Hernia Treatment

What is a Hernia?

A hernia is a gap or space in the strong tissue known as the "fascia" that holds muscles in place. A hernia occurs when the fascia has weakened, resulting in a bulge or tear. If there is a defect in the fascia, the inner lining of the abdomen pushes through the weakened area of the abdominal wall to form a small balloon like sac. This can allow a loop of intestine or abdominal tissue to push into the sac. Hernias typically, cause discomfort, severe pain, or other potentially serious problems that could require emergency surgery. It is usually easy to recognize a hernia. You may notice a bulge under the skin. You may feel pain or discomfort when you lift heavy objects, cough, strain during urination or bowel movements, or during prolonged standing or sitting. Many times a hernia may be detected by your doctor on a routine physical examination.

Hernia quick facts:

  • Both men and women can get a hernia.
  • You may be born with a hernia (congenital) or develop one over time.
  • A hernia does not get better over time, nor will it go away by itself. There are no exercises or physical therapy regimen that can make a hernia go away.
  • Hernia can be caused by previous abdominal surgery.
  • The common areas where hernias occur are in the groin (inguinal), belly button (umbilical), and the site of a previous operation (incisional).

Hernia Treatment

Dr. Schultzel treats a variety of hernias robotically including:

  • Inguinal
  • Ventral
  • Umbilical
  • Parastomal
  • Incisional

What are the Advantages of Robotic Hernia Repair?

Robotic Hernia Repair is a technique to fix tears in the abdominal wall (fascia) using small incisions, a special camera and a patch (mesh). A Robotic repair offers a shorter return to work and normal activity for most patients. Dr. Schultzel employs the use of the robot for his hernia repairs.

Common advantages may include:

  • Less post-operative pain
  • Shortened hospital stay
  • Faster return to regular diet
  • Quicker return to normal activity
  • Less wound infections

What Preparation is Required?

  • Mostly hernia surgery is done as a same day surgery. Some Hernia surgery that is very large or involves significant scar tissue removal from the abdomen may require stay in the hospital.
  • Preoperative preparation includes blood work, medical evaluation, and an EKG depending on your age and medical condition.
  • After your surgeon reviews with you the potential risks and benefits of the operation, you will need to provide written consent for surgery.
  • Prior to surgery patients are asked to bathe with an antibiotic soap, eating and drinking is usually stopped the midnight prior to surgery, and blood thinners are usually stopped prior to surgery.
  • Smoking cessation is essential for a good hernia repair. Most surgeons will recommend this.

How is the Procedure Performed?

Dr. Schultzel employs the use of the DaVinci Robot to surgically repair hernias.

The Robotic hernia repair is done with the use of a laparoscope (a special) is inserted through a cannula (portal), allowing Dr. Schultzel to view the hernia and surrounding tissue on a video screen.

Other portals are inserted which allow your Dr. Schultzel to work "inside." The hernia is repaired from inside the abdominal wall. A small piece of surgical mesh is placed to cover the hernia defect, and is held in place with sutures. This operation is usually performed with general anesthesia. Dr. Schultzel will perform a Transverse Abdominus plane block (TAP Block), which is conducted via ultrasound guidance and reduces the patient’s pain after surgery.

What Should I expect After Surgery?

  • After surgery you will go to a "post-operations area" for 1-2 hours until you are fully awake. Once you are able to walk and drink you will be sent home unless an overnight stay is required.
  • Most patients will have abdominal pain after surgery, you will be able to walk, however we recommend no heavy lifting for a few weeks after surgery.
  • Call and schedule a follow-up appointment within 2 weeks after you operation.

What Complications Can Occur?

The most common complications after hernia surgery are:

  • Pain
  • Bleeding
  • Wound
  • Infection
  • Bowel
  • Injury
  • Bruising
  • and swelling of the scrotum
  • Seroma
  • Hematoma
  • Hernia
  • repair failure

The majority of these complications are treated conservatively and are self-limiting.

When to Call Your Doctor

Be sure to call your physician or surgeon if you develop any of the following:

  • Persistent fever over 101 degrees F (39 C)
  • Bleeding
  • Increasing abdominal or groin swelling
  • Pain that is not relieved by your medications
  • Persistent nausea or vomiting
  • Inability to urinate
  • Chills
  • Persistent cough or shortness of breath
  • Foul smelling drainage (pus) from any incision
  • Redness surrounding any of your incisions that is worsening or getting bigger
  • You are unable to eat or drink liquids