Ryan Engram
Surgical Review
Instructor Darin Smith
McCann School of Business and Technology
02/07/2015

Hernia
Have you ever wondered what a hernia is? A hernia is where a part of an organ in any condition where it starts to protrudes through a weak point in the muscular wall of the abdominal cavity. A hernia can be noticeable if there is tightening of the abdominal muscles, which then would cause pain. Also, lifting heavy objects and having to strain while having a bowel movement can cause worsen a hernia. A good way to explain what a hernia is to compare it to a tire. Inside the tire there is a tube which would be considered our intestines and the tire wall would be our abdominal wall. If there is a weakness in the tire wall it allows a bulge to develop allowing the inner tube to protrude, eventually leading to a failure in the tire, this is very similar to how a hernia occurs. There are many different types of hernias, but the most common types are; umbilical, inguinal, femoral, incisional, and hiatal. The most common hernia is typically harmless and it is mostly found in newborns, women that had many children or women that are obese, it is an umbilical (belly button) hernia, in which a small part of the intestine protrudes through the abdominal lining around the navel. Inguinal (inner groin) hernias occurs mostly in men, mainly because there is a natural weakness in the groin area. An inguinal hernia can be caused from the intestine or the bladder which protrudes through the abdominal wall or down into the groin area. A femoral hernia occurs in the upper thigh, the intestine enters the canal carrying the femoral artery to the thigh. After abdominal surgery an incisional hernia is most likely to occur due to inactivity, the intestine pushes through the abdominal wall where the previous surgery occurred. But with Hiatal hernias they are a little bit different than all of the other hernias. And this is because them being feebleness and are opening within the diaphragm area where muscle splits or divide the abdominal cavity from the thoracic cavity. Hiatal hernias will cause acid to reflux from the stomach and go into the opening of the esophagus, which will lead to extreme heartburn, chest pain, and sometime cause deterioration of the esophagus.
In most cases if the person has a hernia and cannot be pushed in or fixed on its own a doctor will suggest to the patient to have surgery to fix or correct the problem. If the patient chooses to have the surgery, it can be performed as an open procedure or MIS (minimally invasive surgery). Doctors prefer to perform a laparoscopic surgery for hernias, so yes they are the most common when it comes to hernia repairs. For umbilical hernias most children grow out of a hernia by the ages three to four. If the hernia has not fixed itself, surgery would be required. For this procedure to be performed the patient will first arrive to the hospital and will be checked into pre-op, after the patient is in pre-op they will be seen by the surgeon and anesthesiologist then taken to the operating room. At this time the patient will receive a general anesthetic and be put to sleep. The surgery begins with the surgeon making an incision below the belly button which is usually no longer than an inch to two inches. Once the incision is made, the surgeon will then try to manipulate the abdominal lining that is coming through the muscle. Once the surgeon has access of the protrusion known as the hernia sac the surgeon will return it to its proper position. If the weakness in muscle is minor it would just be sutured and closed. The suture that would be used would be 0-prolene which would remain permanently, this is done so the hernia is stopped from returning in the future. If the muscle had a larger diameter then a half dollar in the opening the surgeon will then opt to use a mesh graft 3x6 or 6x6 depending on the opening of the muscle. If a sutures was used to repair a hernia of such size it will