Did you know there are multiple types of hernias? These bulges, caused by tissue that protrudes through weak areas of muscle, are classified by their cause and where they occur on the body.
When it comes to abdominal hernias, Spigelian hernias stand apart from their more common counterparts. These rare hernias develop through a specific weakness in the abdominal wall and can be challenging to diagnose without proper medical attention. Spigelian hernias typically require prompt evaluation due to their high risk of complications.
"Spigelian hernias account for only 0.12% to 2% of all abdominal wall hernias, but they deserve special attention because they carry a significantly higher risk of incarceration compared to other hernia types," explains board-certified general surgeon Dr. Desiree D’Angelo.
What is a Spigelian Hernia?
A Spigelian hernia happens when tissue, often fat or part of your intestine, pushes through a weak spot in your abdominal wall, specifically where two muscles meet. Unlike more visible hernias that create obvious bulges, Spigelian hernias are often less noticeable from the outside, making them frequently misdiagnosed or discovered later than other hernias.
These hernias are more common in:
- Adults between 40-70 years of age
- Women slightly more than men
- People with conditions that increase intra-abdominal pressure
- Individuals who have had previous abdominal surgeries
Causes & Symptoms of Spigelian Hernia
Several factors can lead to weakness in your abdominal wall, including:
- Chronic coughing (especially with lung conditions)
- Heavy lifting or straining
- Pregnancy or multiple pregnancies
- Previous abdominal surgery
- Sudden weight loss or aging
What Are Some Risk Factors for Spigelian Hernias?
Certain conditions can increase your likelihood of developing a Spigelian hernia:
- Being overweight or obese
- Age (more common after 50)
- History of multiple pregnancies
- Chronic liver disease with fluid accumulation (ascites)
- History of abdominal trauma
- Regular heavy lifting
Recognizing the Symptoms of Spigelian Hernias
Symptoms of Spigelian hernias can be subtle and easily confused with other conditions. The most common signs include:
- A tender spot or small lump on the abdomen, typically located a few inches to the side of the midline and below the navel
- Pain that increases with physical activity, coughing, or straining
- Discomfort that improves when lying down
- A bulge that appears when standing and disappears when reclining
- In some cases, no visible bulge at all despite pain
It's particularly important to pay attention to symptoms that worsen with activity. Unlike muscle strains that often improve with rest, hernia pain tends to recur with similar activities that increase abdominal pressure.
"What makes Spigelian hernias particularly challenging is that patients may experience significant discomfort without the typical visible bulge we associate with hernias," notes Dr. D’Angelo. "This is why any persistent, localized abdominal pain should prompt a medical evaluation, especially if it worsens with physical exertion.
If you experience sudden, severe pain along with nausea, vomiting, or inability to pass gas or stool, seek immediate medical attention. These could be signs of a strangulated hernia—a medical emergency where blood supply to the trapped tissue is cut off.
Diagnosing a Spigelian Hernia
Because Spigelian hernias can be difficult to identify through physical examination alone, your doctor may order imaging tests like:
- Ultrasound: Usually the first imaging test, especially effective when performed while the patient is standing or during a Valsalva maneuver (bearing down as if having a bowel movement)
- CT scan: Provides detailed images of the abdominal wall and can identify the contents of the hernia
- MRI: May be used in certain cases for additional clarity
Spigelian Hernia Surgery in New Jersey: What Are My Treatment Options?
If you’ve been diagnosed with a Spigelian hernia, surgery is usually the recommended treatment to repair the abdominal wall and prevent complications. There are three main hernia surgical options, and the best one for you will depend on the size and location of your hernia and your overall health.
Open Surgery
This is the traditional method, where your surgeon makes a direct incision over the hernia to access and repair it. Open surgery is often preferred for larger or more complex hernias, since it offers a clear view of the area and allows for precise repairs.
Laparoscopic Surgery
Laparoscopic surgery uses a few small incisions and a tiny camera to guide the procedure. It’s less invasive than open surgery, which means less post-op pain, quicker recovery, and smaller scars. Many patients are able to return to normal activities faster with this method.
Robotic-Assisted Surgery
This advanced approach builds on laparoscopic techniques but uses robotic technology to give the surgeon even greater control and precision. It can be especially helpful for complex or hard-to-reach hernias and may offer an even smoother recovery for certain patients.
Occasionally, surgeons use a surgical mesh to reinforce the abdominal wall. This helps reduce the risk of the hernia returning and adds long-term strength to the repair.
Recovery and Post-Treatment Care
Most people recover well from hernia surgery. Here’s a general idea of what to expect:
- Back to light activity in 1–2 weeks
- Non-strenuous work in 2–4 weeks
- Strenuous activity in about 6 weeks
- Full recovery in 6–8 weeks
Your surgeon will give you personalized instructions on wound care, pain management, and when to ease back into daily activities.
Frequently Asked Questions About Spigelian Hernia Surgery
Is Spigelian hernia surgery painful?
Most patients report mild to moderate discomfort that improves within a few days after surgery. Minimally invasive approaches, such as laparoscopic or robotic-assisted surgery, can reduce post-operative pain and speed up recovery.
What is the recovery time for Spigelian hernia surgery?
Recovery typically takes 2 to 4 weeks, depending on the size of the hernia and the surgical technique used. Many patients return to light activity within one week and resume normal activities within a month.
Do you use mesh for Spigelian hernia repair?
Yes, mesh is often used to strengthen the abdominal wall and reduce recurrence risk. Your surgeon will discuss the best option based on your anatomy and health history.
Where can I get Spigelian hernia surgery in New Jersey?
Premier Surgical Network provides advanced hernia repair services at multiple locations across New Jersey. Our experienced team will guide you through diagnosis, treatment, and recovery.
Experiencing Unexplained Abdominal Pain? We’re Here to Help.
If you're experiencing localized abdominal pain or suspect a hernia, early diagnosis is key. Schedule a consultation with a Premier Surgical Network hernia specialist today to explore your options.
At Premier Surgical Network, we specialize in diagnosing and treating even the rarest types of hernias. Using advanced, minimally invasive techniques, we’ll help you recover quickly and get back to feeling your best.
Schedule a consultation with a hernia specialist in New Jersey today and get a personalized treatment plan from one of our experienced surgeons.
