Are you having back pain with any of the following?

  • Severe pain, weakness or tingling in your leg(s).
  • Difficulty stopping urination or loss of control of bladder or bowels.
  • Unexplained fever, nausea or vomiting.
  • A history of cancer or unexplained weight loss.

We understand that you are experiencing one or more of the health issues that might be impacting your back pain.

We recommend that you discuss these health issues with your doctor before proceeding with this program.

Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.

Provider photo for Ninad Dabadghav

Ninad Dabadghav, MD

Surgery: General

Welcome to My Doctor Online, a web site that my colleagues and I developed to make it easier for you to take care of your healthcare needs. On this site you will find answers to many of your questions about my clinical practice. Also included are several online features that will allow you to e-mail me, check your laboratory results and refill prescriptions. I hope you find its content informative and useful.

My Offices

Santa Clara Homestead
Appt/Advice: 1-408-851-2000

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Overview

A hernia is a hole or weakness in the abdominal wall or diaphragm. When the abdominal muscles are too weak, tissue or intestine can bulge through the hole. This can cause a visible lump and pain. 

Hernias are not unusual. They can occur at any age. They can be caused by:

  • A birth defect 
  • Muscle strain or weakness 
  • Twisting or pulling, such as when lifting heavy objects  
  • Weight gain including weight gain during pregnancy
  • Chronic coughing

Most hernias develop in the lower abdomen in the groin area. These are called inguinal hernias. Some very small hernias that are not causing symptoms can be left alone. 

We’ll check the area regularly. Most of the time surgery is the only way to repair a hernia. Sometimes, delaying surgery can increase the risk of complications. 

Types

We classify hernias based upon their location.

Inguinal hernias develop in the lower abdomen in the groin area. Most occur in males.  

Epigastric hernias develop in the upper abdomen between the breastbone and the belly button. 

Hiatal hernias develop in the diaphragm. They may be associated with heartburn and acid reflux. 

Umbilical hernias develop in the belly button area. Multiple pregnancies and excess weight can make it more likely that you will develop this type of hernia.

Incisional hernias occur at the site of a prior operation due to weakening of the abdominal wall. 

Femoral hernias are far less common. They develop in the groin at the top of the thigh. Tissue bulges into the femoral canal. The femoral canal contains blood vessels and nerves. Older women are more likely to develop them. 

Ventral hernia is a general term. It refers to an epigastric, umbilical, or incisional hernia.

Symptoms

Some hernias cause no symptoms. Others cause visible lumps and pain.  

In the case of an inguinal hernia, symptoms include:

  • Stomach muscle weakness or sharp pain. You may notice this when lifting a heavy object. 
  • A bulge in the groin.
  • Swelling in the scrotum.

Sometimes part of the intestine or bowel can become trapped in the abdominal muscles. This is known as a strangulated hernia and requires immediate medical treatment. Symptoms include:

  • Extreme tenderness at the site of the swelling
  • Sharp pains
  • Nausea 
  • High fever

Not all abdominal bulges are caused by hernias. Some people notice a bulge in the upper abdomen especially when they sit up. This is due to separation of the abdominal wall muscles. The condition is called a "rectus diastasis." Since there is no hole in the muscle, no treatment is necessary. 

Diagnosis

We will ask you about your symptoms and medical history. During a physical exam we:

  • Will examine your abdomen and groin.
  • Will look for signs of swelling, tenderness, or pain. 
  • May ask you to cough to check for any pain related to movement.

Methods of Surgery

Frequently, hernia surgery can be performed on an outpatient basis. This means that you can go home on the same day as your surgery. Some hernias, such as an extensive incisional hernia, may require that you be admitted to the hospital to recover.

There are different approaches to performing hernia repair surgery. The method we choose will depend on where your hernia is and how severe it is. The options are:

  • Laparoscopic hernia repair 
  • Open hernia repair 

In both types of procedures, we may use a specialized mesh to repair the hole or weakness in the abdominal wall. Studies indicate that using mesh makes it less likely that a hernia will recur. A small repair may not need mesh.

After Your Surgery

Some swelling or bruising is normal. After inguinal repair, swelling can spread to the scrotum. To ease swelling:

  • Use ice. Place an ice bag or a cold pack on the area. Place a thin cloth between the ice and your skin. Apply for 10 to 20 minutes at a time, every 1 to 2 hours if needed. 
  • Wear supportive clothing. After inguinal hernia repair, wear briefs rather than boxers. Spandex bicycle shorts may be helpful in the first week for men and women. A stretchy garment called an abdominal binder can help protect and support abdominal incisions.  

You may resume your usual diet as soon as you feel ready. Some people prefer clear liquids or a bland diet for the first few meals.

You may shower in 48 hours. Do not soak the wound in a tub, swimming pool, hot tub, or sauna for about 2 weeks after surgery.

