Hernias are a common problem caused by a defect in the muscle and strength layer of the abdominal wall. This strength layer is called the fascia.
These defects can occur anywhere on the abdominal wall, but are most common in the groin, belly button and anywhere you had previous surgery. The hernia allows fatty tissue or intestine to poke through the fascia.
You can usually see a bulge of tissue under the skin, which can be tender or painful. The only way to fix a hernia is with surgery. However, this is not always an emergency, and many people can wait months or years before needing to have their hernia fixed.
Hernia causes and risk factors
Sometimes, a hernia just happens. It may be something you’re born with or that forms when you’re an adult.
Hernias can also happen following another surgery. The place where a surgeon cut may not have healed properly or may weaken, causing fat and intestine to poke through.
Other risk factors for hernia include:
- Chronic cough
- Smoking
- Pregnancy
- Excess weight, especially in the abdomen
- Straining while lifting or using the bathroom
- Certain medications
How are hernias diagnosed?
The first step is a physical exam. Then, your doctor may send you for an imaging test. This can tell us exactly which tissues and organs are affected. To prepare for hernia surgery, you may need more tests.
What are the types of hernia?
The most common hernias are inguinal (groin) and umbilical (belly button) hernias.
Groin hernias are more common in men because of the way our abdominal walls develop in the womb. Umbilical hernias (under the belly button) are very common to see at all ages.
Incisional hernias occur where a surgeon has previously made a cut. This usually happens after an open abdominal surgery, but it can happen with cuts anywhere along the abdomen.
A hiatal hernia is when the stomach pushes up through the diaphragm and into the chest cavity. The stomach may go in and out of your chest cavity, or the stomach may become trapped in the chest cavity next to the esophagus. In rare cases, other organs (such as your colon, small bowel, spleen or pancreas) may enter the chest cavity through the hiatal hernia.
About 1% of abdominal hernias are Spigelian hernias, or when a hole forms in a specific place in your abdominal muscles. The treatment is still hernia repair surgery.
Another rare type of hernia is an obturator hernia. This is when fat and organs push through a small, naturally occurring hole in your pelvis. Because this type of hernia is at increased risk of complications (such as strangulation), proper diagnosis is key. Obturator hernia is a kind of pelvic floor hernia.
Do I have to have surgery?
Left unchecked, no hernia will repair itself. In fact, the longer you have an untreated hernia, the more likely it is to get bigger and be harder to repair. Surgery is the best hernia treatment.
However, most hernias aren’t an emergency. Once your hernia is diagnosed, you can talk with your surgeon about what you can do to ensure a successful hernia repair surgery.
Meet our hernia surgery providers
I had hernia repair surgery, but it didn’t work. Can you help?
Hernias can and do come back after surgery. But Rush is committed to making this your last hernia surgery — even if you’ve had several in the past. Rush surgeons use evidence-based care researched for decades to select the best repair method for your hernia. This includes using surgical mesh, Botox and other advanced techniques.
If you want a second opinion about your hernia repair, whether it’s your first time or you’ve had the procedure before, Rush surgeons can help. Rush is home to the first comprehensive abdominal wall reconstruction program in Chicago, and we can help you repair your complex hernia close to home.
I’m worried about using surgical mesh for my hernia repair. Is it safe?
Surgical mesh is often used in hernia repairs. The mesh provides architecture for your body to heal around, strengthening the surgical repair. Without mesh, hernias may come back as much as 50% of the time. With mesh, rates of hernia recurrence are significantly lower.
Hernia repair mesh has been used since the 1950s, and Rush surgeons are very comfortable using it with most of our patients. There are many different types of mesh. The type of mesh you receive will be specific to you.
Rush Excellence in Hernia Repair
- Leading the way. Under the leadership of Brittany Mead, MD, a fellowship trained abdominal wall reconstruction surgeon at Rush, we have the first comprehensive abdominal wall repair program in Chicago. Trained under one of the best abdominal wall repair specialists in the country, Mead’s leadership, experience and training allows every possible chance for a successful hernia repair.
- Preparing for success. An important part of Rush’s program is ensuring patients are as ready as they can be for surgery. This may include losing weight, quitting smoking or a meeting with another specialist about an outstanding health issue. We work with you and your other doctors to get ready for what we hope is your last hernia repair surgery.
- Your safety and comfort. Rush has adopted the enhanced recovery after surgery (ERAS) program, which has been shown to improve patient outcomes and quality of life. Under ERAS, we follow a number of best practices before, during and after surgery. The practices vary depending on the surgery you are getting but could include eating a nutritious diet prior to surgery to help you heal and treating post-surgical pain with non-opioid medication. When surgeons follow ERAS, patients have fewer post-surgical infections, better pain control and shorter hospital stays after surgery.
- Second opinions: If you are looking for a specialist to weigh in on whether you need surgery, we can share our expertise.
Hernia Frequently Asked Questions
Some people with hernias have no symptoms. Other people deal with pain and soreness where the hernia is. They may also see a bulge.
