Jennifer Schwartz, MD, a Yale Medicine surgeon, performs hernia surgeries at Bridgeport Hospital with the Da Vinci® Xi™ robotic surgical system.

No bellyaching over hernia repair

So, you spent the weekend moving and lifting heavy boxes, and now your abdomen hurts. Could that pain in your belly or groin be a sign of a hernia? It could be. Hernias are quite common and getting them checked out by a medical professional is the best way to know for sure. A free, three-hour hernia screening at Bridgeport Hospital in October brought out about 50 area residents looking for answers.

“Hernias are very common in people of all ages,” said Jennifer Schwartz, MD, a Yale Medicine surgeon who specializes in hernia repair at Bridgeport Hospital. “The two most common types of hernias we see are inguinal or groin hernias, and umbilical or belly button hernias. We also see an array of other hernias, such as hiatal hernias and incisional hernias, but inguinal and umbilical are the top two.

“Inguinal hernias are more common in men than women and are the most commonly performed general surgical operations in the United States,” Dr. Schwartz said. “They account for about 800,000 of over 1 million hernia repairs each year.”

What is a hernia, anyway?

A hernia is a hole or weakness in the muscles of the belly through which parts of the intestine or other organs push through, creating a noticeable bulge that may be soft to the touch. While there are no studies linking specific activities to their cause, often, people who develop hernias have a family history of them, Dr. Schwartz explained.

Symptoms of a groin or inguinal hernia may include:

• A bulge or asymmetry you can see or feel
• A feeling of fullness or tugging sensation on the affected side
• Discomfort when lifting heavy things
• Bulge and discomfort go away when lying down

“With an umbilical hernia, the patient’s belly button tends to stick out,” Dr. Schwartz said. “It can be tender if it is not reducible and it can be unsightly; depending on how big it is, it may cause people to feel that their core isn’t as stable as it once was.”

The problem with hernias

Hernias do not always cause pain, but they do grow over time. “It’s usually months to years, not days to weeks,” said Dr. Schwartz, who sees patients in Fairfield as well as in Westport at Yale New Haven Health’s new Digestive Health Center, 325 Riverside Ave. “Hernias will get bigger, especially the inguinal hernia. If you let that go on for years, it’s going to extend out into the scrotum (in males) and continue to get bigger. Activities of daily living will become more difficult to do.”

The other problem that can develop is when fat or part of the intestine gets stuck inside. “When you have intestine stuck in there, it can be a life-or-death situation. If the intestine dies, you can get very sick,” she explained.

If you suspect you have a hernia, it is important to contact your doctor because waiting too long could result in a trip to the emergency room. A doctor is normally able to see or feel a bulge from a hernia during a physical exam, but some cases might require a CT scan, ultrasound or other imaging to accurately diagnose the condition.

Treating a hernia

At Bridgeport Hospital, the Da Vinci® Xi™ robotic surgical system is favored by some surgeons for hernia repair. “It’s surgeon preference, I would say,” said Dr. Schwartz who routinely uses the Da Vinci robot for hernia surgery, a procedure typically done on an outpatient basis.

Advantages of robotic surgery include three-dimensional images of the inside of the abdomen (as opposed to the two-dimensional in laparoscopic surgery), smaller scars and less pain. The surgeon closes the small abdominal incisions with a stitch or two or with surgical tape.

“For me, the visualization is so much better,” said Dr. Schwartz, who controls the arms and instruments of the Da Vinci robot from a console. “Being able to get the surgical mesh out of the abdominal cavity and place it between the muscle layers is another huge advantage.”

For the patient, smaller incisions can also mean a faster recovery. “With an open inguinal hernia surgery, people often have pain for two to three weeks, and are not lifting heavy items for up to six weeks,” Dr. Schwartz said. “With minimally invasive Da Vinci and laparoscopic surgery, they are usually back to work between three and seven days.

“Everybody has different restrictions in terms of lifting, but people are up walking around, living their normal lives right after surgery,” she said.

Learn more about digestive services at Bridgeport Hospital.