Some people may be embarrassed to discuss an unusual bulge in their lower abdomen with their doctor. But it could be a potentially dangerous condition that requires immediate medical attention.
Hernias occur suddenly when a section of the intestines, fatty tissue in the colon, or part of the bladder or stomach, protrudes through an opening or a weakness in the abdominal wall.
“Hernias can be extremely debilitating and painful, especially when they become strangulated, a condition that requires emergency surgery,” says Sharique Nazir, MD, attending robotic and advanced laparoscopic surgeon at NYU Langone Hospital—Brooklyn. “Conventional surgery can reduce a hernia’s protrusion or push it back in place. It’s a very common procedure—but also one of the least talked about operations.”
Martin B., an actor who asked that his last name be omitted, endured pain and swelling in his right groin for several months while making a movie. An ultrasound revealed a large hernia, which Dr. Nazir repaired in January.
“Once I had my hernia repaired, I felt like a new person,” he says. “It made a big difference.”
Prashant Sinha, MD, chief of surgery at NYU Langone Hospital—Brooklyn, points out that many patients with complex hernias fear surgery. “They rely on temporary solutions like trusses, which only help short-term,” he says. “Laparoscopic and robot-assisted surgical techniques provide effective, permanent relief. In the hands of our experienced surgeons, patients can return to normal activities in no time.”
Dr. Nazir points out that the fascia, normally the strongest layer of tissue that holds the body together, can weaken from pressure, previous surgery, or other causes, including physical injury, poor diet, weight gain, pregnancy, excessive coughing, and constipation.
The most common types of hernia are those that occur in the groin (inguinal), in an earlier surgical site (incisional), in the navel (umbilical), in the femoral artery canal of the upper thigh (femoral), and in the diaphragm (hiatal). Because hernias often occur in tight spaces, repairing a hole or a weakness in the abdominal wall must be done delicately to avoid harming the surrounding network of nerves and tissues.
Who’s At Risk?
Adults who are overweight and those who carry heavy loads are at high risk for hernia. Sudden twisting movements or change of direction can lead to fascial tears as well as injury to soft tissue, muscle, and tendon attachments.
In addition, some babies are born with hernias, and there is a strong genetic predisposition to the condition.
Small hernias may not need immediate surgery but should be monitored carefully. Some hiatal hernias can be managed with diet and medication to alleviate gastroesophageal reflux disease (GERD), but if the problem persists, surgery may be necessary.
“A full-service hernia center can make a big difference in a patient’s experience and long-term outcome,” says Dr. Sinha. “We are able to provide patients a high level of pre- and post-operative support including programs for smoking cessation, diabetes care, weight loss, and physical therapy.”