Hernia treatment and surgery

What is a hernia?

A hernia occurs when an organ protrudes through an opening in the muscle or tissue holding the organ in place. For example, a patient’s intestines may pop through a weakened area of their abdomen.

Commonly a hernia appears in the abdomen, however a hernia may also occur in the upper thigh and groin area.

TYPES OF HERNIAS

Inguinal hernia

An inguinal hernia is when tissue of the small intestine protrudes through a weak spot or tear in the muscles of the abdominal wall. This results in a bulge appearing in the groin area which can be painful, especially when bending over, lifting or coughing.

This is the most common type of hernia a patient presents with, and affects more men than women. This is due to the fact that the testicles descend through inguinal canal, and occasionally the canal may not close properly after the dissention leaving the area weakened and prone to hernias.

Symptoms

Inguinal hernia symptoms include:

  • A bulge appearing on either side of the pubic bone, which becomes more evident when standing upright
  • Pain or discomfort in the groin, especially when bending over, lifting or coughing
  • A heavy or pulling sensation in the groin
  • Possible pain and swelling around the testicles when the protruding intestine descends into the scrotum

Hernia Treatment

Painful and enlarging hernias generally require surgery to remedy the pain or discomfort, and to avoid serious health complications.

There are two types of hernia surgery; open surgery and laparoscopic surgery:

Open Surgery
Under general anaesthesia, the surgeon will make an incision in the groin or abdominal area close to the hernia. If the tissue is healthy, the surgeon is able to gently push the hernia back in place. Occasionally, the surgeon may also need to remove some surrounding tissue. The surgeon then sews the weakened area of the abdominal wall, which may be reinforced with mesh to ensure nothing bulges through.

Laparoscopic Surgery
This is a minimally invasive surgical procedure. Performed under general anaesthesia, the surgeon operates via small incisions made in the abdomen. The patient’s abdomen will be inflated with gas and then a small tube fitted with a camera (laparoscope) is inserted into an incision. Using the laparoscope as a guide, the surgeon repairs the hernia using surgical instruments inserted through the other incisions.

Patients who have laparoscopic hernia surgery tend to have less scarring and discomfort following surgery and a quicker return to day to day activities.

Risks

As with any surgery, there are risks involved. Possible risks and complications include:

  • Infection – where the incision site or wound will appear noticeably swollen and red, and is generally painful to the touch
  • Organ or tissue damage
  • Recurrence of the hernia
  • Nerve damage
  • Incontinence or urine leakage
  • Internal bleeding and hematoma
  • Blood clots
  • Extensive scaring or adhesions

OTHER TYPES OF HERNIAS INCLUDE

Hiatal hernia
A hiatal hernia occurs when the upper part of the stomach pushes through the diaphragm (the muscle separating the abdomen and the chest) and into the chest cavity.

The small opening in the diaphragm, known as the hiatus, is where the oesophagus passes through before connecting to the stomach. It is this small opening where a hiatal hernia appears.

This type of hernia commonly affects patients over 50 years of age.

Generally, a small hiatal hernia has no real signs or symptoms. Larger hiatal hernia may require surgical treatment.

Incisional hernia
An incisional hernia is when tissue protrudes through the healed site of past surgical incisions.

Umbilical hernia
An umbilical hernia occurs when tissue or part of the intestine pushes through the abdomen near the belly button.