Understanding Abdominal Hernias
What is a hernia?
Usually when using the term “hernia,” doctors and patients are referring to abdominal wall hernias. These are defects, or holes, in the abdominal wall that allow contents to protrude beyond the confines of the abdominal cavity into the fatty layer just beneath the skin. Usually this occurs at a point of natural weakness in the abdominal wall. Hernias in scars are common because surgical scars often create weak areas or further weaken natural weak spots.
Our abdominal wall is a complex arrangement of muscles and tendinous tissue that not only contains our vital abdominal organs but also plays an important role in the muscular activity of almost the entire body; stabilizing the trunk for arm and leg motions, maintaining posture, bending over and others. Hernias can cause problems by trapping or pinching protruding contents in the hernia opening, and, in the case of very large hernias, interfering with the normal muscular functions of the abdominal wall.
The most common hernia problems are:
Inguinal hernias are commonly referred to as groin hernias. The name comes from an anatomic area called the inguinal canal, which in men contains a passage for the blood supply of the testicles to penetrate the abdominal wall. In women an inguinal canal also exists containing a suspensory ligament of the uterus (round ligament). Inguinal hernias are the most common of all naturally occurring hernias and are more often present in men than women, but are seen in both. They can even be seen fairly frequently in children and young adults.
Vertically up and down the middle of the abdomen (anatomically this midline is called the linea alba) there are no muscles, only connective tissue. The umbilicus, or “belly button” is where the umbilical cord penetrated the abdominal wall before birth. This then leaves a natural weak area in this already relatively thin midline area. Hernias here often occur in women after childbirth, as a persistent defect since birth, or acquired as one ages and gains weight. To add insult to injury this is also one of the favorite areas for surgeons to make incisions for laparoscopic procedures, creating more scar tissue. These are understandably very common hernias.
An incisional hernia is a hernia that occurs in any scar from previous abdominal surgery. Surgical scars in the midline area are the most vulnerable to form this type of hernia, but these can occur in any scar on the abdomen. These can range from small hernias from a laparoscopic surgery to giant hernias involving most of the abdominal wall. The type of repair and complexity can vary considerably depending upon the size and location of the defect.
When very large hernias require repair, special surgical techniques are needed for adequate reconstruction of the abdominal wall. These are referred to as abdominal wall reconstruction techniques. Dr. Wright has been utilizing these type techniques, when needed, for more than 10 years. This is a constantly evolving field. Tracking and evaluating