A hernia is a hole or defect in the strength layer that supports the abdomen, allowing abdominal contents to protrude outside the normal abdominal cavity.

There are a wide variety of hernia types, generally categorized by location:

• Inguinal/groin
• Ventral
• Parastomal

And symptoms:

• Asymptomatic: A noticeable bulge, but no pain, bowel, or bladder symptoms
• Painful
• Incarcerated: Intra-abdominal contents are confined to the hernia sac, outside the normal abdominal cavity
• Strangulated: Bowels twisted out in the hernia sac such that the blood supply is cut off and the bowel tissue dies

At Duke, we are well qualified and highly experienced at all types of hernia repair. There are many options currently available, and we are at the forefront of many new advances. After a clinical consultation, you and your surgeon will discuss available options and make a joint decision about your care plan.

Inguinal (Groin) Hernia Repair

Inguinal hernias occur in men more frequently than women, but both sexes can be affected. The hernia is generally identified as a bulge in the groin, to the side of the pubis. It may extend down into the scrotum or labia.

The hernia may be a painless mass or a painful bulge that is difficult to reduce. The bulge consists of a hernia sac, which may include bowel, bladder, or intra-abdominal fat.

Asymptomatic hernias may be watched or repaired electively. Painful or irreducible hernias warrant prompt repair.

Inguinal hernia repair can be performed via incision directly over the bulge (an “open”, “tension free”, or Lichtenstein repair) or via a camera inserted near the umbilicus with one or several additional small incisions nearby for instrument placement (laparoscopic repair).

Both techniques involve the placement of a prosthetic mesh (made of polypropylene, polyester, or bioprosthetic). Each technique has benefits and risks, and these can be fully described for your particular case by your surgeon.

Ventral (Abdominal) Hernia Repair

Ventral hernias vary from small umbilical (belly button) hernias to large defects in the abdominal wall. Symptoms can range from an asymptomatic bulge to significant pain, difficulty in reducing contents, or bowel obstruction.

Repair of ventral hernias can be performed via incision directly over the hernia (open method) -- generally with the placement of a piece of mesh across the defect -- or through small incisions made to the side of the hernia defect (laparoscopic repair).

In laparoscopic repair, the surgeon views the hernia on a TV monitor, and mesh is placed across the defect and fastened in place with tacks and/or sutures.

Parastomal Hernias

Parastomal hernias are enlarged openings for stomas that carry stool or urine out of the abdomen through the abdominal wall. These enlarged openings allow other abdominal contents to protrude outside the abdominal wall. This can result in a painless bulge around the stoma, a painful bulge, difficulty in placing the stoma “appliance,” or incarcerated or strangulated bowel.

These hernias are repaired by moving the stoma to a different position on the abdominal wall or placing a piece of mesh around the opening.

Appointments

For more information or to schedule an appointment, call 919-684-6437.

Information for referring physicians can be found on the Appointments and Referrals page.

Physicians

Physicians offering this service include:

• Cline, W. Tucker
  • Surgery / General and Advanced GI
• Lagoo-Deenadayalan, Sandhya A.
  • Surgery / General and Advanced GI
• Omotosho, Philip A.
  • Surgery / Metabolic & Weight Loss
• Pappas, Theodore N.
  • Surgery / General and Advanced GI
• Park, Chan W.
  • Surgery / Metabolic & Weight Loss
• Perez, Alexander
  • Surgery / General and Advanced GI
• Pickett, Lisa Clark
  • Surgery / Trauma and Critical Care
  • Medicine / Medicine-Pulmonary
• Pierce, Richard A.
  • Surgery / General and Advanced GI
• Portenier, Dana D.
  • Surgery / Metabolic & Weight Loss
• Scarborough, John E.
  • Surgery / Trauma and Critical Care
• Shapiro, Mark L.
  • Surgery / Trauma and Critical Care
• Sturdivant, Mark C.
  • Surgery / General and Advanced GI
• Sudan, Ranjan
  • Surgery / Metabolic & Weight Loss
  • Psychiatry
• Torquati, Alfonso
  • Surgery / Metabolic & Weight Loss
• Vaslef, Steven N.
  • Surgery / Trauma and Critical Care
  • Anesthesiology / Anesthesiology-Critical Care Section
• Watters, Christopher R.
  • Surgery / General and Advanced GI
• Yoo, Jin S.
  • Surgery / Metabolic & Weight Loss

Locations

This service is available at:

• Duke General Surgery of Raleigh at Cedarhurst Drive
  1212 Cedarhurst Drive, Suite 102, Raleigh, NC 27609
• Duke University Hospital
  2301 Erwin Road, Durham, NC 27710
• Durham Regional Hospital
  3643 Roxboro Road, Durham, NC 27704