What is a Hernia?
Many people ask us: what is a hernia? The word hernia is derived from Latin, roughly meaning “protrusion of contents of a body cavity, through the lining of that cavity”. The abdomen is a cavity which has several areas of weakness where a hernia can occur. For example, when the stomach pushes into the chest cavity, this condition is called a hiatal hernia. There are many other types of abdominal hernias. In our practice, we focus on inguinal hernia and umbilical hernia.
Abdominal wall hernias are the most common types of hernias that general surgeons take care of. Many surgeons repair all kinds of hernias, while some choose to focus on specific types of hernias.
Inguinal and Femoral Hernia
The most common abdominal wall hernia, and the one that we focus on primarily, is a groin hernia or inguinal hernia. Three possible types of hernias fall into this category, including indirect inguinal hernia, direct inguinal hernia and femoral hernia. In each of these hernias, abdominal contents such as intestine, bladder, or fat herniate through a hole in the abdominal wall into the groin and occasionally down into the scrotum or labia. Because the holes are in the lower abdomen, these hernias are most noticeable and symptomatic when people stand, sit, or cough.
The human anatomy of the groin is complex, involving many different muscles, blood vessels, and nerves. In men, there is also the spermatic cord, which contains nerves and blood vessels that travel to the testicle. Because of the complexity, groin hernia surgery is not always straightforward, and great outcomes from surgery are not guaranteed. Currently about 1 in 8 people who undergo inguinal hernia surgery in the United States experience some level of chronic pain as a result of surgery. We specialize in inguinal hernia, because there are best practices that allow for a much lower incidence of chronic pain. The two inguinal hernia repairs that we perform – mesh and non mesh – offer the lowest incidence of chronic pain, while having excellent long term success rates.
Umbilical and Epigastric Hernia
Umbilical hernias and epigastric hernias are also very common. They result from a very small opening in the front of the abdomen. Typically, most people are born with a very small hole that stretches out over their lifetime. This can occur as a result of aging, weight gain or pregnancy. Once the hole is large enough, abdominal fat, and less frequently intestine, can herniate out of this hole. Since gravity is not pushing abdominal contents out of these types of hernias, they are less dangerous.
Incisional hernias occur as a result of previous surgical incisions of the abdomen. These can range in size from small hernias, like umbilical hernias, to much larger and more complex hernias.
About Dr. Reinhorn & Dr. Fullington
Dr. Michael Reinhorn is a specialist in inguinal hernia and umbilical hernia. Dr. Reinhorn started his practice as a full service general surgeon in 2001. In 2012 Dr. Reinhorn started to focus on the care of hernia and pilonidal patients. In 2020, Dr. Nora Fullington was recruited from her work as a general surgeon performing hundreds of laparoscopic hernia repairs to Boston Hernia. Together with their physician assistant team, they provide a focused practice designed to provide a superior clinical experience. The team performs approximately 700 hernia surgeries every year and offers a tailored approach for each patient from anesthesia type to consideration of mesh and no mesh repairs, laparoscopic and open surgery. We have published outcomes and continue to participate in hernia and surgery societies. Our research led to a reduction in opioid prescribing after hernia surgery. Currently, Dr. Reinhorn serves as the chair of the Opioid Reduction Task Force of the Americas Hernia Society Quality Collaborative.