Cascade Hernia Institute Hernia Specialists in Puyallup, WA Like us on Facebook Contact Cascade Hernia Institute About Cascade Hernia Institute Mount Ranier is a geological "hernia"

Frequently Asked Questions

What is a hernia?
Who gets hernias?
What are the symptoms of a hernia?
What are the different types of hernias?
What is the cost and what could my insurance cover?
Will my hernia go away?
What about complex hernias?
What is the recovery time?
When can I return to work?
When can I return to recreational/athletic activity?
Can I travel after surgery?
Why choose a hernia specialist?
What if I have existing medical problems?
When and how can I schedule surgery?
What about office visits after my surgery?
What if I have other questions?

What is a hernia?

A hernia is a small sac containing tissue which protrudes through an opening in the muscles of the abdominal wall. This opening can be a result of a congenital flaw or the opening may be an acquired flaw due to sudden or even repeated stress or strain on the abdominal muscles. A hernia develops when the outer layers of the abdominal wall weaken, bulge or actually rip causing internal organs and tissue to push through the tear creating the typical "bulge" found with most hernia patients.

Any part of the abdominal wall can develop a hernia, however, the most common site is the groin area. With an inguinal hernia, the sac protrudes into the groin and sometimes the scrotum. Umbilical hernias occur through the naval, femoral hernias occur below the groin and incisional hernias occur through surgical scars. A hernia is reducible if the sac of the hernia can be pushed back into place inside the abdomen. Non-reducible, incarcerated, or imprisoned hernias cannot be replaced back in the abdomen.

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Who gets hernias?

Approximately five million Americans suffer from hernias every year, according to the National Center for Health Statistics. Most adult hernias result from sudden or repeated strain or stress on the abdominal muscles. Some hernias are congenital or run in families due to tissue abnormalities. Types of activity typically associated with the appearance of a hernia include:

Lifting heavy objects
Sudden twists, pulls or muscle strain
Chronic straining with urination
Chronic constipation
Repeated coughing attacks

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What are the symptoms of a hernia?

If you are afflicted by any one or more of the following symptoms, contact your doctor as soon as possible.

A noticeable bulge or swelling in the groin area
Groin pain
Nausea or vomiting
Constipation
Urinary difficulties

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What are the different types of hernias?

Inguinal hernias occur in the groin, which is the area between your abdomen and thigh. As the most common type of hernia in adults, inguinal hernias are most common with men although they can also occur in women. With an inguinal hernia, the contents of the abdomen - namely the intestine - protrude through a weakness or tear in the abdominal wall muscle creating a visible bulge and sometimes pain. Pain caused by an inguinal hernia can be a constant, daily pain or may be sporadic, occurring once in a while. Pain may be a sign of nerve damage, which may become permanent quickly.

Umbilical hernias occur in or around the naval, or umbilicus. This type of hernia may be due to congenital factors. Umbilical hernias may also result from sudden or repeated strain or stress on the abdominal muscles. In adults, as with any hernia, an umbilical hernia will not heal and go away but rather grows larger with time and often becomes problematic in that incarceration or strangulation can occur. With infants, however, an umbilical hernia may slowly close, delaying surgery until age 3 or 4 unless the hernia causes problems before then.

Incisional hernias can occur in the abdomen in the area of any prior surgical incision or scar. Hernias of this type are often accompanied by a swelling or bulge near the area of the prior incision, typically along straight incisional scars running down from the breastbone to the pubic area. Incisional hernias can be a result of 1) tension placed on the tissue from the prior surgical procedure, 2) disruption in the general area of prior suturing to the abdominal wall or 3) inadequate healing, which can be due to obesity, metabolic diseases, infection or poor nutrition. Since suturing (tension) can be the cause of some incisional hernias, it is highly advised that incisional hernias be repaired with the Tension Free Mesh technique to avoid future recurrence. Pain may be an early warning sign of an incisional hernia, as there may not be any initial presence of a bulge, though this type of hernia can develop soon after the original surgery or at any time thereafter.

Femoral hernias are almost exactly the same as inguinal hernias. The femoral hernia occurs when abdominal contents are forced through the "femoral canal". Typically, this type of hernia forms near the crease of leg in the abdominal region, but in an area relatively lower than the more common inguinal hernia. Females tend to have a slightly larger femoral canal because of the angle and shape of the pelvis. The two types of hernias are often too difficult to tell apart in diagnosis, which is why a hernia specialist is often required to confirm diagnosis. Femoral hernias are more likely to become incarcerated or strangulated because of their location.

Epigastric hernias occur between the lower part of the breastbone and the naval and is caused by a weakness or opening in the fibrous tissue of the abdomen. This type of hernia usually consists of fatty tissue and rarely contains intestinal tissue. Although generally small in size (no bigger than a golf ball), epigastric hernias can easily become pinched in their small area, sometimes causing a great deal of pain.

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What is the cost & what could my Insurance cover?

Dr. Wright with Cascade Hernia Institute is a provider for many insurance plans - most health insurance plans cover the costs of hernia surgery at the including many PPO plans. Please call our office to verify your coverage. Copays and deductibles are due at time of service. Bring insurance card, ID, and payment to all appointments. For more information on these and other options, please contact us at 253.840.1999.

