A hernia is a defect or a hole in the abdominal wall. A common misconception is that a hernia is a bulge but that is not correct. The bulge happens due to a defect in the abdominal wall and a piece of fat or bowel from the abdominal cavity protrudes through the defect and it causes the bulge that patients can see.
Hernias are very common and they can present in many different areas. It is estimated that 5 million Americans have a hernia. Inguinal hernias are the most commonly seen, closely followed by ventral and incisional hernias.
Inguinal hernias are the most common type of hernias. They make up approximately 70% of all hernias. Several techniques are available for repair.
Ventral or Epigastric hernias are usually located in the upper part of the abdomen. They tent to be small defects and are more common in males.
Incisional hernias developed in the site of a prior abdominal incision. They are very common hernias and they can be subclassified base on the location of the incision.
Flank hernias are incisional hernias located on either side of the abdominal wall. They are usually secondary to prior kidney surgery. They are some of the most difficult hernias to treat.
Femoral hernias are similar to inguinal hernias but slightly lower in the groin area. They are less common than inguinal hernias and they are treated slightly different.
Umbilical hernias are very common hernias. As the name suggests they are located around the umbilicus. This area is the weakest point of the abdominal wall, making it a prime place for hernias.
Hernias can present in different ways. Symptoms are highly dependent on the size and location of the hernia. Many patients are completely asymptomatic and their hernias are found by the Primary Care Provider during a routine physical exam.
The quick answer to the question above is NO. Not every hernia needs to be repaired. Especially completely asymptomatic hernias. Every patient does need to know that every hernia has the potential to become symptomatic and incarcerated or even strangulated.
The chance of a hernia becoming incarcerated or strangulated is around 5 percent. An incarcerated hernia happens when the content inside the hernia gets caught inside the hernia and it doesn’t go back inside the abdomen with manipulation. Strangulation is when the blood flow to the hernia content gets compromised, causing necrosis of the tissue.
Patients that present with painful incarcerated hernias area at higher risk of strangulation and the hernia should be repaired soon. Patients that present with strangulation require immediate surgical intervention as this can be life-threatening.
For decades hernias have been fixed around the world using open techniques. This is a reliable way to fix hernias and in many cases, this is the best and only way to fix a hernia. As with other operations, open hernia repair is usually associated with more pain, more complications, longer hospital stay, and longer recovery.
The decision to proceed with an open hernia repair is base on the hernia, patient condition at the time of presentation, surgical history and several other factors that could contraindicate a less invasive approach.
Dr. Angel Caban will discuss with you the surgical options base on your particular situation.
Laparoscopic hernia surgery was established in the late 1990s to early 2000s. Many types of hernias can be fixed using these less invasive techniques. It has been shown in many studies that laparoscopic hernia surgery offers less pain, faster recovery, shorter hospital stay, and overall fewer complications. This is true when the surgery is done by an advanced laparoscopic surgeon.
Dr. Caban has performed thousands of complex hernia procedures, including laparoscopic repairs. When it comes to hernia surgery, experience really makes a difference.
The robotic DaVinci platform from Intuitive Surgical has become in recent years a valuable platform for hernia repairs. Because of the set of tools available in the DaVinci system some hernias can now be fixed minimally invasive when before they could only be done using open surgery.
A clear example of this is a posterior component release for complex abdominal wall hernias. Dr. Caban can now perform this surgery using 6 small incisions versus a large midline incision. Dr. Caban is the only surgeon in Ocala Florida that has performed this type of surgery.
“Dr. Angel Caban performed my surgery almost 5 years ago on 6/2/2014. He is a kind doctor and always treated me fairly. I always felt welcome in his office. I recommended him to many over the past 5 years”.
Gina
“Me encanta no lo cambio. Exelente el doctor caban y su personal. Muy buen grupo”.
Johanna
“Dr. Caban did my colon resection and did an outstanding job all the way across the board. I highly recommend him as well”.
Dan
“I have the privilege of working with Angel M Caban in the hospital environment. I also have had him be the surgeon to one of my family members. I would like everyone to know that he is a great surgeon. We are fortunate to have him here in Ocala. He is personable, easy to talk too and has excellent bedside manners”.
Karen
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