Hernia Surgery

From Dr. Patching

Hernias are holes in the abdominal wall or diaphragm that can cause problems and can cause pain for the patient.   The biggest concern is when part of the stomach or intestine goes through the hole, and this can cause disruption of blood supply to that organ and can lead to gangrene, which is a surgical emergency.  Hernias typically require surgery when diagnosed, even if the patient is not experiencing pain.  At times a patient can be watched, without surgery being recommended, if the hernia is very small or if the patient represents a high surgical risk.   Many hernia operations are a relatively minor procedure, but very large hernias can be complex and are considered major operations.   For this reason, hernias should be repaired when they are relatively small.   Our practice specializes in hernia operations performed with incisions smaller than a dime (laparoscopy).  We have the largest experience in the Sacramento region for a complex diaphragm hernia called a paraesophageal hiatal hernia.

We can offer patients a vast experience in performing groin hernias (inguinal and femoral hernias) using laparoscopy (tiny incisions), as well as the Intuitive Surgical robot (see robotic section in the website), which further decreases operative pain.  Dr. Patching was the first surgeon in California to perform an Intuitive Surgical Xi robotic operation, a technique I use to perform most of our hernia operations.   We pioneered, along with our anesthesia group, using preoperative nerve blocks which minimizes postoperative pain and recovery, with most of our hernia patients only requiring Tylenol for pain control. 

Hernia Q & A

What is a hernia?

A hernia occurs when an organ or fatty tissue tunnels through a hole in the connective tissue area, creating a bump/bulge.  There are many types of hernias, and they are generally classified by the area where they appear. 

Some common hernias include:

Inguinal hernia

Inguinal hernias usually appear as a bulge in the groin area. They more often affect men. 

Ventral hernia

Ventral hernias occur in the front part of the abdominal wall.

Femoral hernia

Femoral hernias usually affect women, commonly appearing in the inner thigh/groin area.

Umbilical hernia

Umbilical hernias occur around the navel and are very common.

Hiatal hernia

Hiatal hernias occur when part of your stomach pushes up into your chest, through the diaphragm.

There are other types of hernias as well. For example, any hernia that appears at the site of a previous surgery is called an incisional hernia. 

When might I need hernia repair?

In general, if your hernia is causing symptoms, like chronic pain, or disrupts your daily life, Dr. Patching will recommend hernia repair.   As mentioned above, most times we will recommend repair even if the patient has no pain.

How does hernia repair work?

In most cases, Dr. Patching performs hernia repair using minimally invasive surgery. 

With many of his hernia repairs, he utilizes robotic surgery, in which he sits at a console where he moves robotic arms to perform the procedure; using the robot further decreases pain when compared to laparoscopic surgery which does not use the robot.  Laparoscopic surgery uses tiny incisions as well, but he holds the surgical tools himself. 

Minimally invasive hernia repair only requires small (button-size) incisions, versus much longer incisions used with traditional surgery. The small incision size and more advanced techniques lead to a lower risk of infection, faster recovery, less pain, and less time in the hospital. Most patients go home as an outpatient. book your appointment online now. 

If you have a hernia and want more information, please call us and make an appointment today.  We can answer all of your questions, and explain your specific issue in detail.