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Maggie McKay (Host): When you're lifting heavy boxes while cleaning out the garage, you might have heard your spouse say don't lift that, you'll get a hernia. But what is a hernia and how do you know if you have one? Today, we're talking with Dr. Matthew Smith, general surgeon with North Florida Surgeons, who practices at Baptist Medical Center South, about what we need to know about hernias, the symptoms, types, treatment and more.

Welcome to Baptist Health Radio. As the most preferred healthcare provider in Northeast Florida, we're here to help you stay informed with the latest news, views and resources for your health and wellbeing. I'm your host, Maggie McKay, and I invite you to join us as we talk about hernias. Dr. Smith, it's a pleasure to have you here with us today. Thank you for your time.

Matthew Smith, DO: Thank you. Maggie, pleasure to be here.

Maggie McKay (Host): What is a hernia?

Matthew Smith, DO: A hernia is oftentimes a bulge or protrusion of an organ or part of the organ, or even fat through the abdominal wall.

Maggie McKay (Host): And what causes it?

Matthew Smith, DO: There are many different causes, but essentially it is when the pressure inside the abdomen increases to a point that's greater than the pressure of the abdominal wall to hold it in. Things that can increase the pressure inside the abdomen are things like heavy lifting, pregnancy, chronic coughing –all can increase pressure inside the belly. In terms of weakening of the abdominal wall, old age, as we get older, the connected tissue of the abdomen can lessen in strength, predisposing individuals to a hernia. Additionally, chronic steroids or steroid use can result in a hernia or predispose people to weakening of their abdominal wall, which can result in a hernia.

Maggie McKay (Host): And what are the silent signs to be on the lookout for?

Matthew Smith, DO: Most oftentimes people will complain of a bulge. A lump in the abdomen that can be worsening in presentation with coughing or straining. This bulge can sometimes be completely asymptomatic or oftentimes it can cause some vague discomfort pressure or heaviness in the sensation either on the anterior abdominal wall or even in the groin itself.

Maggie McKay (Host): Are there other symptoms that people are more likely to ignore?

Matthew Smith, DO: Yes. Not everybody's gonna have symptoms of pain or discomfort associated with the hernia. So, going back to just the, vague lump or bumpiness in the abdomen or groin. In women, groin hernias are typically associated with some vague pelvic discomfort that may not always be common in terms of its recognition. If a hernia is large, sometimes part of the bowel can be stuck in the hernia itself and can cause a bowel of blockage or nausea or vomiting. But I would say if there is mild discomfort or pressure sensation or an abnormal texture or change to the abdomen or groin that would be more concerning for a possible hernia.

Maggie McKay (Host): And what are the symptoms of groin hernias for men?

Matthew Smith, DO: Most oftentimes for men, groin hernias are gonna be associated with either completely asymptomatic, like I said, with a, noticeable bulge or a lump. But oftentimes when it's associated with pain, it's gonna be that heaviness, sensation in the groin, the dull discomfort. It can sometimes radiate down the leg. And like I said, in women, it's a little bit more vague. It's not always associated with a bump or lump. Women typically get hernias that are lower down in the pelvis. And that can again, be associated with some vague, pressure discomfort.

Maggie McKay (Host): What are the different types of hernias?

Matthew Smith, DO: Hernias are often classified based on their location in the abdomen or in the groin itself. Patients that have hernias along the front of the abdomen or center of the abdomen, that's oftentimes classified as a ventral hernia. You have the umbilical hernias or belly button hernias, and then you have the groin, hernias. Groin hernias are oftentimes labeled as inguinal, hernias, or even femoral hernias.

Maggie McKay (Host): And you mentioned that women can get hernias. So what type is most common for a woman?

Matthew Smith, DO: For women, the most common type of hernia is gonna be umbilical hernia. Going back to the increased pressure within the abdomen, it's not uncommon that women develop umbilical hernias during pregnancy. As the pressure inside the abdomen increases, belly button hernias by far are the most common for women. Now in terms of groin hernias, women are more likely to have what we call femoral hernias. And that's just a hernia that's lower down in the pelvis or in the groin. Those femoral hernias are oftentimes associated with females and are more likely to result in a surgical repair to fix those.

Maggie McKay (Host): When is the right time to see a physician?

Matthew Smith, DO: I think the best time to seek medical attention is when somebody notices a change within the abdomen itself. When they notice a lump that's new, they have some vague discomfort or even frank pain associated with the abdomen in a certain location or even groin. Not everybody's gonna need a surgery for a hernia. But I think it's important to have an assessment, to discuss the pros and cons, individualized, to that patient to figure out what is the best next step in their treatment.

Maggie McKay (Host): How is a patient diagnosed with a hernia and how do they repair a hernia?

Matthew Smith, DO: Most hernias are diagnosed just with a clinical exam. If the hernia is not easily identified on clinical exam, sometimes we will order an ultrasound, a CT scan, or even an MRI to get a better idea of what's going on to diagnose a hernia. In terms of fixing a hernia, like I said before, not everybody needs a surgery to fix a hernia. If it's asymptomatic and small, sometimes we can watch it. But, for the ones that will benefit from surgery or repair, the most common approaches to repair are an open repair involving a bigger incision a laparoscopic repair, smaller incisions, and then a robotic repair. A robotic repair is a form of minimally invasive surgery like laparoscopic surgery, but it allows better visualization using a 3D HD camera and finer precise surgery movements which oftentimes correlates to less pain and discomfort postoperatively.

Maggie McKay (Host): Can you tell us about robotic hernia surgery at Baptist Medical Center South?

Matthew Smith, DO: So here at South we have the benefit of having a robotics program. Prior to coming to Baptist South, I was doing a majority of the hernia pairs via open approach. In the United States, there's more than 1 million abdominal hernia repairs performed annually. Unfortunately, greater than 58% of the hernia repairs done in the United States are still occurring via an open approach. Having robotics allows us to perform minimally invasive surgeries on more complicated patients. I'm able to perform a minimally invasive surgery on a bigger hernia on a recurrent hernia in an easier fashion with the robotics versus, attempting to do it laparoscopically.

So, it's really allowed us to provide more complete and better repair to our hernia patients.

Maggie McKay (Host): And what are tips to reduce your chance of developing a hernia?

Matthew Smith, DO: Like we were talking about before, as you get older the tissues aren't as strong as they once were. So as we age, I think it's important to be mindful of the type of activities that we're doing. To be cognizant and aware, not to overexert ourselves and lift very heavy whether it's exercise or actual work. Minimizing or quitting smoking has been shown to help in terms of lessening the chance of hernia formation.

Maggie McKay (Host): Thank you so much, Dr. Smith, we appreciate your expertise. This has been so informative and helpful.

Matthew Smith, DO: Absolutely. Anytime. Thank you for having me.

Maggie McKay (Host): A hernia won't go away on its own. If left untreated, your hernia could grow, get more painful or even become dangerous. The good news is that today's minimally invasive and robotic hernia treatment options can offer you a fast recovery. To learn more or request an appointment, visit Baptisthernia.com or call 904-202-2019 that's 904-202-2019.

Thank you for listening to Baptist Health Radio. I'm Maggie McKay, be well.