Hernias

Charles Castillo, MD, FACS specializes in using minimally invasive techniques to treat different types of hernias. He provides patient-focused care, and each hernia treatment is tailored to meet the needs of the individual patient. When a minimally invasive procedure is not the best solution, Dr. Castillo will perform traditional (open) surgery. His goal is to provide the least invasive surgical solution of the most benefit to each patient.

A hernia is the abnormal bulging of an internal organ (usually the intestine) through a tear or weakness in the abdominal wall. Many people suffer no pain or symptoms from hernias. Hernias are often discovered by the doctor during a physical exam. A hernia does not get better over time, and will not go away by itself. Hernias can become serious if the intestine becomes trapped in the balloon-like sac formed by the bulging area.

Groin Hernias (Inguinal and Femoral)

Inguinal and femoral hernias are evidenced by a bulge on one or both sides of the groin. Groin hernias are the most common type of hernia. A groin hernia can be an emergency if the intestine becomes trapped within the hernia sac. You should seek immediate medical attention if the pain is very severe and the bulge won't go away when you put pressure on it or lie down.

Symptoms

• A visible bulge on one or both sides of the groin
• Discomfort or sharp pain while lifting, bending over or straining
• Weakness, dull ache, pressure, or burning sensation in the groin or scrotum

When part of the intestine becomes trapped (incarcerated) within the hernia sac, it is a medical emergency. Symptoms of an incarcerated inguinal hernia include:

• Severe pain and redness
• Pain that keeps getting worse
• Fever
• Rapid heart rate
• Nausea and vomiting

Seek medical treatment immediately if you experience any symptoms of an incarcerated hernia.

Diagnosis

To diagnose a groin hernia, Dr. Castillo conducts a physical examination that will include asking you questions about hernia symptoms. During the exam, he will look and feel for a bulge in your groin or scrotal area.

Treatment

After examining you, Dr. Castillo will determine the best way to repair your hernia. There are two surgical techniques to repair groin hernias, open and laparoscopic. An open repair is the most common, but there are multiple factors he takes into consideration when making his recommendation. If the hernia is recurrent or if there is a hernia on both sides, Dr. Castillo may recommend a laparoscopic repair.

Open hernia repair is performed under local and/or general anesthesia. During this surgery, Dr. Castillo makes a small (approximately 4 cm) incision in the groin. After identifying the defect, he returns the herniated tissues back into the abdomen. He then reinforces the lower abdominal wall with two pieces of mesh. This results in a very strong repair. All of the muscle and skin layers are then closed with absorbable suture. Patients go home the same day. Typical recovery is 10-14 days.

Laparoscopic hernia repair is performed under general anesthesia. During laparoscopic surgery, Dr. Castillo uses a camera which is inserted through a small incision by the navel. He makes two small (5mm) incisions on the lower abdomen for instruments that help him identify the defect and return the herniated tissue to the abdomen. He then reinforces the inside of the lower abdominal wall with a piece of mesh that is held in place by absorbable fasteners. This results in a very strong repair. Patients go home the same day and typical recovery is also 10-14 days.

Abdominal Wall Hernias (Ventral/Umbilical/Incisional)

Abdominal wall hernias are also called Ventral Hernias. When the hernia is right at the umbilicus or "belly button," it is called an umbilical hernia. When the hernia is at a previous surgical site, it is called an incisional hernia.

Symptoms

A ventral hernia typically presents as a bulge that comes and goes and is occasionally uncomfortable. It can grow in size over time.

When tissue inside the hernia becomes stuck or trapped in the bulging abdominal muscle, it can lead to a potentially life-threatening condition known as "strangulation," which requires emergency surgery. Symptoms of hernia strangulation include:

• Abdominal pain
• Profuse sweating
• Rapid heartbeat
• Severe nausea, vomiting and high fever

Seek medical treatment immediately if you experience any symptoms of a strangulated hernia.

Diagnosis

To diagnose a ventral hernia, Dr. Castillo conducts a physical examination of your abdomen and asks you questions about hernia symptoms. During the exam, he will examine the area where a ventral hernia may exist. You may be asked to stand and cough so the doctor can feel the hernia. A CT scan may be performed.

Treatment

Ventral hernias can be repaired with either open or laparoscopic techniques. Dr. Castillo conducts a thorough examination to determine whether a laparoscopic or open surgical repair is right for you.

Open repair is performed under general anesthesia. During this surgery, Dr. Castillo makes an incision on the abdominal wall over the hernia. After identifying the defect, he returns the herniated tissues back into the abdomen. He then repairs and reinforces the defect in the abdominal wall with a piece of mesh. This results in a very strong repair. Most patients go home the same day and typical recovery is 10-14 days.

Laparoscopic hernia repair is performed under general anesthesia. During a laparoscopic surgery, Dr. Castillo uses a camera and small instruments to do the repair. These instruments are placed through small incisions on your abdominal wall. He uses the instruments to identify the defect and return the herniated tissue into the abdomen. He then reinforces the inside of the abdominal wall with a piece of mesh that is held in place by absorbable fasteners. This results in a very strong repair. Most patients go home the same day and typical recovery is also 10-14 days.