Hernia (Abdominal Hernia)

  • Medical Author:
    Benjamin Wedro, MD, FACEP, FAAEM

    Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

What types of surgery repair an abdominal hernia?

Inguinal hernia repair is one of the most common surgical procedures performed in the U.S. with almost a million operations occurring each year. Most abdominal wall hernias are repaired electively when the health of the patient can be maximized to decrease the risk of both the surgery and the anesthetic.

Surgery to repair a hernia may use a laparoscope or an open procedure called a herniorrhaphy, where the surgeon directly repairs the hernia through an incision in the abdominal wall. The type of operation depends upon the clinical situation and the urgency of surgery. The decision as to which operation to perform depends upon the patient's clinical situation.

Other abdominal wall hernias can similarly be repaired to strengthen the defect in the abdominal wall and decrease the complication risk of bowel incarceration and strangulation.

Sliding hiatal hernias may be treated surgically to place the stomach back into the abdominal cavity and to strengthen the gastroesophageal junction. However, doctors do not routinely offer surgery because most symptoms are due to GERD and medical therapy is often adequate. Medication, diet, lifestyle changes, and weight loss may help control symptoms and minimize the need for surgery.

Paraesophageal hernia repair is done to prevent the complication of strangulation or volvulus.

What non-surgical treatments are available for an abdominal hernia?

If an inguinal or umbilical hernia is small and does not cause symptoms, a watchful waiting approach may be reasonable. Routine follow-up may be all that is needed, especially if the hernia does not grow in size. However, if the hernia does grow or if there is concern about potential incarceration, then surgery may be recommended. Patients who are at high risk for surgery and anesthesia may be offered a watch and wait approach.

Trusses, corsets, or binders can hold hernias in place by placing pressure on the skin and abdominal wall. These are temporary approaches and potentially can cause skin damage or breakdown, and infection because of rubbing and chafing. They are often used in older or debilitated patients when the hernia defect is very large and there is an increased risk of complications should they undergo surgery.

Unless the defect is large, umbilical hernias in children tend to resolve on their own by 1 year of age. Surgery may be considered if the hernia is still present at age 3 or 4, or if the defect in the umbilicus is large.

Hiatal hernias by themselves do not cause symptoms. Instead it is the acid reflux that causes gastroesophageal reflux disease (GERD). Treatment is aimed at decreasing acid production in the stomach and preventing acid from entering the esophagus. For more, please refer to the Gastroesophageal Reflux Disease (GERD) article.

Medically Reviewed by a Doctor on 6/23/2017

Subscribe to MedicineNet's Newsletters

Get the latest health and medical information delivered direct to your inbox!

By clicking Submit, I agree to the MedicineNet's Terms & Conditions & Privacy Policy and understand that I may opt out of MedicineNet's subscriptions at any time.

Health Solutions From Our Sponsors