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Will my hernia go away?

Although a hernia may not worsen for months or even years, an untreated hernia WILL NOT get better on its own. Hernias which are reducible are not generally an urgent danger to your health, though they can be painful. A non-reducible hernia can become life-threatening if any part of the intestine becomes trapped or strangulated in the opening or weakness and then requires emergency surgery. Delaying repair indefinitely can precipitate an emergency or force a repair as an elderly patient.

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What about complex hernias?

Even if the hernia is large or complex, most inguinal, umbilical and many incisional hernias can be repaired. Dr. Wright will advise determine the most appropriate course of action upon examination of your condition. In most cases, mesh is advised. At times, excessive skin is best removed.

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What is the recovery time?

Rapid recovery after surgery is dependent on the location of the hernia, the type of hernia, the repair technique used as well as your individual, physical health. With the advanced surgical techniques used at the Cascade Hernia Institute, our patients experience considerably less post-operative pain, have fewer restrictions after surgery and recover rapidly. Recovery following incisional and/or more complex hernias may be slightly longer to some extent depending on the procedure required, type of hernia and general heath of the patient.

Typical recovery involves walking in your home the night of the surgery, walking in the yard the next day, and walking the neighborhood the next. Driving is OK within a week. Use of a stairclimber, exercise bike or elliptical can commence within a week. Lifting is restricted to under 15 lbs for a month and under 50 lbs for six weeks. Don't be fooled by promises of strenuous activities within days - the biological healing process takes time and a leading cause of hernia repair failures is excessive early activity.

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When can I return to work?

After hernia repair surgery at the Cascade Hernia Institute, you will be able to rapidly return to normal, daily activities as well as work and athletic activities. You will be examined by your surgeon after surgery to determine your individual guideline for returning to work.

Sedentary Work: Generally, patients may return to unrestricted work 3 to 5 days after surgery.

Minimal to Moderately Physical Work: Generally, patients can return to unrestricted work two weeks after surgery. They may return to work in one week with a light duty restriction of no lifting over 15 pounds.

Heavy Physical Strenuous Work: Generally, patients can return to unrestricted work four weeks after surgery. They may return to work in one week with a light duty restriction of no lifting over 15 pounds. They may return to work in four weeks with a work restriction of no lifting over 50 pounds and no repetitive lifting.

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When can I return to recreational or athletic activities?

Depending on the type of hernia and surgery performed, patients are typically advised to return to recreational or athletic activity in stages, as soon as possible. Since each patient is a unique individual with their own needs and abilities, we specifically tailor each patient's progressive return to recreational and athletic activity to their needs and abilities. Patients generally follow a four week progression, allowing light or easy activities in the first week, minimal to moderate activities in the second, moderate activities in the third, and more strenuous activities in the fourth. Note that patients are advised depending on the complexity of their surgery and overall health.

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Can I travel after surgery?

Many patients travel to the Cascade Hernia Institute from all over Washington, Alaska and even Canada. Since our surgical techniques are minimally evasive and allow patients to return home the SAME DAY of surgery, traveling for anywhere from 1-4 hours after surgery is permitted, as long as the patient is not operating a vehicle on his/her own. Patients visiting from further distances are advised to take up local lodging and after a follow-up visit the day after surgery, patients are then allowed to travel home by any way of travel. Patients diagnosed with complex or incisional hernias may require a stay of two or more days in the area. You will be advised of all travel restrictions prior to your procedure.

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Why choose a 'hernia specialist'?

With over 10,000 hernia surgeries and multiple publishings in widely-respected surgery journals, Dr. Robert Wright has become the foremost, trusted hernia surgeon in Western Washington. Patients travel from all over the Pacific Northwest and even Alaska and Canada to seek out Dr. Wright's services. Having performed thousands of laparoscopic surgeries and authored a number of articles in reputed medical journals, patients trust in Dr. Wright's experience as a top surgeon in his field.

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What if I have existing medical problems?

Your overall safety is the biggest goal. Many patients with controlled, preexisting medical conditions have no issues with hernia treatment. In some cases, however, it may be necessary to obtain medical clearance from your primary care physician or cardiologist, but this can be discussed prior to your visit.

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When and how can I schedule surgery?

Scheduling surgery at the Cascade Hernia Institute is simple, quick and convenient. In most cases, surgery can be scheduled within 1-2 weeks or less and can be scheduled on a date that works best for you and your schedule. Call 253.840.1999 for more information.

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What about office visits after my surgery?

After you have undergone surgery with the Cascade Hernia Institute, you will be scheduled for a free follow-up appointment. We pride ourselves on attentive patient care and want to do the most we can to make sure you are back to your regular, everyday activities as soon and as safely and comfortably as possible. Any and all postoperative care will be carefully discussed and reviewed with you immediately following surgery, however, please feel free to contact our office with any questions regarding your surgery and we will be happy to assist you.

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What if I have other questions?

Please do not hesitate to contact our office at 253.840.1999 if you have any additional questions about hernias or hernia surgery that were not answered in your visit to our web site.

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"Thank you for being not just a good surgeon but a nice guy too."
-- patient