncture and physiotherapy exercises can be prescribed.Treatment with ultrasound and electrical impulses makes it possible to relieve pain and improve tissue repair processes.

Surgery to remove herniated discs surgically is a radical approach to eliminate the causes of pain and neurological abnormalities. The main methods of surgical intervention: vertebroplasty, endoscopy, percutaneous discectomy, laser vaporization.

Surgical treatment of intervertebral hernia is carried out in the presence of the following indications:

• intractable pain syndrome;
• an increase in neurological deficit;
• dysfunction of the pelvic organs;
• numbness of body parts, decreased potency.

The cost of herniated disc treatment in Moscow at the Yauza Clinical Hospital depends on the degree of progression of the disease, the presence / absence of complications. Check prices by phone indicated on the website.

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Preventive measures

Herniated discs are the result of improper stress on the spine. The conditions for the normal functioning of the spine are the preservation of its mobility and the strength of the muscles surrounding it (muscle corset).

To keep the back healthy, patients are advised to:

1. Take daily walks in comfortable shoes.
2. Do regular exercises to strengthen the back muscles.
3. Eat a correct and balanced diet to maintain optimal weight.
4. Sleep on the correct orthopedic mattress (medium to high firmness).
5. Observe the optimal mode of work and rest.

Sources

1. https: // cyberleninka.ru / article / n / gryzha-diska-pozvonochnika-diagnostika-i-lechenie / viewer
2. http://www.neurosklif.ru/diseases/spine/disc-herniation

Literature:

4. Parfenov V.A. Nervous diseases. General neurology: textbook. for students // First Moscow State. honey. un-t them. I.M.Sechenov.2014.

5. Yakhno N.N., Shtulmana D.R., Melnichuk P.V. Diseases of the nervous system. A guide for doctors // Moscow. 2003.

Surgeon Ulyanovsk | Department of surgery

A hernia of the abdominal wall is a protrusion of an internal organ or its part through a defect in the connective tissue of the peritoneum into a hernial leathery sac.Passes with a displacement of internal organs.

There are congenital and acquired abdominal hernias. Congenital hernias are operated on in early childhood, but here we will talk about acquired hernias as a result of the patient’s life

Causes of a hernia of the anterior abdominal wall or hernia of the abdomen

• weak muscles of the anterior abdominal wall

• hard physical labor

• technically incorrect weight lifting

• a sedentary lifestyle, as a result of which muscles weaken and lose elasticity

• bearing children and childbirth

• incisional hernias (resulting from problems with the healing of surgical sutures)

• chronic constipation

• predisposition due to heredity

• severe prolonged cough

Gender Difference

Hernias occur in both men and women, but more often in men

Types of hernias of the anterior abdominal wall

There are the following types of abdominal hernias that can be operated on at Medgard Medical Center, according to their location

• umbilical hernia

• inguinal hernia

• femoral hernia

• hernia of the white line of the abdomen

• diastasis of the rectus abdominis muscles (this is not a hernia, but the treatment is similar, so we will highlight it separately)

Treatment of hernias of the anterior abdominal wall

With hernias of the anterior abdominal wall, only surgical treatment is indicated.At the same time, it is important to do this in a planned manner, to avoid emergency measures.

What is the risk of hernia infringement

Infringement of a hernia is one of the most frequent and at the same time dangerous consequences of delaying the issue of hernia treatment. In case of infringement in the hernial orifice, the contents of the hernial sac “close”, blood circulation is disturbed. Both the tissues and all the contents begin to die off. This development of events often leads to the removal of part of the intestine, peritonitis. In an emergency operation, it is difficult to make a beautiful cosmetic suture, here it is not about beauty, but about saving the patient’s life.The recovery period after the operation is longer than with the planned one. In this case, recurrent hernias often occur.