Laparoscopic and Open Hernia Repair

We make several small incisions in the abdomen. We then insert small surgical instruments and a laparoscope with a tiny camera into the incisions. This allows us to see inside the abdomen and repair the hernia. Laparoscopic hernia repair requires general anesthesia, so it may not be an option for everyone.  

The advantages of laparoscopic surgery include:

  • Smaller incisions
  • Less pain in most cases 
  • A potentially quicker return to your usual activities 
  • The ability to fix inguinal hernias on both sides with the same incision

Open hernia repair 

This approach requires a single, larger incision. We may choose this method if you have thick scar tissue from a previous surgery. You may not need a general anesthetic. We use a local anesthetic and sedation to keep you comfortable.

Recovering from Surgery

Recovering from hernia surgery usually takes several weeks. Recovery times are typically faster for laparoscopic hernia repair. You may return to work as soon as you feel comfortable. This is usually 1 to 2 weeks after surgery. 

You may need more time off if your work requires strenuous physical activity. 

Modifying Your Activities

Your surgeon will give you specific instructions about resuming your activities, depending on your surgery. General guidelines include:

  • Walk daily at a gentle pace. Gradually increase the amount you walk each day. Walking boosts blood flow, keeps the lungs clear to prevent pneumonia, and prevents constipation. You may have some pain when walking or climbing stairs. 
  • Be as active as possible. This will help you recover more quickly. 
  • Rest when you feel tired. Getting enough sleep will help you recover. 
  • Follow your doctor’s instructions about lifting and activities that strain your abdominal muscles. 
  • Don’t drive while you are taking prescription pain medications. Wait until you are no longer taking pain medicine and can easily move your foot quickly from the gas pedal to the brake. Make sure you can sit comfortably in case your journey takes longer than expected. 
  • Resume sexual activity whenever you feel able. Sex may feel uncomfortable for several weeks.

Your Care with Me

If you are having symptoms that concern you, your first contact will typically be with your personal physician, who will evaluate your health and symptoms. If specialty care is needed, your personal physician will facilitate the process of scheduling an appointment in my department. If appropriate, she or he might call me or one of my colleagues while you are in the office so we can all discuss your care together. If we decide you need an appointment with me after that discussion, we can often schedule it the same day.

When You See Me

During your office visit, we will discuss your medical and family history and I will perform a physical exam. I will explain the findings of your exam and answer any questions or concerns you may have. We will discuss treatment options based on the findings.

Lab resources

We will also discuss the results of any tests ordered by your personal physician. If further tests are needed I will use our electronic medical record system to send the requisition to the Kaiser Permanente laboratory of your choice.

  • When the results are ready, you can view most of them online, along with any comments that I have attached to explain them.
  • If your results are normal, I will also send the results in the mail.
  • If they are outside the normal range, I will call you to discuss the results.
Pharmacy resources

If medications are warranted, I will prescribe them and work with you to minimize side effects. If refills are indicated in the future, you can order them online from my home page or by phone using the pharmacy refill number on your prescription label.

  • You can also arrange to have your refill mailed to you at no extra cost. If no refills remain when you place your order, the pharmacy will contact me regarding your prescription.
  • You can choose to pick up your medications at the pharmacy or have them delivered by mail at no extra cost.
After Visit Summary

At the end of our visit, you will receive a document called the After Visit Summary that will summarize the issues we discussed during your visit. You can also view it online from this site.  The online version is called Past Visits.

  • This summary includes my name and the date and time of your visit, your vital signs, my test orders and your medications or immunizations.
  • It often includes the instructions I have given you during our visit and follow-up information.
  • You can refer to your After Visit Summary if you forget what we discussed, or if you just want to recheck your vital signs and weight.
Coordinating your care

Having all of our Kaiser Permanente departments located together or nearby, including pharmacy, laboratory, radiology and health education, makes getting your care easier for you. Another major benefit is our comprehensive electronic medical record system in which all of the doctors and clinicians involved in your care can stay connected on your health status and collaborate with each other as appropriate. When every member of the health care team is aware of all aspects of your condition, care is safer and more effective.

Preparing for Surgery

If surgery is indicated, I will ask you to review an online educational program called Preparing for Your Procedure (Emmi). This online program is available on this site. It will help you decide whether surgery is right for you. It will also provide information about how to prepare and what to expect.

If we proceed with surgery, I will have my Surgery Scheduler contact you to determine a surgery date and provide you with additional instructions regarding your procedure. Once your surgery is scheduled, a medical colleague of mine will contact you to conduct a pre-operative medical evaluation that will assure that you are properly prepared for your surgery.

Contacting Me

If you need to talk with me after your visit or procedure, please call my office. You can also e-mail me with nonurgent issues from this website whenever it is convenient for you.

If you have urgent concerns or issues while my office is closed, or need general medical advice, you can call the Appointment and Advice line, available 24 hours a day, 7 days a week. You will be connected with a nurse who can give you immediate advice.

If you are experiencing an emergency, call 911 or go to the nearest Emergency Room.

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If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.

This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.

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