What Is An Inguinal Groin Hernia?

A hernia can form when an individual has a weak spot in their abdominal muscles and pressure is exerted on internal tissues and organs. The pressure caused by straining or lifting a heavy object can push a small section of the intestinal tissue out through that weak spot creating a hernia. An inguinal groin hernia is normally located on either side of the pelvic bone.

What Are The Symptoms Of An Inguinal Groin Hernia?

Inguinal groin hernias are not usually dangerous but often cause pain or discomfort. Some signs of an inguinal groin hernia include the presence of a bulge on either side of the pubic bone. The bulge is usually more noticeable when standing, coughing, or straining. Pain or burning at the bulge area. Pain in the groin when coughing, lifting, or bending over. A feeling of heaviness, pressure, or weakness in the groin area. Men may experience pain or swelling around the testicle.

What Are Emergency Symptoms of an Inguinal Groin Hernia?

Vomiting, nausea or both, fever, the hernia bulge turns purple, red, or dark in color, sharp sudden pain that gets worse, constipation and bloating from unpassed gas.

Who Is A Candidate For Inguinal Groin Hernia Repair?

Some surgeons prefer to repair hernias rather than take the “watchful waiting” approach to avoid any potential complications but in general, you may be a candidate for surgical hernia repair if the hernia is large, continues to grow, is causing pain, or appears to be in danger of becoming strangulated.

What Inguinal Hernia Treatments Are Available?

Hernias do not go away on their own and approximately 75% of individuals with a hernia will require surgical treatment to repair the hernia and alleviate symptoms. Wearing a protective corset, Truss, or Binder can help contain the hernia bulge but will not fix the hernia. Unfortunately, there are no options for inguinal hernia treatment without surgery. Two surgical techniques can be used to perform inguinal hernia repair: laparoscopic and open. Laparoscopic surgery can be performed free hand by the surgeon or robotically where the surgeon controls robotic arms through a computer.

How is Laparoscopic Inguinal Hernia Repair Done?

Laparoscopic or robotic inguinal hernia repair is performed under general anesthesia and is normally done as an outpatient procedure. Laparoscopic hernia repair is minimally invasive and is performed through several small incisions in the abdomen. A laparoscope, a small hollow tube-shaped surgical instrument that is outfitted with a camera, is used to guide the surgeon while the inguinal groin hernia is repaired. Using the camera as a guide, other tiny instruments are inserted through the incisions, to complete the inguinal hernia repair. Not all, but most groin hernias are repaired using surgical mesh. Repairing an inguinal hernia with mesh strengthens the weak portion of the abdominal wall preventing the hernia from protruding.

How Long Is Recovery From Groin Hernia Surgery?

Recovery from hernia repair varies depending on the degree of the hernia, the surgical technique used, and the overall health of the patient. The typical recovery from laparoscopic inguinal hernia surgery is one to two weeks while recovering from open hernia surgery can take three to four weeks.

How Much Does Inguinal Groin Hernia Repair Cost?

The cost of groin hernia surgery will vary due to multiple factors such as the use of mesh, size of the hernia, the technique of hernia repair used, patient health, etc. The average cost of inguinal groin hernia repair in the United States ranges between $4,200 and $6,200. Inguinal groin hernia surgery is not considered cosmetic and is usually covered by health insurance.

Paraesophageal Hernia

What Is A Paraesophageal Hernia?

A paraesophageal hernia occurs when the lower part of the esophagus, the stomach, or other organs move up into the chest. The hiatus is an opening in the diaphragm (a muscle separating the chest from the abdomen) through which organs pass from the chest into the abdomen. The lower part of the esophagus and the stomach normally reside in the abdomen, just under the diaphragm. The gastroesophageal (GE) junction is the area where the esophagus connects with the stomach and is usually located 1 to 2 inches below the diaphragm. A hiatal or paraesophageal hernia occurs when the GE junction, the stomach, or other abdominal organs such as the small intestine, colon, or spleen move up into the chest where they do not belong. There are several types of paraesophageal hernias. Type I is a hiatal hernia or sliding hernia, in which the GE junction moves above the diaphragm, leaving the stomach in the abdomen; this represents 95% of all paraesophageal hernias. Types II, III, and IV occur when part or all of the stomach and sometimes other organs move up into the chest.

Common Symptoms of Paraesophageal Hernia

More than half of the population has a hiatal or paraesophageal hernia. However, most people are symptom free. Hiatal hernias and paraesophageal hernias may cause symptoms such as reflux and heartburn; nausea, burping, and vomiting; regurgitation of food; unexplained upper abdominal or chest pain; a sense of fullness after eating; bloating; shortness of breath or coughing; or a sense of food getting stuck in the chest. Severe symptoms occur when the bowel or stomach twists or loses its blood supply. These include heart racing, palpitations, shortness of breath, chest pain, severe vomiting, lack of bowel movements, and severe abdominal pain. These symptoms require immediate medical attention.

Diagnosis

A paraesophageal hernia may be incidentally identified during imaging such as chest x-ray, computed tomography (CT), or magnetic resonance imaging. Patients with symptoms may undergo barium swallow, in which a contrast agent is swallowed and a series of x-rays reveal the anatomy of the esophagus and stomach. An upper endoscopy (esophagogastroduodenoscopy) is a procedure done under sedation in which the doctor visualizes the anatomy of the esophagus and stomach by inserting a thin camera to look at the upper gastrointestinal tract. Manometry may be used to measure the severity of the disease and to establish treatments. This is a study that allows the pressure inside the esophagus to be measured to determine if the muscles are too loose or too tight. A CT scan may be used for surgical planning.

What Paraesophageal Hernias Treatments Are Available?

Treatment of paraesophageal hernias depends on the type of hernia and severity of symptoms. Type I hiatal hernias are typically managed with medications for reflux and do not require other treatment. Type II and III hernias may require surgery if they become symptomatic. In type IV hernias, when organs such as the small bowel, colon, or pancreas are trapped in the chest, surgery is often necessary. Depending on the type and severity of the hernia, the surgical approach may be from the abdomen or from the chest. The operation is often minimally invasive (with small incisions), but it may require open surgery.

How Long Is The Recovery Time For Paraesophageal Hernia Surgery?

Because this is a major surgery, a full recovery can take 10 to 12 weeks. That being said, you can resume normal activities sooner than 10 to 12 weeks. For example, you can start driving again as soon as you’re off narcotic pain medication. As long as your job isn’t physically strenuous, you can resume work in about 6 to 8 weeks. For more physically demanding jobs that require a lot of hard labor, it may be closer to three months before you can return. If you are interested in learning more about Paraesophageal Hernias Surgery, call or contact IBI Healthcare Institute and schedule a consultation with a specialist.

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PARAESOPHAGEAL HERNIA