How is the operation in Medgard-Ulyanovsk for hernia suturing carried out

• at LDK Medgard, operations are only planned, we do not have emergency medicine

• hernia repair can be performed both under local and general anesthesia. What is the best course of action for you, you decide in consultation with a doctor, but operations under local anesthesia predominate.At the same time, the patient does not experience unpleasant sensations, talks with the doctor during the operation, and there are no risks associated with general anesthesia

• in Medgard-Ulyanovsk, hernias are sutured within the framework of “one day surgery”, that is, after several hours spent in the hospital after the operation under the supervision of medical personnel, the patient is discharged home

• during the operation itself, the contents of the hernial sac are returned to their place, and the abdominal wall is reinforced with a mesh implant, which prevents the possibility of recurrence

Mesh implants have a number of advantages

• do not cause allergies, inflammation, rejection

• do not move or break

• completely implanted into the tissue

• not felt by the patient

• reliably strengthen the skeleton of the muscles of the abdominal wall, excluding relapses

• there is no stretching of tissues, and therefore painful sensations

• quick recovery after surgery

Restrictions after surgery

there are practically no restrictions after surgery to suture a hernia with the installation of a mesh implant, and this is good news

• you can lift weights (at first, without fanaticism)

• you can take a shower after 2-3 days

• you can walk

• you can bend over

Do not delay the visit to the doctor.Sign up for a consultation with a surgeon and be healthy!

Removal of an umbilical hernia in Chelyabinsk

How is the operation

Umbilical hernia removal surgery (hernioplasty) in adults involves several stages:

1. Hospitalization of the patient the day before the planned intervention.
2. Introduction of local or local anesthesia. Spinal anesthesia may be used as directed by a physician or general anesthesia.
3. Direct operation according to the selected method (Mayo, Lexera, Sapezhko, using mesh implants, laparoscopy).

In mild cases, the patient can be discharged from the hospital within 1-2 days after surgery.

Readings

The surgical method of assisting the patient is considered in medicine to be the only effective one in identifying an umbilical or inguinal hernia:

• Pinching.If it is not possible to correct the protruding parts of the organs, which can lead to tissue death.

• Bowel obstruction. If the patient complains of frequent constipation, vomiting, pain in the intestines. This condition can lead to blood poisoning or peritonitis, so immediate help is required.

Conditions in which there is no threat to life, the operation can be scheduled as planned according to the indications of the attending physician.

Contraindications

Contraindications include:

• Removal of umbilical hernia in children under 5 years of age, if there is no threat to life, because there is a chance that the disease will disappear;
• active stages of infections at the site of the operation or the body as a whole;
• identification of incurable diseases in a patient, because a hernia is not a pathology that carries a direct threat to life;
• second half of pregnancy, since stress should be avoided in this position;
• heart attack, stroke, other conditions in which anesthesia can be poorly tolerated;
• severe cardiovascular disease, asthma, pulmonary insufficiency;
• age over 70 years;
• complications of liver cirrhosis;
• varicose veins of the esophagus;
• renal failure and diabetes.

Types of Operations and Expected Result

Depending on the patient’s condition, the following methods of removing an umbilical hernia can be prescribed:

• Tensioner. The navel is strengthened by muscular-aponeurotic tissues.
• Slack. An additional medical mesh is used to strengthen the walls.
• Laparoscopic. Manipulations are performed without incisions by punctures.

By type, the operation can also be urgent (prescribed for a strangulated hernia) and planned.

Preliminary preparation

Before prescribing an operation, the attending physician must prescribe a comprehensive examination in order to find out the state of the body, to exclude possible contraindications.

Diagnostics includes:

• Analysis of urine and blood.
• Ultrasound of the abdominal cavity.
• Fluorography.
• ECG.
• Therapist.

You should also get the opinion of the therapist and his recommendations for subsequent treatment.

The preparatory phase also includes:

• Exclusion of blood thinning medications (aspirin, cardiomagnet, etc.) 7 days before manipulation.
• Carrying out preparatory hygiene procedures. (bowel preparation – microlax, etc. at night before the operation).
• Refusal of food on the eve of the procedure.

Recovery period

Rehabilitation involves:

• Up to 2 weeks of a sparing diet to reduce the stress on the gastrointestinal tract to avoid relapses.
• Slag diet (fresh vegetables and fruits).
• Wearing a bandage (up to 2-3 months).
• Exclusion of sudden movements, physical exercise (up to 2-3 months).
• Exclusion of loads over 3 kg (up to 2-3 months).
• Prescribing a course of antibiotics.
• Daily dressings.
• Use of physiotherapy according to indications.

removal of stitches for 10 days, limiting overheating, hypothermia to 2 weeks, limiting physical activity to 3 months.