MountainView Hospital - July 30, 2018

Approximately 5 million people in the United States have an abdominal hernia, but only about 700,000 seek medical attention every year. No matter the type, a hernia happens when pressure pushes an organ, oftentimes the intestine, through a weak spot in a muscle face or wall. Different types of hernias have different risk factors.

Treatment for hernias can be no treatment or going under surgery. Modern surgical methods have allowed hernias to be easily treated with a shorter recovery time.

“The surgeons of MountainView, including myself, see and fix all sorts of hernias,” says Dr. Brian Citro, MountainView Hospital Chief of Surgery. “The most common types we see are umbilical hernias and inguinal hernias. After that, hernias from previous operations.”

The most common types of hernias include:

Femoral Hernia - Femoral hernias occur more often in women, and is the most common type of hernia to become a life-threatening complication when the blood supply is cut off. These hernias are often found in the upper thigh.

Incisional Hernia - Incisional hernias occur in the abdominal wall where a surgical incision did not heal properly. They may cause discomfort more than it does lead to complications.

Inguinal Hernia - Inguinal hernias are the most common. The intestine, or occasionally the bladder, pushes through the lower abdominal wall near or into the groin. Most of these occur in men and can be common in newborns because their abdominal walls are weak.

Umbilical Hernia - Umbilical hernias result from a weakness in the abdominal wall around the belly button. Umbilical hernias are more common in young boys than girls and something one can be born with. Symptoms might not arise until adulthood.

“Hernias come in a wide variety of sizes and with a wide variety of problems” explains Dr. Citro. “For very small hernias that are not causing pain or other problems, surgery can wait. If the hernia is large or is getting larger, causing pain, or if there is bowel or fatty tissue in the hernia, then we recommend repair.”

Hernias typically occur due to a combination of aging, weakening of the tissues, straining and lifting, genetics, and sometimes, just bad luck. Smaller hernias, particularly inguinal, femoral, and ventral, are more likely to cause problems such as pain or strangulation, which is when fatty tissue or a section of the small intestines gets stuck and leads to a cut in blood supply. Such hernias should be fixed when they begin to cause pain and discomfort. Larger hernias are less likely to become incarcerated or strangulated, but can still cause discomfort or be cosmetically bothersome.

There are hernia cases that can be managed manually; however, hernias may post a health risk and surgery may be recommended based on the specific condition and patient’s preferences.

“Our surgical teams have a lot of experience with various types of hernias. We support clinically advanced technology that allows to perform minimally invasive procedures including robotic surgery systems,” explains Dr. Citro.

The key principal of a hernia repair is to expose the hole in the skin of the muscle face or wall, push the bulging content back inside without causing damage, then close the hole up, typically with mesh.

“The two generally acceptable surgical approaches to repairing a hernia are open or laparoscopic and robotic,” says Dr. Morgan Pomeranz, Chief General Surgery Resident at Sunrise Health GME Consortium. “The approach depends on a several different factors: the size of the hernia, if the hernia has been operated on previously and how it was operated on, other previous surgeries, and the surgeon’s preference.”

“Robotic systems allow us to perform minimally invasive procedures which give surgeons a better view of and access to the hernia,” says Dr. Emanuel Shapera, Chief General Surgery Resident at Sunrise Health GME Consortium. “As a result, patients are left with less scars, less pain, and less time spent recovering in a hospital.”

It’s important to be careful and conscious of your health and body, as there are risk factors that could increase the chances of developing a new or reoccurring hernia. Risk factors include increased pressure in the abdominal such as constipation, urinary obstruction and heavy lifting, smoking, loss of tissue strength and elasticity, weakening of the muscles, and obesity.

“There are various risk factors when it comes to hernias,” explains Dr. Pomeranz. “For example, obesity is a factor for developing certain hernias, and for recurrence after repair. Smoking and nicotine patches impair circulation and blood flow to the tissues at the repair site, and can increase the chances of recurrence.”

Starting July 2018, MountainView Hospital will be offering a free Hernia Education Class to help you start your hernia education journey! The class consists of a discussion with our physicians and surgeons regarding types of hernias, the surgical method to correct them, and what to expect after surgery.

“If you think or know you have a hernia, get it fixed before it gets big. Big hernias are much harder to repair than smaller ones and carry a much higher risk of coming back,” says Dr. Citro. “Most people don’t know very much about hernias so attending a class is a good opportunity to get some answers.”

“We will always strive to improve the quality of our patient’s life, no matter how bad the hernia is,” explains Dr. Shapera. “At the end of the day it’s about their comfort and making them more comfortable to carry on with daily activities.”

For more information and to register for a free hernia class, visit or call (702) 962-5021.