A hernia can develop in the many areas in the body:

• Abdominal wall around a previous incision (incisional or ventral hernia)
• Groin (inguinal hernia or femoral hernia)
• Middle of the abdomen (epigastric)
• Diaphragm (muscle between the abdomen and chest)
• Around the esophagus (hiatal hernia)

Hernias in children are rarely caused by an injury or tearing of tissue and are usually the result of incomplete closure in the groin (inguinal hernia) or around the umbilicus (umbilical hernia).

Inguinal hernias account for the majority of all hernias and are more common in men than women-- about 25% of men and 2% of women develop an inguinal hernia in their lifetime.

There are two types of inguinal hernia. A direct hernia occurs when the intestine passes through the muscle layers of the abdominal wall into the groin. An indirect hernia occurs when the intestine passes through the groin and descends into the scrotum.

Tissue such as intestine can become trapped in the hernia (incarcerated hernia). When blood flow is restricted, it is called a strangulated hernia. If blood flow is restricted or the intestine is blocked, emergency surgery is necessary

For surgery, the patient may be sedated (drowsy) and pain-free with a local or spinal anesthesia. In some cases the patient is under general anesthesia (unconscious and pain-free).

An incision is made over the hernia. The bulging tissue or organ is replaced inside the muscle wall, the muscle tissue is repaired, and the skin is closed. In many inguinal hernia repairs, a small piece of plastic mesh is used to repair the defect in the muscle tissue.

Laparoscopic hernia repair is gaining popularity. This approach uses a minimally invasive technique.

Hernia repair may be recommended for the following:

• Large bulges through a small hole (where restricted blood flow or a blocked intestine is likely)
• Painful hernia
• Symptoms that interfere with lifestyle

Most hernias should be repaired to prevent the possible complications of restricted blood flow or blocked intestine.

Risks for any anesthesia include the following:

• Reactions to medications
• Problems breathing

Risks for any surgery include the following:

• Bleeding
• Infection

Additional risks of hernia repair include the following:

• Injury to adjacent structures
• Recurrence of the hernia

Small children have no restrictions following routine hernia repair. Older children should avoid contact sports for at least 3 weeks -- a blow to the incision could burst the skin closure or disrupt the repair (less common).

Adults should avoid heavy lifting or straining for several weeks (usually 6 to 8) after surgery. Such activity can disrupt the hernia repair.

Avoid bathing for at least 5 days after the operation. Soaking may separate the skin tapes and the wound could break open. Sponge bathing for infants and showering for older children are permitted the day after surgery. The wound tapes should be carefully patted dry after showering.

Expect complete recovery from surgery in about 2 to 4 weeks.