Rush treats all types of hernias, including inguinal (groin), femoral, hiatal, ventral, umbilical, pelvic floor and postsurgical hernias.
Sometimes hernias are straightforward to repair. Some hernias require a more complex procedure. Some factors that could make your hernia surgery complex include:
- Size of the hernia. The larger the hernia, the more difficult it is to repair.
- Prior hernia repair surgery. Rush surgeons specialize in patients who have had prior hernia repair surgeries that failed. Our goal is for this hernia repair surgery to be your last.
- Carrying excess weight. Excess fat, especially around the midline, can make the abdominal wall more difficult to repair. Rush doctors will work with you to ensure you’re in the best position for surgery.
- Diabetes. This chronic condition makes it more difficult for your body to heal. We want to make sure your A1C is within a healthy range before hernia repair surgery.
- Smoking and tobacco use. Smoking also makes it more difficult for your body to heal following hernia repair surgery.
Some hernias need repair immediately, while most can be observed and left alone while you prepare for surgery. Our physicians can help you decide the right timing for your procedure.
No hernia will heal itself. Left alone, it will get bigger over time, and the bigger the hernia is, the harder it may be to fix. Hernia surgery is the gold standard of care.
Prior to surgery, your doctor will make sure you are in the best shape possible to avoid complications. This may mean losing weight, stopping smoking and controlling your diabetes. We’re here to help you succeed in each of these areas.
The day of your procedure, you won’t eat or drink anything for about six hours prior to surgery. You’ll be given medicine to make you less nervous, then put you to sleep for the procedure.
The time it takes to repair your hernia depends on how big it is. It may take as little as 30 minutes, or multiple hours. Your surgeon will attach a piece of surgical mesh over the hernia, pulling the abdominal wall as closed as possible around the hernia.
When you wake up, some pain is expected. Hernia surgery often requires pulling together the abdominal wall muscles, which may cause discomfort. The worst of the pain is experienced in the first 48-72 hours after surgery.
If your hernia was small and your surgery was straightforward, you may go home the same day or the next day. If your hernia was bigger or you had complications, you may need multiple days in the hospital to recover.
Most people get back to normal life within six weeks. You should not lift anything heavy while recovering from hernia surgery.
Every procedure has risks. Hernia repair surgery has different levels of risk depending on the location and severity of the hernia. These risks may include infection, bleeding, scar tissue forming inside the abdomen and pain.
Your surgeon will explain the risks of your procedure in detail and answer any questions you may have.
During hernia repair, the goal is to completely close the defect in the abdominal wall. Most of the time, a mesh is used to support the repair of your abdominal wall and make it stronger. This mesh also makes the hernia less likely to come back long-term.
Hernia mesh is safe, and it reduces the risk of your hernia coming back.
The main goal of hernia surgery is to completely close the hernia – this often requires significant movement of your abdominal wall muscles. It may require cutting one layer of abdominal wall muscles to get the hernia closed completely.
Botox (botulism toxin injections, the same kind used for wrinkles in your face) is one way to help the surgeon close the defect. Injections are placed in the muscles on both sides of your abdomen. Botox relaxes the abdominal wall muscles and allows them to stretch further during your repair, avoiding extra cuts into the muscle.
Recovery time depends on how complex your hernia is and whether you had an open procedure. Some people can go home the same day. Other people need multiple days in the hospital.
Most people are back to normal life within six weeks. Rush hernia repair surgeons will make sure you know what to expect for your procedure.
Yes. Many people are good candidates for minimally invasive and robotic hernia surgeries. This can lead to lower risk of infection and a shorter hospital stay.
Some hernias may benefit from a traditional, open procedure. It depends on the location of the hernia, the size and whether you’ve had hernia repair before. Your surgeon will discuss the risks and benefits of both approaches for your type of hernia.
Preparing for hernia surgery is one way to ensure you don’t need another hernia surgery later in life. Some ways to prepare may include losing excess weight, quitting smoking and controlling diabetes. It’s important to talk to your surgeon beforehand about how you can be in the best shape possible for your surgery.
What makes Rush’s hernia surgery services unique? Providers
Brittany Mead, MD
SurgeryRush is the first hospital in Chicago to offer comprehensive abdominal wall repair. This program is led by Brittany Mead, MD, a fellowship-trained abdominal wall surgeon at Rush. Her leadership, experience and training allows Rush to offer every possible chance for successful hernia repair surgery.
Yes. However, our hernia repair surgeons are specially trained in evidence-based abdominal wall reconstruction techniques. We can offer you personalized hernia care with a low chance of the hernia coming back.
Left alone, a hernia will not heal itself. However, most people don’t need emergency hernia surgery. This gives you time to prepare for hernia surgery — whether that’s losing excess weight, quitting smoking or getting your diabetes under control. There are some hernias that can be observed long term without surgery. Your surgeon will talk to you about the approach that is right for you.
Call (888) 352-7874 to request an appointment, or use MyChart.
