Johns Hopkins Hernia Center - Comprehensive Hernia Care and Repair

Overview of the Johns Hopkins Hernia Center

The Johns Hopkins Hernia Center located in Baltimore, Maryland is a world leader in hernia care, research and education. The center offers comprehensive care and treatment for all types of hernias from the most basic to the most complex.

History and Background

The Johns Hopkins Hernia Center was founded in the 1990s and was one of the first specialized hernia centers in the United States. Dr. Michael Rosen, the current director, helped pioneer minimally invasive hernia repair techniques. The center brings together a multidisciplinary team of surgeons, nurses and support staff dedicated specifically to hernia patients.

Over the past three decades, the Johns Hopkins Hernia Center has remained at the forefront of innovations in hernia care. The center conducts cutting-edge research to advance treatment techniques and improve patient outcomes. The team has trained hundreds of surgeons from around the world on proper hernia repair methods.

Services and Procedures

The Johns Hopkins Hernia Center provides advanced treatment options for all types of hernias in both adults and children. Some of the main services and procedures offered include:

• Advanced laparoscopic robotic hernia repair
• Treatment of primary and recurrent hernias
• Hiatal hernia repair
• Incisional hernia repair
• Complex abdominal wall reconstruction
• Inguinal, femoral, umbilical and epigastric hernia repairs
• Emergency hernia treatment

The center uses both open and minimally invasive laparoscopic techniques to repair hernias. The precise technique utilized depends on the specific type and complexity of the hernia.

Advantages of Treatment at Johns Hopkins

There are many benefits to having a hernia repaired at the Johns Hopkins Hernia Center, including:

• Access to hernia specialists with decades of focused experience
• Highest success rates for hernia recurrence prevention
• Shorter recovery times with minimally invasive procedures
• Leading-edge treatment options not widely available
• Expert care for complex and unusual hernias
• Academic setting focused on research and education

Patients come from around the country and internationally to have their hernias treated at Johns Hopkins due to the expertise and reputation of the specialized hernia team.

What is a Hernia?

A hernia occurs when an organ or tissue protrudes through a weak spot or opening in the surrounding muscle or connective tissue. This allows the internal structure to push through and cause a bulge under the skin.

Hernias often occur in sections of the abdominal wall, groin region or hiatal opening in the diaphragm. They can develop in men, women and children.

Types of Hernias

There are several common types of hernias:

• Inguinal hernia: Occurs in the inner groin region when abdominal contents protrude through a weak spot in the inguinal canal. This is the most common type of hernia.
• Hiatal hernia: Portion of the stomach pushes up through the diaphragm and into the chest cavity.
• Incisional hernia: Tissue bulges through a surgical scar or incision.
• Femoral hernia: Protrusion of tissue through the femoral canal in the outer groin area.
• Umbilical hernia: Occurs when part of the intestine pushes through abdominal wall near the umbilicus or belly button.

There are also less common hernia types such as epigastric, spigelian and lumbar hernias. Hernias can occur at any ages from newborns to seniors.

Symptoms

Symptoms of a hernia can include:

• A visible bulge under the skin or protrusion
• Pain or discomfort in the affected area - sometimes a heavy or dragging sensation
• Weakness, pressure or a feeling of heaviness in the groin or abdomen
• A burning, gurgling or aching feeling at the hernia site
• Difficulty with bowel movements
• Incarcerated hernia - inability to push hernia back into place, severe pain, vomiting, constipation

A hernia will not always cause symptoms, especially small or reducible hernias that can be pushed back into place. But all hernias have the risk of becoming incarcerated or strangulated, which can cut off blood flow and damage the trapped tissue. This is why it is recommended to have even an asymptomatic hernia repaired.

