Patients who have a bulge in the groin or the abdominal area might have a hernia. If this bulge can be pushed back inside and continues to recur, it may be an indication that a hernia is present.

Symptoms most likely appear after standing for long periods of time or when a person is engaged in activities which increase pressure inside the abdomen (heavy lifting, persistent coughing or straining).

Some patients may only have pain in the groin, thigh, or lower abdomen.

This happens when irritated nerves around the hernia share a nerve root with other parts of the body. Hernias can encompass many less specific discomforts depending on the placement of the hernia sac or the pressure that the sac places on nearby tissues.

Hernia-related symptoms usually become worse towards the end of the day, but may be relieved at night, when you are lying down and the hernia naturally becomes smaller.

Do not attempt self-diagnosis, it might be something entirely different. If you display symptoms, the only way to know if have a hernia is to be examined by a hernia specialist.

Most hernias can be diagnosed with a simple groin and abdominal physical exam. You will be examined whilst standing, as well as on the couch whilst lying down while coughing or straining your muscles, which will reveal a hernia. Both sides of the groin are examined. Your abdomen will be examined, as will all possible areas in the abdominal wall where a hernia can appear. In men, the scrotal area is checked as hernias can descend into the scrotum. The testicles are also checked. Additional investigations are usually not required for the diagnosis of a hernia.

In case the doctors are unable to diagnose a hernia by simple examination, but there is a qualified assumption that it is a hernia, some patients will need additional screening. These steps are important when the hernia is not palpable. Sometimes with umbilical hernias an ultrasound is required to rule out additional defects. For some large incisional hernias a CT or MRI of the abdomen might be recommended.

Unfortunately, hernias can't heal on their own, and they never simply disappear. If hernias are left untreated they often become bigger and painful which can make recovery more difficult later in the healing process. If you have a hernia you should see a hernia specialist for an evaluation. Once diagnosed, abdominal wall hernias should be treated as soon as possible by the best techniques.

Yes! There are many reasons as to why. If it is not treated, hernias normally only get worse. In fact, every day you do not treat your hernia, it becomes slightly bigger; and you as well as your tissues become a day older. If a hernia is left untreated, the risk of complications can escalate to the point where a larger, more complex operation is needed. The danger of clamping is heightened, as well as the need for emergency surgery, by neglecting the treatment process. A hernia should be treated if it is: impeding your lifestyle, causing pain, abdominal bloating or obstruction, bulging, interfering with your job and sexual life, requiring hospital visits for pain or distension. Only small, asymptomatic hernias may be safely overseen but will not disappear without surgery.

There is always a risk that an untreated hernia may lead to clamping where the abdominal contents entering the hernia become stuck. If your hernia suddenly becomes painful and cannot be pushed back in, this can lead to abdominal pain, nausea, vomiting and constipation with intestinal blockage, and, in rare cases, necrosis of the herniated bowel. The results could be fatal. A clamped hernia requires emergency surgery. Our hernia specialists recommend that you have elective surgery and avoid the chances of experiencing an obstruction or surgical emergency in the future.

Surgery remains the only way to treat a hernia. There are different types of surgical procedures available to treat hernias. Surgery typically involves treating the defect in the abdominal wall and reinforcing it with a piece of surgical mesh. Modern hernia treatment places emphasis on it being tension free or minimally invasive and using the highest quality bio-synthetic materials with new and improved techniques.

There are two basic types of hernia treatments:

Open hernia treatment:

Open or traditional hernia treatment uses an incision to get to and directly treat the hernia. The hole and weakness in the muscles is identified and repaired. The muscles and skin are then closed. It is a proven approach which is still the most commonly used method of treating a hernia. It is used in all types of hernia treatments and can be done in local anesthesia.

Laparoscopic hernia repair:

Laparoscopy is a minimally invasive technique where a small camera is used to look at the weakened muscles and the hernia from inside of the abdomen. The hernia is treated from the inside without opening the skin or the muscles. Laparoscopic surgery requires general anesthesia. Only an experienced laparoscopic surgeon can determine if laparoscopic hernia surgery is right for you.

At our Center, both options are available.

Both open hernia surgery and laparoscopic hernia surgery are excellent treatments for abdominal wall hernias. There are benefits and downsides of both types of hernia treatments. Your surgeon will discuss all the various options and recommend the best procedure for you.

This is probably the most important decision you will have to make. Research and expert opinion recognize the importance of specialization for any surgery. When given a choice, most people would go to a surgeon with extensive training and experience, understanding that this could lead to safer and more effective outcome.

Hernia dedicated surgeons have considerable experience in diagnosing and treating hernias of all types, performing few hundreds operations of this type every year and providing the best result with minimal discomfort and quick return to normal lifestyle.

Not all hernia operations are the same, nor are the outcomes, so choose wisely. Most repairs are performed by general surgeons in large hospitals which are more focused on patients with complicated issues which doesn’t make them the best choice for your hernia. A highly dedicated practice to hernia care places an emphasis on you and your hernia. If the surgeon with their team and the unit are performing hernia surgeries daily, then there is a clear indication of a good outcome.

