The Center for Abdominal Wall Reconstruction at Creighton University Medical Center is led by Dr. Robert Fitzgibbons, a world leader in the treatment of abdominal wall hernias. The Center offers evaluation and treatment for inguinal groin hernias. Our team of surgeons, plastic surgeons, physical therapists, dietitians and experienced nursing staff work collaboratively to provide comprehensive care and treatment to our patients.

Hernias of the groin are divided into three types:

1. Indirect (E)
2. Direct (D)
3. Femoral (F)

An indirect hernia (E) is the most common type of groin hernia and is considered congenital because it is the result of incomplete closure of the passageway from the abdomen to the scrotum when the testicles normally descend into the scrotum at about 28 weeks in gestation. As might be expected, these are frequently detected in newborns. However, this hernia can also develop any time in life because the passageway may be so small that contents from inside the abdomen cannot get into it. Over time, the space gradually enlarges and a hernia develops. The hernia passageway traverses the inguinal canal along with the spermatic cord in males, or the round ligament in females. It is called indirect because the inguinal canal takes an oblique course from inside the abdomen towards the scrotum. In the past, a strenuous event such as heavy lifting was felt to be an important cause of the development of these hernias, i.e., the patient would ”rupture” himself: the heavy lifting event would force something from inside the abdomen into the passageway like a wedge. As noted above, this theory is now questioned by many authorities.

Direct hernias (D) are about one half as common as indirect, and are the result of weakened muscular tissue in the groin area rather than a congenital abnormality. They do not follow the oblique pathway of the inguinal canal but rather travel directly through the abdominal wall, hence the name direct.

Femoral hernias (F) follow the canal that contains the main vessels that supply blood to the leg. They are more dangerous than direct or indirect hernias because the opening of the canal has rigid borders, making it more likely to trap contents in the hernia, resulting in strangulation.

Abdominal Hernia Locations

A. epigastric B. incisional C. umbilical D. direct E. indirect F. femoral

Learn More:

• The Center for Abdominal Wall Reconstruction and Hernia Repair
• Inguinal (Groin) Hernia Treatment
• Sports, Umbilical, Incisional and Epigastric Hernias
• Clinical Research
• Meet Dr. Fitzgibbons