Hernias 101: Q/A with Dr. Sean O’Neill, Chelsea Hospital

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Sean O’Neill, MD, PhD, is a board-certified surgeon with Chelsea Hospital/Michigan Medicine General Surgery Clinic. 

Dr. O'Neill attended Northwestern University’s Feinberg School of Medicine and completed General Surgery training at the University of California Los Angeles. At UCLA, he trained at the Lichtenstein-Amid Hernia Clinic, where he co-authored multiple book chapters on hernia repair surgery. Dr. O’Neill spoke with The Sun Times about hernias, how to know when you are suffering from one and available treatment options for local residents.

STN: So tell us, what is a hernia?

Dr. O’Neill: A hernia is a hole in the strength layer (the fascia) of the abdominal wall. We have natural weak spots in this layer at the belly button and groins, and hernias can occur when those weak spots grow, potentially allowing fat or other organs to slip through the hole. Hernias can also develop at the site of abdominal surgery incisions. Hernias are common, especially for people who exercise and lift heavy weights often, but anyone can be at risk.

STN: What kinds of hernias are there?

Dr. O’Neill: There are three main kinds of hernias — inguinal, umbilical and incisional. An inguinal (groin) hernia is the most common type and is caused by an enlargement of one of the natural weak spots in the groin fascia. An umbilical (belly button) hernia is most commonly seen as an “outie” and can cause bothersome symptoms. Finally, an incisional hernia occurs at the site of a previous surgery, as the fascial layer is opened for the operation and then closed at the end, which reduces its strength at that site by at least 10%.

STN: What are some signs or symptoms of a hernia? Is there always a bulge?

Dr. O’Neill: The most common symptoms include discomfort or soreness, particularly with prolonged activity such as a day of yard work or even a long walk. Pain is another frequent symptom. A visible bulge is a more obvious sign that occurs with larger hernias. These bulges may be able to be pushed back in, but often pop out with physical activity. These signs and symptoms can occur with inguinal, umbilical or incisional hernias.

STN: What are the options in treating a hernia?

Dr. O’Neill: Surgery is the only proper long-term solution for a hernia. No amount of medication, physical therapy or exercise can make a hernia go away. Once a hernia forms, the hole in the strength layer will either stay the same size or grow over time, but it cannot close on its own. There are things you can use to help with the discomfort, like a hernia truss or hernia belt, which put pressure over the bulge to help hold it in place. But to fix the problem entirely, surgery is the only effective treatment.

STN: This is where you and Chelsea Hospital come in.

Dr. O’Neill: We are pleased to offer our patients with both open and minimally invasive repair options, but most of our practice consists of minimally invasive repairs. Data suggests patients undergoing a minimally invasive repair are back up on their feet a few days quicker than with an open repair, and there is also a slightly lower rate of infection. An open approach does not always require general anesthesia and may be the best option in many cases. Both approaches are well-established, safe and provide durable long-term results. We are happy to learn more about your symptoms and goals and develop a surgical approach that fits you best.

To contact Dr. O’Neill for more information or to schedule an appointment, call 734-936-5738.

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