Causes and Risk Factors

Some key factors that contribute to or increase the chance of developing a hernia include:

• Increased pressure in the abdomen from straining, heavy lifting, chronic coughing, constipation, pregnancy, etc.
• A natural weak spot or opening in the muscular abdominal wall
• Prior surgery or incision
• Improper healing following surgery
• Congenital defects or abnormalities in the abdominal wall
• Chronic conditions that cause increased pressure in the abdomen such as ascites or peritoneal dialysis
• Obesity or sudden weight gain
• Advanced age
• Family history of hernias
• Gender - some types of hernias are more common in females or males

Anything that causes increased strain or pressure on the abdominal cavity or muscular wall can potentially contribute to a hernia. Weak spots that develop in the connective tissue or muscle provide an opening where protrusion and herniation can occur.

Diagnosing Hernias

Some hernias have overt symptoms and are easily diagnosed upon physical exam by a telltale bulge in a common hernia location. But other hernias can have vague, nonspecific symptoms or not be readily visible or palpable.

Tools used to help diagnose hernias include:

• Medical history - Looking for risk factors, related symptoms, pain triggers
• Physical exam - Visual inspection and manual palpation of potential hernia sites
• Imaging - X-rays, ultrasound or CT scan to visualize abdominal cavity
• Laparoscopy - Inserting tiny camera into abdomen for direct visualization

Determining the type, location and extent of the hernia is important for proper surgical planning and repair.

Common Locations for Hernias

Some of the most frequent locations hernias occur include:

• Inguinal - Inner groin/inguinal canal region, most common in men
• Umbilical - Near belly button or umbilicus
• Incisional - Through prior surgical scar
• Hiatal - Upper stomach protruding through diaphragm
• Femoral - Outer groin through femoral canal, more common in women

Other less common sites include the upper thigh, belly button, lower back and other areas of abdominal muscle weakness.

Hernia Treatment and Prevention

The standard treatment for almost all diagnosed hernias is surgical repair. Waiting to repair a hernia allows the protrusion to potentially increase in size and risk of complications.

Hernia Surgery Techniques

The surgical techniques utilized to treat hernias include:

• Open hernia repair - A single incision is made over the hernia and the protruding tissue is pushed back into place and the weakened muscle/tissue defect is reinforced and repaired.
• Laparoscopic hernia repair - Minimally invasive approach where small incisions are made to insert a camera and instruments into the abdomen. Mesh is used reinforce the hernia site.
• Robotic hernia surgery - Similar to laparoscopic method but uses a specialized robotic system operated by the surgeon.

The choice of surgical approach depends on multiple factors like hernia type and size, surgeon expertise and medical history of the patient.

Recovery After Hernia Surgery

Recovery time after hernia surgery can take 2-4 weeks for minor repairs and longer for complex hernias. Patients will need to avoid strenuous activity and heavy lifting for about 4-6 weeks after surgery to allow proper healing.

It is common to have some post-operative pain, swelling, bruising and numbness near the incision sites. This typically improves over the first few weeks. Hernia repair with mesh often causes less recurrence risk but can sometimes cause chronic pain issues for some patients.

Preventing Hernias

While heredity plays a role, there are some measures that can help lower hernia risk:

• Maintain a healthy body weight
• Control coughing from lung conditions
• Avoid straining with constipation or prostate conditions
• Use proper lifting techniques - bend knees, keep back straight
• Do not smoke or quit smoking
• Eat a high-fiber diet to avoid constipation
• Get treated for ascites fluid buildup

Talk to your doctor if you notice possible hernia symptoms or have ongoing conditions that increase abdominal pressure. Certain high-risk individuals may want to consider elective hernia surgery before an emergency repair is needed.

Why Choose Johns Hopkins for Hernia Care

The Johns Hopkins Hernia Center offers patients many benefits when it comes to hernia care and repair including:

• World-renowned hernia specialists with decades of focused experience in complex hernias
• Access to innovative treatment options and clinical trials
• Both open and advanced minimally invasive repair techniques
• One of the highest success rates for preventing hernia recurrence
• Leading-edge research and training programs to advance hernia treatments
• Seamless coordination for patients traveling from out-of-town

The Johns Hopkins Hernia Center provides complete, tailored care for patients ranging from straightforward to highly complex hernia repair needs.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.