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1 The TV Series Produced By: INFORMATION TELEVISION NETWORK ONE PARK PLACE 621 NW 53RD ST BOCA RATON, FL INFO-ITV Information Television Network. All Rights Reserved.

2 UNDERSTANDING HERNIA A hernia occurs when the contents of a body cavity bulge out of the area where they are normally contained. These contents, usually portions of intestine or abdominal fatty tissue, are often enclosed in the thin membrane that naturally lines the inside of the cavity. Most people first discover their hernia when they notice a bulge in their abdomen or groin, perhaps while taking a shower. Many people have a tendency to ignore the problem or hope it will go away. But if left untreated, hernias tend to grow larger and the associated symptoms may get worse. In rare instances, hernias can become strangulated a serious and potentially life-threatening complication. Hernias are a very common medical problem. In fact, it is estimated that 5 million Americans, the majority whom are men, have hernias. Unfortunately, a hernia won t go away on its own. Surgery is the only way to repair these defects and today many people are turning to hernia repair surgery. Types of Hernias Abdominal wall hernia: Also called an epigastric or ventral hernia; affects 1 person in 100 nationwide. Technically, this group also includes inguinal hernias and umbilical hernias. Indirect inguinal hernia: This affects men only and occurs when a loop of intestine passes down the canal from where a testis descends early in childhood into the scrotum. Direct inguinal hernia: This affects both sexes and occurs when the intestinal loop forms a swelling in the inner part of the fold of the groin. Femoral hernias develop in the upper thigh. Though rare, they are especially prone to strangulation. Umbilical hernias form around the navel. Incisional hernias occur at the sites of prior surgeries. Since women tend to have more abdominal surgeries such as c-sections and hysterectomies, they are more prone to developing this type of hernia. Hiatal hernias form when the upper portion of the stomach slides into the chest cavity. Inguinal hernias account for 75 to 80 percent of all hernias. They can develop on either or both sides of the groin.

3 TREATMENTS and OPTIONS Risk Factors The risk factors associated with hernias do not appear to be a direct cause of the disease, but seem to be connected in some way. Having a hernia risk factor makes the chances of getting the condition higher but does not always lead to a hernia. Symptoms of hernias vary, depending on the cause and the structures involved. Most begin as small, hardly noticeable breakthroughs. At first, they may be soft lumps under the skin and there usually is no pain. Age, smoking and obesity are three of the primary risk factors for developing hernias. Other factors include: weak and/or injured muscles, previous surgery, pregnancy, lifting and straining. Hernia Repair Techniques The Conventional Method (the most common method of hernia repair) entails an incision that is made over the site of the hernia. The protruding tissue is returned to the abdominal cavity, and the sac that has formed is removed. The surgeon repairs the hole or weakness in the abdominal wall by sewing strong surrounding muscle over the defect. Tension-free Mesh Technique Involves an incision that is made at the site of the hernia and a piece of mesh is insert ed to cover the area of the abdominal wall defect without sewing together the sur rounding muscles. Recovery is swift, and the likelihood of the hernia recurring is small. The mesh is safe and generally well-accepted by the body's natural tissues. The Laparoscopic Method A fairly new technique and it is not an option for every patient) involves the use of a laparoscope A laparoscope is a long metal tube with a fiberoptic light source and a telescopic eyepiece, which is connected to a TV monitor. The scope is inserted into the abdominal cavity through a small incision and is used to view the hernia in the abdominal wall while the surgeon repairs the hernia through additional tubes that are inserted into the abdomen through separate incisions. Complications As with any operation, infection and bleeding may occur. A slight chance also exists that the intestine or bladder can be injured during the operation. The formation of scar tissue is another possibility. Since the laparoscopic method of hernia repair is relatively new, its complications are not as well defined as the complications that are associa ted with the other methods. It is important for the patient to talk with their surgeon to determine what type of repair method is appropriate for them.

4 FREQUENTLY ASKED QUESTIONS How safe are hernia repair operations? Hernia-repair operations are among the most routinely performed and safest of all surgeries. Thanks to new breakthroughs involving the development of special mesh materials and the initiation of minimally invasive surgical techniques known as laparoscopy, patients are now experiencing less pain, faster recoveries and a reduced risk of recurrent hernias. Do hernia repair surgeries require a hospital stay? Many hernia surgeries are performed on an out-patient basis and the majority of hernia patients return to normal activities within 3-7 days. Is it true that hernia surgery can be performed through one small incision? Yes. Hernia surgery can be performed through one small 4-6cm incision. What are some of the symptoms associated with hernias? The most common symptoms of a hernia generally include pain or discomfort, as well as localized swelling. However, sometimes there are no symptoms at all. Are hernias a serious medical condition? Judging from the fact that up to 800,000 hernia-repair procedures are carried out each year, there is no disputing that hernias are a serious medical issue. What are the risk factors associated with hernias? Age, smoking and obesity are three of the primary risk factors for developing hernias. Other factors include: weak and/or injured muscles, previous surgery, pregnancy, lifting and straining. How long should a person wait to get hernia repair surgery? The longer a person waits to have a hernia repaired, the larger it gets and in some cases, it can be life-threatening. How many men experience hernias? Studies show that 10 percent of all men will have a hernia at some point. What type of hernias do men form most and why? In men, most hernias form in their groin. These inguinal hernias result from a weakness in the abdominal wall caused either by congenital factors or the wear and tear associated with aging. What type of hernias do women form most and why? For women, hernias are more likely to develop near the scars from previous operations (incisional hernias).

5 DATA, RESOURCES, HOTLINES, PUBLICATIONS and MEDIA CONTACTS National Ambulatory Hernia Institute 1837 Sunny Crest Drive Fullerton, CA (P) Cherubs: The Association of Congenital Diaphragmatic Hernia Research 1109 Williamsboro Street Oxford, NC (P) American Hernia Society P.O. Box Orlando Florida, (P) Hernia Resource Center PO Box 8500 Cranston, RI (P) 800-Hernias National Digestive Diseases Information Clearinghouse 2 Information Way Bethesda, MD (P) For a DVD copy of a 30 minute documentary style program on HERNIA call or visit. To watch on television, consult your local public television station for air-times in your area. The American Board of Surgery 1617 John F. Kennedy Boulevard Suite 860 Philadelphia, PA (P) American College of Gastroenterology 4900 B South 31st Street Arlington, VA (P) American Gastroenterological Association 7910 Woodmont Ave. Bethesda, MD (P)

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