Patients should find a center that has three important components of outstanding hernia care:

• Dedication and comprehensive approach to hernia surgery
• Highly experienced surgeon with hundreds of successful operations behind them
• Highly dedicated team with bountiful experience in the professional environment

Yes, most of the time. Today, mesh is mainly used to replace lost or weakened tissue at the site of a hernia, which significantly improves the results of hernia treatment. The mesh is a surgically designed sterile, soft and elastic material that is adaptable to body movements and at the same time strong enough to enable a very quick return to life, work and sports activities. The mesh can be in the form of a patch that goes under or over the weakness, or it can be in the form of a plug that goes inside the hole. Mesh acts as "scaffolding" for new growth of a patient's own tissue and incorporates into the surrounding area. There is no need for cutting or suturing of the surrounding muscles which results in significantly less postoperative pain and discomfort. The mesh decreases the tension on the weakened area, reducing the risk of recurrence to almost zero. Polypropylene mesh is most often used, and mesh can be made of polyester or Gore-Tex also. It is extremely rare for the mesh to be rejected. Your surgeon will select the appropriate type and size of the mesh according to your individual characteristics.

Hernia in elderly patients is a common condition because of the abdominal wall weakness and conditions which increase intraabdominal pressure. Tension-free hernia surgery performed under local anesthesia, nowadays, can be routinely done even on older patients (over 80 years), which was not the case before. The procedures now are safe, comfortable and effective for a patient, who can go home on the same day with prompt return to daily activities. Elective hernia surgery in elderly with symptomatic hernias should be considered in order to avoid the increased risks of clamping.

Yes. Most inguinal, femoral, epigastric and umbilical hernias can be repaired under local anesthesia. Hernia surgery under local anesthesia is now widely and successfully performed around the world and is a routine procedure. Many patients prefer local anaesthesia because of a fear of general anaesthesia or a previous unpleasant experience. It is a safe, simple and effective procedure, with a low frequency of side effects such as cardiovascular instability, nausea, vomiting or urinary retention. Contraindications for local anesthesia are rare and it can be used particularly in older patients very successfully. Sedation may be administered based on individual preference in consultation with our anesthesiologists so even the most nervous patients and anxious patients will be able to have the procedure. Our standard is to give you intravenous sedation and then insert local anaesthetic into the operative field. You will not feel the pain, but are awake during the procedure. You are able to walk around and eat soon after the operation. All this adds up to most patients being able to go home a few hours after the operation.

This depends on individual factors such as sensitivity to pain as well as the type of work you do. Most people go back to work in 3 to 5 days after surgery. Walking, movement and routine activity are encouraged immediately after surgery. Typically, office workers with desk jobs can return to work after a few days. Patients with jobs which involve moderate physical activity may require 2 or 3 weeks before returning to work. Patients that do heavy lifting at work will need to be off duty for 3 to 4 weeks after surgery. Our patients are typically able to return to everyday activities within a few days of surgery and can return to work and back to recreational activities within 1 to 2 weeks. Your post-operative recovery will be discussed and your return to work assessed with your surgeon.

This is one of the most common questions for athletes to ask. Recovery is a process that will be different for all patients. It depends on type and location of hernia and the chosen repair method. Patients return to their sports regimen and exercise activities in progressive stages.

By day 3-4 you are able to participate in light cardio activities such fast walking, easy jogging, stretching, or some forms of yoga. You can slowly increase activity with more moderate exercises but without lifting anything heavier than 10 kg within the second week after surgery.

Three or four weeks after hernia surgery, most patients are safe to resume all of their strenuous athletic activities by gradually increasing in intensity. This includes distance running, swimming, cycling, lifting heavy weights at the gym, and contact sports.

Our surgeon will customize recovery program to your individual needs, with respect to the type of hernia and operation, form of exercises, and other factors.

Driving a car is usually advised when you can safely perform sudden braking or reversing without feeling any pain. This usually happens 7 to 10 days after hernia surgery.

It is normal to feel pain after your surgery. Most patients experience some postoperative pain in the area of hernia operation, also they will notice some level of swelling and bruising in this area. The first 2-3 days are usually the worst, the pain is moderate and does not exceed 4 on a scale of 1-10. During this time, sitting up, long walking, coughing, sneezing, and laughing will remind you of your operation. In this situation, some patients require oral pain medications. We recommend that painkillers be taken regularly for the first 72 hours and then as needed thereafter. Soon you will be able to return to daily activities with only occasional reminders of the operation. Each day the discomfort should improve to the point of very little pain by 10 days. It is not uncommon to feel occasional pulling, burning, numbness and other unusual sensations in the operative area for up to a year. If you have any concerns, ask your surgeon about different medications and postoperative activity.

Modern hernia treatment has led to rapid recovery. Our approach to hernia surgery makes it possible for patients to return home the same day of the operation. Most inguinal, umbilical and epigastric hernias are done outpatient. These procedures take under an hour to perform under local anesthesia. The rest of the time is spent in preparing the patient for surgery, and in recovery afterward. Usually, patients are discharged 2-3 hours after the surgery, when they meet the conditions for home rehabilitation. The assessment is performed by the on-duty medical staff in consultation with the attending surgeon. It is necessary for a competent adult to take you home and spend the first postoperative day and night with you. An overnight stay can be arranged, if it is necessary.

Yes. All of our patients need preoperative general medical exam and permit for operation. These include medical evaluation, preoperative laboratory analysis, and electrocardiogram and can be done with your general practitioner or by an internal medicine specialist in our office. If there are complicating factors such as cardio-vascular, respiratory, metabolic or urinary problems, you will be also examined by the other specialists.

Postoperative care is included free with the operation, for the standard four-to-six-week recovery period, for all of our patients. A follow-up appointment will be scheduled following hernia treatment, and you will be evaluated at 7. and 28. day and one year postoperatively by your surgeon.

You are welcome to call us or contact us online to ask about hernias and hernia treatment. You can also review our website for additional information. If our staff is unable to answer any of your questions, you will be contacted by one of our surgeons.