Hernias are common conditions that involve weakened tissue and/or muscle that organs can pass through. This condition occurs most frequently in males and may be in the groin, belly button or diaphragm area. A hernia may appear as a bulge just under the skin and may be congenital or as a result of trauma or injury.

The contents of some hernias may be pushed back into normal position, making it reducible, while others cannot and may develop into a strangulating hernia in which blood flow is obstructed. Mild, congenital hernias may not cause any symptoms, but others can cause severe pain and swelling.

Hernias can often be effectively treated through surgery to move the herniated structures back into position. If you think your pet may have a hernia, see a vet right away as they can lead to serious complications.

What is a hernia?

A hernia occurs when tissue or part of an organ, usually the intestines, protrudes through a weak point or tear in the abdominal wall, forming a sac. The protruding tissue may lose blood supply and become obstructed, resulting in health problems as serious as life-threatening gangrene.

What causes hernias?

Hernias may be caused at birth when the abdominal lining does not close properly (this occurs in about 5 in 100 children); or they may occur later in life from a number of causes, including heavy lifting. The exact cause is often unknown, although risk factors for developing a hernia seem to include:

• Family history of hernias
• Cystic fibrosis
• Excess weight
• Chronic cough
• Chronic constipation from straining to have bowel movements
• Enlarged prostate from straining to urinate
• Undescended testicles

Where do hernias form?

Most hernias occur in the abdominal wall, either in the groin (inguinal, femoral) or navel (umbilical) or at surgical incision sites (incisional).

What are the symptoms?

Hernias usually cause pain in the groin or abdomen when lifting heavy objects, coughing or straining during urination or bowel movements. A tender or non-tender lump or bulge may also be apparent.

Are there tests to find hernias?

A doctor can confirm the presence of a hernia during a physical exam. The mass may increase in size when coughing, bending, lifting, or straining. The hernia (bulge) may not be obvious in infants and children, except when the child is crying or coughing.

How are hernias repaired?

Surgery is the only method to correct hernias. Among the most common procedures in the U.S., hernia surgery is performed to alleviate pain and to correct or prevent the occurrence of more serious problems. Surgery should be performed on any hernia, but it is especially recommended for patients with pain, who are at high risk for blockage such as large amounts of tissue protruding through a small hole, and whose life s are hampered by the hernia.

What are my surgical options?

The most common hernia repair procedure is traditional(open or "tension-free") surgery. Usually done with local anesthesia, a large, deep incision is made through the muscle. The tissue is pushed back behind the muscle, which is then stitched closed, and plastic mesh is placed over the former hole site for support. Full recovery takes a month to six weeks.

The more recent, minimally invasive technique of laparoscopy, done under general anesthesia, involves the creation of three small incisions in the abdomen, the injection of carbon dioxide gas to create a "work space" and the use of a laparoscope, a thin instrument with a camera on the end allowing the surgeon to see inside the patient’s body without the need for large incisions. Other necessary surgical instruments are employed through the other small incisions. This "transabdominal" method causes less trauma to the body, so post-operative pain is less and recovery is shorter (about a week) than with the open approach. Disadvantages include the risk of organ puncture.

In extra-peritoneal balloon laparoscopic hernia surgery, the "work space" is created with an inflatable balloon outside rather than inside the abdominal cavity. This reduces the risk of bowel and blood vessel perforation associated with regular laparoscopic surgery. General anesthesia is still required and recovery takes about a week.

Is there risk of complications?

As with any surgery, there is risk of bleeding, infection and allergic reaction to anesthesia. There is also the potential for abscess formation, organ or blood vessel injury and hernia recurrence (only 1-3%).

Hiatal Hernia Repair

A hiatal hernia is an abnormally large opening in the diaphragm, the organ that separates the abdomen from the chest. If the size of the opening (the hiatus) is not reduced, the stomach and other organs can bulge into the chest. Acid from the stomach then flows backwards into the esophagus, causing acid reflux, tissue damage or even cancer.

In a hiatal hernia repair, the stomach and any other organs that have protruded through the opening are pushed back into the abdominal cavity. Then the hiatus is closed and the muscle wall strengthened to prevent hernias from occurring in the future. Nissen fundoplication may then be performed to reduce reflux.

Inguinal Hernia Repair

An inguinal hernia is a hernia that occurs in the groin. They may occur in children as a congenital defect or in adults as a result of aging, injury, previous surgery, repetitive lifting, chronic cough or constipation, or other reasons. During laparoscopic inguinal hernia repair, the surgeon inserts instruments through three to four small incisions, pushes the protruding tissue back into the abdominal cavity, and patches the hernia with a surgical mesh.

Ventral Hernia Repair

A ventral hernia is an opening that forms in the abdominal wall, usually at the site of a previous surgical incision where the muscles are weak. The inner lining of the abdomen pushes through the opening, forming a sac, and a portion of the intestine or other abdominal tissue can then slip into the sac. Organs that get stuck in the sac (a condition known as incarceration) can cause severe problems that require emergency surgery. During laparoscopic surgical repair under general anesthesia, the surgeon pushes the protruding tissue back into the abdominal cavity and attaches a mesh to the muscles around the hernia to strengthen the area.