mature female with abdominal pain

Each year an estimated 5 million Americans experience a hernia

A hernia is a medical condition where an organ or soft tissue pushes through a weak spot in the abdominal wall. Hernias occur in a variety of places including the mid-abdomen, groin, areas of a prior incision, and sides of the body. Some hernias don't cause symptoms, and no treatment is required. However, if you are experiencing discomfort or pain, we can help. You don't have to avoid treating your hernia for fear of a lengthy recovery. Most routine hernia surgeries are performed on an outpatient basis, and you can quickly return to normal activity.

Any signs of a hernia should be promptly evaluated by a healthcare professional to determine the most appropriate course of action and prevent potential complications. Our surgeons perform more than 3,000 hernia procedures each year, from routine repairs to complex reconstructions. We have a number of convenient locations throughout Northern Virginia, making it easy to get the hernia care you need.

Director's Message

Michael Svestka, MD, FACSMichael Svestka, MD, FACS
Program Director

Our mission is to provide the highest quality hernia care to our patients using state-of-the-art, evidence-based practices. We are committed to the following core principles:

  • Integrity: We provide honest and transparent care to our patients.
  • Excellence: We utilize state-of-the-art techniques and evidence-based practices. All members of our program are encouraged to participate in the ACHQC, a national hernia organization dedicated to tracking outcomes and evaluating best practices.
  • Patient-centered Experience: We offer a seamless and personalized experience for our patients.
  • Multidisciplinary Team: We have a team of expert surgeons who work together to provide comprehensive care for our patients.

We offer a range of hernia repair techniques including robotic, laparoscopic, and open surgery. As a regional referral center, we are committed to providing high-quality care for all types of hernias, from routine to complex revisional surgery requiring abdominal wall reconstruction. Our surgeons are skilled at a variety of techniques and will help determine the approach appropriate for your circumstances. We are committed to compassion and look forward to serving your needs with skill and empathy.

Our goal is to provide the highest quality care to our patients with a focus on their individual needs and preferences.

Inova’s comprehensive approach to hernia care

Inova is dedicated to a comprehensive approach to hernia care, with streamlined protocols involving both pre-operative optimization and post-operative rehabilitation, in accordance with national guidelines and evidence-based practices. Your surgeon may recommend pre-operative testing in our Inova Pre-Procedure Evaluation clinic, in addition to hernia-focused post-operative physical therapy to improve functional mobility after surgery.

Meet our surgeons by location

Meet our plastic surgeons

Plastic surgeons offer expertise in cosmetic and reconstructive procedures of the abdominal wall including repair of rectus diastasis, liposuction, and abdominoplasty (tummy tuck).

Meet our plastic surgeons

Frequently asked questions about hernias

The most common type of hernia is an inguinal hernia, which appears in the groin area and can occur in both men and women, but there are several other types:

  • Umbilical hernias are very common and are present at the belly button.
  • Ventral hernias are protrusions of intestine or other tissue through a weakness or gap in the abdominal wall.
  • Epigastric hernias occur in the epigastric region of the abdomen, which is located above the belly button and below the rib cage. They are caused by a gap between the two sides of the abdominal muscles, which allows fat tissue to push through the abdomen.
  • Hiatal Hernias occur when part of your stomach pushes up into an opening (the hiatus) in your diaphragm. The diaphragm is the muscle between your belly (abdomen) and your chest.
  • Femoral hernias are a special type of groin hernia more common in women and can lead to significant pain.
  • Incisional hernias occur as a result of connective tissue weakness at the site of a previous incision.
  • Parastomal hernias occur around the site of an ostomy and can cause pouching issues and pain.
  • Flank hernias can occur around the sides of the abdomen.

The symptoms of a hernia can vary depending on its location and size. Common symptoms include:

  • A visible or palpable bulge or lump in the affected area, which may be more noticeable when standing or straining.
  • Pain or discomfort at the site of the hernia, especially during physical activities or lifting.
  • A feeling of weakness or pressure in the abdomen.
  • Nausea, vomiting, or difficulty passing stools (for some types of hernias).

If left untreated, a hernia can potentially become incarcerated or strangulated. An incarcerated hernia occurs when the herniated organ or tissue becomes trapped and cannot be pushed back into place, while a strangulated hernia happens when the blood supply to the herniated tissue is compromised. Both of these situations are medical emergencies and require immediate attention.

