A hernia is the output or "bulge" of abdominal viscera (small intestine, large, ovary, etc..) Through a weakness in the abdominal wall. Imagine an old car tire. His cover is like the abdominal wall. The inner rubber tube is like a thin layer inside your abdomen (peritoneum). Instead of containing air inside the intestines and other vital organs.

In a manner similar to a rubber tube that is inserted through a damaged tire, when the outer covering weakens formed a small hernia sac. This may allow abdominal viscera to push into the sac. The hernia can cause severe pain and other potentially serious problems that may necessitate emergency surgery.

What types of hernias are there?
Most occur in the groin area (inguinal and femoral hernia). Outside this place, the most common hernias occur in the navel (umbilical hernia) and at sites of previous operations (incisional hernia or eventration). Other less common sites are the midline above the belly button (epigastric hernia) and line the sides semilunar (Spigelian hernia). Other types are extremely rare.

What causes a hernia?
Most hernias are acquired, is produced by increased abdominal pressure. The upright position of human beings, chronic constipation, obesity, multiple pregnancies, chronic coughers, little exercise, and previous abdominal surgery contribute to the development of hernias. Congenital hernias (from birth) are less frequent. Hernias can occur in both children and adults and affect both men and women.

How do I know if I have a hernia?
It is usually easy to recognize a hernia. It manifests as a lump or tumor that arises in the region where the hernia is located. You may feel pain when lifting heavy objects, coughing, straining while urinating or defecating, or standing for prolonged periods.

The pain may be sharp and immediate, or a mild pain that becomes more intense towards the end of the day. Continuous severe pain, redness and tenderness are signs that the hernia may be entrapped or strangulated. These symptoms are cause for concern and indicate that you should immediately contact your surgeon.

What is an inguinal hernia?
Occurs when there is an opening or an area of weakness in the lower part of the muscular wall of the abdomen (groin). Some of the contents of the abdomen may press and make their way through this defect. Inguinal hernias are the most frequent (65%) and can occur in both infants, children and adults.

How is an inguinal hernia?
They occur most frequently when opening the groin that is present in the fetus does not close tightly before birth. The organs in the abdomen and may push their way through this opening. In the male. A loop of intestine may hold the hernia sac and even reach the scrotum. In girls, the fallopian tubes and ovaries are the organs that are often within the hernia sac.

Inguinal hernias are more common in men than in women. They can occur on either side, but are most common on the right side. Factors such as premature birth or family history of hernias increases the risk of developing inguinal hernias in children. In adults, are usually produced by a zone of weakness in the wall of the groin that is evidenced by the realization of significant efforts at the time of defecation, heavy lifting, coughing, etc..

How is an inguinal hernia?
The inguinal hernia repair requires surgery. Do not go away by itself and there is no medication or treatment that achieves repair a hernia. The hernia usually enlarges over time and can damage abdominal viscera if these organs are trapped or stuck (strangulated hernia). It is much safer than an inguinal hernia treated surgically before this happens be treated in an emergency situation. The inguinal hernia repair is one of the most common operations in children and adults.

What is an umbilical hernia?
Is an opening in the abdominal muscles around the navel, which allows a portion of the abdominal organs protrude and push the umbilicus outward.

How is an umbilical hernia?
Occurs when a child is born with an opening in the abdominal muscles around the navel. In general, muscles are closed before the child is born. However, if not close, you can produce a hernia. Umbilical hernias occur in about 20% of newborns, but are more common in African-American babies and premature babies. In adults, the reopening may be due to states of increased intraabdominal pressure and frequent pregnancies, obesity, chronic constipation, abnormal fluid (ascites), tumors, etc..

How is an umbilical hernia?
In most cases umbilical hernias close on their own. Usually, the surgeon will look and wait for this to happen naturally when the child is four or five years. If the umbilical hernia has not closed when your child is five years, surgery may be recommended to close it. Sometimes the hernia enlarges and causes discomfort before the child turns five years. If this happens, check with your surgeon.

If you decide to trade in children, surgery is performed under general anesthesia. In the case of an adult, can be performed under local or regional, depending on the characteristics of the hernia and the patient's physical condition. In both cases, surgery performed on an outpatient basis (without hospitalization) and patients go home the same day of surgery.

What is the modern concept for the treatment of inguinal hernia?
Operations "tension free" are the current concept. These are interventions to repair the anatomical defect that led to the hernia, by placing a synthetic mesh, avoiding produce tension in the muscle wall, thus allowing rapid mobilization postoperatively and the return to everyday activities.

How are these operations?
These operations under this new concept can be realized in classic or laparoscopic.

• Classical Surgery (Open): This consists of making an incision in the groin that extends through the skin, subcutaneous fat, fascia and allows the surgeon to reach the site of the hernia by placing a synthetic mesh over the hernia defect. This surgery was performed under regional anesthesia or local anesthesia and sedation. Surgery usually lasts between 30 and 45 minutes and performed on an outpatient basis, ie without the need for hospitalization.
• Laparoscopic Surgery: A minimally invasive technique is the use of very small instrumental and a laparoscope (special telescope) that sends magnified images of the site of the hernia through a video monitor allows the surgeon to repair the defect with minimal trauma operatively. Is placed over the hernia defect a small piece of mesh, which is set with small surgical staples. This operation usually do with general anesthesia, the surgery takes an average of 45-60 minutes and performed on an outpatient basis (without hospitalization).

What is indicated for patients laparoscopic inguinal hernia?
It is particularly indicated in patients with recurrent hernias (development of a new hernia has been operated on previously), bilateral hernias, hernias with suspected unilateral contralateral hernia when performed simultaneously with other laparoscopic procedures. However, your surgeon will suggest that according to a careful evaluation, if the laparoscopic repair of inguinal hernia is convenient for you.

What are the advantages of the laparoscopic approach to inguinal hernia?
Among the advantages of this minimally invasive procedure is the reduction in postoperative pain and the period of incapacity for work, better cosmetic results, recurrence rates similar to traditional surgeries "stress free" and also in the case of the laparoscopic technique called TAPP, allows a full review of both inguinal regions with the possibility of discovering an unsuspected contralateral hernia (present in up to 25%) and bilateral perform a repair in one surgical time.

In case of recurrent hernias classic anterior approach, the laparoscopic repair avoids the anatomy distorted by the previous healing process. In any case, the laparoscopic procedure performed on an outpatient basis, ie without need for hospitalization.

How safe is ambulatory surgery hernia?
It is safer than conventional surgery, hospitalization, due to the use of local anesthesia and the immediate discharge favoring a faster recovery with less pain and fewer complications after surgery, minimal emotional upset, and so on. Moreover, in the operating room you have the presence of an anesthesiologist and the patient is subjected to ongoing monitoring.

What complications can occur if there is any type of hernia?
The two main complications are incarceration (when part of the abdominal viscera are trapped or stuck in the hernia defect) and strangulation (when the above condition is overcome gangrene of the involved organ). Both are considered surgical emergencies and require immediate treatment and hospitalization.

"It has been said that there is no field of surgery which requires more anatomical knowledge and surgical skill more than the hernia, in all its varieties." Cooper 1.804.