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21/02/2024 | How to deal with a hernia?

February 21, 2024

Podcast: WHAT DOES YOUR DOCTOR SAY?

Episode: How to deal with a hernia?

Leading: Dariusz Litera

Guest: Dr. Adam Kuźmiński, surgeon

Duration: about 16 minutes

Hernias are one of the most common surgical conditions in adults, and their risk increases significantly in men. Although initially they may cause only minor pain or discomfort, in advanced cases they pose a real threat to the patient's health and even life. This is particularly true for inguinal hernias, which account for the majority of surgical procedures performed.

In this episode of "WHAT YOUR DOCTOR SAYS," Dariusz Litera speaks with Dr. Adam Kuźmiński, a surgical specialist, about what exactly a hernia is, where it most often appears, what symptoms should prompt a diagnosis, and why surgical treatment is often necessary. The conversation also covers modern surgical methods, possible complications, and principles of safe recovery.

Full podcast transcript:

[00:00:00] Introduction – What is a hernia?

Dariusz Litera:

Medical experts estimate that approximately 3% adults have a hernia. The risk of developing it is several times higher in men than in women. Hospital data indicates that over 60% of surgical procedures related to this condition involve inguinal hernias. Are you worried you might have this problem too? Today, your doctor is surgeon Dr. Adam Kuźmiński. Welcome back, doctor.

Dr. Adam Kuźmiński:

Good morning.

Dariusz Litera:

What exactly is a hernia and what are its causes?

Dr. Adam Kuźmiński:

A hernia is a displacement of abdominal organs outside the abdominal cavity, essentially beneath the skin. This is associated with damage to the fascia that holds the abdominal organs in place. It's most often linked to a genetic defect, although we still don't know the exact cause of hernias. We all lift weights and engage in physical activity, yet only a minority of people develop a hernia.

[00:01:01] Where do hernias most often occur?

Dariusz Litera:

We're hearing more and more about hernias in younger, physically active people. Where do they most often occur?

Dr. Adam Kuźmiński:

Hernias develop in areas lacking muscular protection. These are most common in the groin and around the umbilicus. In these areas, the abdominal cavity is protected only by fascia—a fibrous, collagenous structure. In individuals with a hernia, the fibers of this fascia separate, creating gaps through which the hernia sac passes. This sac is a fragment of the peritoneum, pushed out by, for example, preperitoneal fat or a loop of intestine.

[00:02:27] First symptoms of a hernia

Dariusz Litera:

What symptoms should we pay attention to?

Dr. Adam Kuźmiński:

A visible bulge is already an advanced symptom. The first sign is persistent, unilateral groin pain, especially after physical exertion. Clinically, nothing can be seen or felt, but an ultrasound examination may reveal a hernia.

[00:03:30] Why a Hernia Is a "Time Bomb"„

Dariusz Litera:

What if a clear bulge already appears?

Dr. Adam Kuźmiński:

Then the patient is referred to a surgeon. A hernia is a time bomb. As long as the contents of the hernial sac can move freely, the situation is relatively safe. The problem begins when the intestinal loop cannot return to the abdominal cavity. This leads to necrosis, which is a direct threat to life and can lead to peritonitis.

[00:04:48] Diagnosis and treatment decision

Dariusz Litera:

What should a patient do if they notice asymmetry or a bulge?

Dr. Adam Kuźmiński:

First, you should see your primary care physician and have an ultrasound examination. Once a hernia is confirmed, a surgical consultation is necessary, which in most cases results in a referral for surgery.

[00:06:02] Modern methods of surgical treatment

Dariusz Litera:

How are hernias operated on today?

Dr. Adam Kuźmiński:

In the past, fascial defects were sutured, which resulted in significant tissue tension and frequent recurrences. Currently, we use polypropylene mesh, which is well-tolerated by the body. The mesh acts like a patch, restoring tissue continuity without tension. It can be implanted openly or laparoscopically.

[00:08:07] Open vs. Laparoscopic Surgery

Dariusz Litera:

How do these methods differ?

Dr. Adam Kuźmiński:

The laparoscopic method requires general anesthesia but is less invasive. The open method allows for the use of epidural anesthesia. Each method has its advantages and limitations, so the decision is always made together with the patient.

[00:09:39] Risks and possible complications

Dariusz Litera:

What are the potential complications of such procedures?

Dr. Adam Kuźmiński:

The risk of hernia recurrence after mesh procedures is very low. However, hematomas, bleeding, and—rarely—damage to anatomical structures may occur. Laparoscopic procedures can lead to complications related to the presence of gas in the abdominal cavity.

[00:11:39] Recovery after surgery

Dariusz Litera:

What is the recovery period like?

Dr. Adam Kuźmiński:

The mesh reaches its full strength after approximately three months. During this time, avoid situations that increase intra-abdominal pressure, such as constipation, bloating, or persistent coughing.

[00:13:42] Other types of hernias

Dariusz Litera:

What about a hiatal hernia?

Dr. Adam Kuźmiński:

This is another type of hernia, more often diagnosed by gastroenterologists. It involves the displacement of the stomach into the chest. Treatment is also performed laparoscopically and yields very good results.

[00:15:15] Ending

Dariusz Litera:

So the word "hernia" shouldn't paralyze us with fear?

Dr. Adam Kuźmiński:

Exactly. It's a mechanical disease that modern medicine can handle very well.

Key takeaways for patients:

  • Hernias most often affect the groin and navel area, especially in men.
  • The first symptom may be groin pain without a visible bulge.
  • Treatment of a hernia is, in most cases, surgical.
  • Modern meshes significantly reduce the risk of disease recurrence.
  • Recovery requires avoiding increased intra-abdominal pressure for several months.

Information about the authors:

Dr. Adam Kuźmiński, MD: a well-known and respected general surgeon specializing in endocrine surgery (thyroid, parathyroid glands) and hernia surgery.

Dariusz Litera: journalist and medical communication specialist, host of the podcast "What does Your Doctor say?", focused on patient health education.

Attention!

This material is for informational and educational purposes only. It does not replace an individual medical consultation or medical advice tailored to a specific patient. If you experience any disturbing symptoms or have concerns about your health, please contact us. consult your doctor.

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