The short version
- A hernia is tissue from inside your abdomen pushing through a weak spot in the abdominal wall.
- A hernia will never heal on its own. Surgery is the only way to fix it.
- I repair inguinal, umbilical, epigastric, and incisional hernias either robotically or through an open incision.
- A ridge down the middle of the belly when you sit up is usually a diastasis, which is not a hernia.
- A bulge that is suddenly stuck out, firm, and painful is an emergency. Go to the ER.
A quick summary. The full details are below, and none of it replaces an exam.
What is a hernia?
A hernia happens when tissue from inside your abdomen, usually fat or part of the intestine, pushes through a weak spot in the abdominal wall. This creates a bulge, and often discomfort or pain, especially when lifting, coughing, or straining. Where the weak spot sits decides which hernia you have: in the groin, at the belly button, or through an old scar.
Which hernia do I have?
Where the bulge sits is the first clue. A bulge in the groin points to an inguinal hernia. A bulge at the belly button points to an umbilical hernia. A bulge through an old surgical scar points to an incisional hernia. A lump in the middle, above the belly button, can be an epigastric hernia, while a long ridge there that only shows when you sit up is usually a diastasis, which is not a hernia. An exam is the only way to know for sure. Pick your hernia below, or start with the 2-minute self-check.
Inguinal hernia in men
An inguinal hernia is a groin bulge from tissue pushing through a natural weak spot, often with discomfort when lifting, coughing, or straining. It will not heal on its own. Both open and robotic repair reinforce the weak spot with mesh.
Robotic repair
Three incisions, about 1 cm each. Most patients go home the same day.
Open repair
One incision, about 10 cm, just above the groin crease. Most patients go home the same day.
Overview and comparison →Watch: how a hernia forms in a man →
Inguinal hernia in women
Inguinal hernias in women are less common and more often missed. The pain gets blamed on other causes first. Femoral hernias are more common in women, and the robotic view lets me check both areas in the same operation. I usually recommend robotic repair for women.
Robotic repair
Three incisions, about 1 cm each, with a view of the femoral space at the same time.
Open repair
One incision, about 10 cm, just above the crease at the top of the thigh.
Overview and comparison →Watch: how a hernia forms in a woman →
Umbilical hernia
An umbilical hernia is a bulge at or near the navel. In adults it does not close on its own. Whether mesh is used depends on the size of the defect in the and on any related medical or physical conditions. Rebuilding a natural, inward-appearing navel is part of the plan either way.
Robotic repair
Four small incisions on your left side, with wide mesh overlap.
Open repair
One small incision at the belly button.
Overview and comparison →Epigastric hernia
An epigastric hernia is a lump in the middle of the belly, between the breastbone and the belly button. Most are small, under 2 cm, and easy to mix up with a diastasis.
Small hernias
I mark the spot with you before surgery and repair it through a small incision right over it. About 30 minutes.
Larger hernias
Robotic or open, mesh or no mesh, decided the same way as an umbilical hernia.
Epigastric hernia guide →Incisional hernia and abdominal wall reconstruction
An incisional hernia forms at the site of a prior surgical incision, where the muscle layer never fully healed or has pulled apart. Most grow over time. Abdominal wall reconstruction rebuilds the midline muscle layer and reinforces it with mesh.
Robotic eTEP
Small port incisions. The repair is done from a protected space behind the muscles. Most patients stay one night.
Open reconstruction
One incision, usually along your prior scar. The standard approach for the largest, most complex hernias.
Overview and comparison →Is it really a hernia?
Not every bulge or ache is a hernia. These two come up in my office all the time.
Does every hernia need surgery?
If your hernia does not bother you, waiting can be a safe choice. This is called watchful waiting. When a hernia causes no symptoms, the medical risk of waiting is low. A hernia will never heal on its own. Surgery is the only way to fix it. If your hernia is getting bigger, I recommend fixing it sooner. A smaller hernia is easier to repair, and the recovery is easier too. The only way to know for sure if watchful waiting is appropriate for you is to speak to Dr. Rodriguez or to your surgeon.
If the bulge is suddenly stuck out, firm, and painful, or if you have nausea and vomiting with it, the tissue may be trapped and losing its blood supply. That is an emergency. Go to the nearest ER.
Robotic or open: how do I choose?
I repair hernias either robotically or through an open incision. The choice depends on your anatomy, the size of the hernia, your prior surgery, and your own preference. Robotic repair works through small incisions with a 3D view. Open repair works through one incision over the hernia. Most inguinal and umbilical hernia patients go home the same day with either approach.
Compare the two ways I do it →
Is hernia mesh safe?
The mesh lawsuits advertised on TV mostly involve specific older products, not mesh as a whole. Modern synthetic mesh has decades of data behind it and lowers the chance a hernia comes back, compared with stitches alone, for most hernia types. Some small umbilical hernias can be closed with stitches alone. We will talk about the mesh and where it goes before your surgery.
What is recovery like?
Most patients go home the same day. Nothing over 10 to 15 pounds until your 2 week visit, when we reassess. A gallon of milk weighs a little over 8 pounds, which gives you a sense of the limit. You can shower the day of surgery and pat dry. No soaking in a tub, pool, or hot tub for 4 weeks. Your incisions are closed with absorbable stitches under the skin and waterproof skin glue. After robotic eTEP or open abdominal wall reconstruction, nothing over 10 pounds for 4 weeks.
Recovery and getting back to life →
Plan your visit
Most new patients are seen within 1 to 2 weeks. If your imaging was done outside our hospital system, bring a CD with your images. Each hernia has a patient handout you can print or keep on your phone.
Patient handouts
- Robotic inguinal hernia (PDF)
- Open inguinal hernia (PDF)
- Inguinal hernia in women (PDF)
- Robotic umbilical hernia (PDF)
- Open umbilical hernia (PDF)
- Robotic abdominal wall reconstruction (PDF)
- Open abdominal wall reconstruction (PDF)
Common questions
Does the robot do the surgery, or do you?
I'm at the console the whole case. Every cut, every stitch, every decision is mine. The system translates my hand movements into smaller, steadier motion through a small incision. It does not move on its own.
Will my hernia come back?
The chance a hernia comes back after a modern mesh repair is low, but it is not zero. Smoking, uncontrolled diabetes, and rushing back to heavy lifting raise that chance the most.
When can I drive again?
You're ready to drive once you can manage a full, pain-free emergency stop and you're off narcotic pain medication. For most patients that is around 1 to 2 weeks.