Hernia surgery has been studied extensively for decades. Over that time, doctors and researchers have identified many factors that patients can improve before hernia repair to ensure a good outcome and to limit the risk of surgical complications. Smoking, obesity and diabetes are three of the most important conditions we aim to optimize prior to hernia surgery. Your surgeon may refer you to the Inova Pre-Procedural Evaluation Clinic or to our obesity medicine/bariatric surgery colleagues to help you make a plan and get as healthy as possible before having hernia surgery.

The treatment for hernias depends on the type and severity of the hernia. In some cases, your physician may recommend observation, long-term monitoring, lifestyle changes, or wearing a supportive garment. In many circumstances, surgery is required.

Hernia surgery involves repairing soft tissue and muscular defects using sutures, and in many cases, reinforcing the abdominal wall with mesh prosthetics. A number of different approaches are used depending on the nature of the hernia, including laparoscopic (minimally invasive) surgery, robot-assisted laparoscopic, or traditional open surgery. The choice of surgical approach depends on factors such as the type and size of the hernia and the patient's overall health.

At Inova, we specialize in all types of hernias from small to very large hernias requiring extensive reconstruction techniques. We also specialize in repeat surgeries, hernias that have recurred after prior repairs, and complications related to mesh.

Mesh is a type of flexible material that is used to reinforce hernia repairs. General guidelines for hernia repair indicate the use of mesh reinforcement for hernia defects larger than 1 – 2 cm to protect against repair failure. Most hernia meshes are made out of a plastic polymer called polypropylene and do not dissolve. Television and radio advertisements about hernia mesh products generally refer to older products that were recalled due to labeling issues or mechanical defects. These products have been removed from the market and are no longer available. Inova only uses the highest quality mesh products that are consistent with current evidence-based, national standards. 

Robotic surgery, also known as robot-assisted surgery, is a type of minimally invasive surgical procedure in which a surgeon uses a robotic system to perform the surgery. The robotic system consists of a robotic arm controlled by the surgeon, which holds and manipulates the surgical instruments. The system also includes a high-definition camera that provides a 3D view of the surgical site.

Learn more about minimally invasive surgery

As hernias grow in size, your surgeon many need to use advanced reconstructive techniques to fully repair the abdominal wall. These surgical approaches are generally reserved for hernias that are very large, have failed prior repairs or are otherwise complicated. As a regional referral center, Inova Hernia Surgery is uniquely equipped to manage the full spectrum of hernia disease including revisional and reconstructive procedures.

The recovery time after hernia surgery can vary depending on several factors, including the type of hernia, the surgical approach used, the individual's overall health, and the specific activities they engage in during the recovery period.

Patients generally can walk and navigate stairs the same day of surgery and resume most activities after two weeks.

During the recovery period, patients should avoid heavy lifting, strenuous exercise, and activities that put significant strain on the surgical site. It's also crucial to be aware of potential signs of complications, such as infection, persistent pain, redness, swelling, or fever, and report any concerns to your healthcare provider promptly.

It is essential to follow your surgeon's specific post-operative instructions, including wound care, medication management, and activity restrictions. In some cases, a gradual return to normal activities may be recommended to avoid complications and ensure proper healing.

Always consult your surgeon or healthcare team to get personalized information about your expected recovery time and any specific guidelines or restrictions that apply to your unique

Most routine hernias that are performed as outpatient procedures do not require post-operative physical therapy. However, if you had a more extensive repair or reconstructive procedure, your surgeon may direct you to our physical therapy team for post-operative rehabilitation. The physical therapy team at Inova Hernia Surgery uses the latest evidence-based protocols informed by recent research and evolving data at a national level.

Frequently asked questions about diastasis recti (abdominal separation)

The most common reason for a visible bulge in the abdomen is a hernia, but other conditions can cause bulging as well. One of these is called diastasis recti. It happens when the abdominal muscles that run up and down begin to separate and widen. The result is a weak spot between the muscles that looks like a bulge down the middle of the belly.

Diastasis recti can be caused by:

  • Pregnancy
  • Obesity
  • Prior abdominal operations

It's most common in women after pregnancy, but it can also occur in overweight men.

To diagnose diastasis recti, your provider will conduct a physical examination and may have you lie flat and do a straight leg raise. The diagnosis can be confirmed with imaging tests, which may be CT, MRI or ultrasound.

Treatment options can include:

  • Exercise
  • A minimally invasive procedure to support the abdominal wall, with or without mesh
  • Endoscopic and laparoscopic surgical techniques
  • Abdominoplasty

Sometimes, the layers of skin and fat over the abdominal muscles can get stretched in people who have diastasis recti. You and your healthcare provider can discuss an abdominoplasty to improve the abdomen's appearance by surgically removing the extra skin and fat with a curved incision across the lower belly area.