What is a hernia?
Hernias are holes in the abdominal wall layer called the “fascia,” allowing the abdominal lining and intestines to protrude.

Are there different types of hernias?
Yes. Types include inguinal hernia, which is located in the groin and generally affects men more than women. There are also umbilical hernias, or “belly button” hernias, incisional hernias, which can occur in any location that has undergone surgery, and femoral hernias, usually found in slim women. A hiatal hernia is an enlargement of the natural hole in the diaphragm that allows the esophagus to pass to the stomach. Symptoms include difficulty swallowing, breathing and gastro-esophageal reflux disease. Spigelian hernias, in the lower, lateral quadrants of the abdomen, and lumbar hernias, toward the lower lateral back and flanks, are more rare.

What types of surgery exist?
There are two main approaches to hernia repair: “open repairs” and “laparoscopic repairs.” Laparoscopy is considered minimally invasive; however, some open techniques are minimally invasive, too. Most hernia repairs use mesh patches, which lowers recurrence rates. Classic “non-mesh” repairs are reserved for inguinal and small umbilical hernias. I perform both open and laparoscopic approaches.

Does hernia surgery require a hospital admission?
Most hernia repairs are outpatient. Larger ventral hernias and hiatal hernias require an admission.

Do hernias need to be repaired?
Hernias will not get better. Some are painful, enlarge and protrude further. Emergencies arise if bowel becomes stuck within a hernia (incarcerated), or bowel death (strangulation). Classically, small, asymptomatic hernias can be followed if a patient wishes to avoid surgery, although studies show a number of these patients will eventually need emergency surgery. Cases should be talked over with the patient’s primary doctor and surgeon.

“Dr. Napoliello provides management for complex hernias.”

Dr. David A. Napoliello has had a special interest in hernias for 20 years. As an original consultant for the Origin Corp., a pioneer in laparoscopic hernia repair, he helped train other surgeons in these new techniques. He’s been named to Castle Connolly’s Top Doctors list for 11 consecutive years.

About Dr. Napoliello

• Mayo Clinic, minimally invasive surgery fellowship
• Penn State-Geisinger, surgery residency
• Georgetown University School of Medicine
• Bucknell University, B.A. 
• Board certified, American Board of Surgery
• Fellow American College of Surgeons
• SAGES
• Presenter, First World Congress of Hernia Surgery, Milan, Italy

Contact
(941) 388-9525
Venice, Lakewood Ranch and Sarasota
David Napoliello, MD