A hernia occurs when internal tissue, such as an organ or fat, pushes through a weakened area in the surrounding muscle or connective tissue, often causing a noticeable bulge in the abdomen or groin. While not every hernia requires immediate intervention, surgery is the most common and definitive treatment method to prevent complications like tissue strangulation or obstruction. Hernia repair involves a coordinated team of medical professionals, starting with diagnosis and culminating in a specialized surgical procedure. Understanding which medical professionals are involved at each stage provides clarity for patients navigating this common condition.
The Role of the General Surgeon
General surgeons are the primary specialists for the vast majority of hernia repairs, drawing on extensive training that includes a five-year surgical residency focusing on the abdomen. This expertise allows them to manage a wide range of surgical issues, with hernia repair being a major component of their practice. They routinely address common types of hernias, including inguinal (groin), umbilical (navel), incisional (at a previous surgical site), and femoral hernias.
Surgical Techniques
These surgeons are proficient in both traditional open surgery and advanced minimally invasive techniques. Open repair involves making a single, larger incision over the hernia site to push the protruding tissue back and reinforce the weakened area, often using synthetic mesh. Minimally invasive approaches, such as laparoscopic or robotic surgery, use several small incisions through which specialized instruments and a camera are inserted. The choice of technique depends on the hernia’s size, location, and the patient’s overall health status.
Specialists for Complex and Unique Hernias
While general surgeons handle most cases, certain unique situations require the focused expertise of other surgical specialists. Pediatric surgeons possess the specialized training needed to operate on infants, children, and adolescents, managing congenital umbilical or inguinal hernias in younger patients. Thoracic surgeons may become involved when a hernia involves the chest cavity, specifically hiatal or diaphragmatic hernias. For complicated cases, such as abdominal wall reconstruction or recurrent hernias, general surgeons may work alongside plastic surgeons to ensure optimal repair and sufficient tissue coverage.
Diagnosis and Pre-Surgical Coordination
The journey to surgical repair typically begins with a primary care physician (PCP) or family doctor, who performs the initial physical examination. The PCP often diagnoses the hernia by checking for a bulge, sometimes asking the patient to stand or cough to make the protrusion more apparent. If the diagnosis is unclear or the hernia is complicated, the PCP may order imaging tests, such as an abdominal ultrasound or a CT scan, before referring the patient to a surgeon.
Pre-Operative Preparation
Once a referral is made, a coordination team manages the preparation process before the operation. Nurses and schedulers organize necessary pre-operative tests, which commonly include blood work, an electrocardiogram (EKG), and sometimes a chest X-ray to assess the patient’s health. This team also ensures the patient obtains medical clearance, confirming they are healthy enough for anesthesia and surgery. The surgeon then holds a pre-operative consultation to discuss the specific surgical plan and address patient questions about the procedure and recovery.