A hernia is a condition where an organ or fatty tissue pushes through a weak spot in the muscle or tissue wall that normally contains it, creating a visible bulge. This protrusion most commonly occurs in the abdominal or groin area. While some small hernias can be monitored, they will not disappear on their own and often worsen over time. Surgical repair is the standard and most effective treatment to push the tissue back and reinforce the weakened area. Surgery is generally advised to relieve discomfort and prevent potentially life-threatening complications like tissue strangulation.
The Primary Specialist: General Surgery
The majority of common adult hernia repairs are performed by a General Surgeon. These specialists complete extensive residency training focused on surgical issues of the abdomen and its related structures. This makes them the primary providers for the most frequent types of hernias, including inguinal, umbilical, and incisional.
A General Surgeon is proficient in the three main approaches to hernia repair: open, laparoscopic, and robotic surgery. Open surgery involves a single incision near the hernia site to repair the defect, often using surgical mesh. The minimally invasive laparoscopic and robotic methods use several small incisions, inserting a camera and specialized instruments.
The choice between an open or minimally invasive technique depends on the hernia’s type, size, location, and the patient’s overall health. General Surgeons are adept at selecting the most appropriate method to minimize the risk of recurrence and optimize recovery.
When Other Specialists Are Needed
While General Surgeons manage most cases, specific situations require the specialized focus of other surgical professionals. Pediatric Surgeons are the specialists for children and infants with hernias, such as congenital inguinal or umbilical hernias. The anatomy and surgical needs of a child differ significantly from an adult, requiring a surgeon with specific training in pediatric care.
Complex hiatal hernias, which occur when part of the stomach pushes up into the chest through the diaphragm, may sometimes involve a Thoracic or Cardiothoracic Surgeon. These specialists have expertise in procedures involving the chest cavity and diaphragm. Complicated or recurrent hernias that involve nearby structures like the colon or urinary system may require collaboration with a Colorectal Surgeon or a Urologist to ensure a comprehensive repair.
In some cases of massive or highly complex ventral hernias, a Plastic Surgeon may also be involved alongside a General Surgeon. This collaboration is typically for abdominal wall reconstruction, where extensive tissue manipulation and specialized closure techniques are necessary.
Evaluating and Selecting a Surgeon
Once the appropriate type of specialist is identified, patients should focus on a surgeon’s specific experience with hernia repair. Surgeons who perform a high volume of hernia repairs typically have lower rates of complications and recurrence. It is appropriate to inquire about the surgeon’s annual volume of hernia procedures and their success rates.
A surgeon’s board certification confirms they have met rigorous training standards and possess the necessary technical skills. Beyond general certification, look for affiliation with professional organizations focused on abdominal core health, such as the American Hernia Society, which demonstrates a commitment to staying current with best practices. This continued education is especially relevant given the evolution of techniques like robotic surgery and new mesh options.
Discussing the surgeon’s preferred technique is also a meaningful part of the selection process. Ask whether they favor an open, laparoscopic, or robotic approach for your specific hernia type and why they believe that method is optimal for your circumstances. Selecting a surgeon involves finding a professional with a proven track record who communicates clearly and tailors the treatment plan to your individual health needs.