A hernia often needs specialists attention. Left untreated, hernias tend to enlarge and progress. If a hernia becomes stuck out (incarcerated), it can cut off the blood supply (strangulation) to fatty tissues, or rarely to parts of your intestines which can be life-threatening. In this case, emergency surgery is required.
Newer surgical techniques make hernia repair much easier. Minimally invasive laparoscopic techniques, also called keyhole surgery, require just a few small incisions.
What is a hernia?
Technically speaking a hernia is an abnormal protrusion of tissue or an organ through the investing fascia designed to enclose it. As most visible hernias occur in the abdomen then you can think of a hernia as occurring when tissue pushes through a weakened area of your abdomen causing an abnormal lump to appear. There may be a vague discomfort or a dragging sensation around the area - especially after lifting a heavy object. This may become worse as the hernia expands.
Hernias usually improve and may disappear after rest or lying flat; only to return on standing or as the day progresses. The bigger a hernia gets the more likely it is not to reduce fully on lying flat or to be stuck out permanently. Hernias are easier to repair and the repair is more durable the smaller they are.
Hernias or herniae - as they are sometimes called - can occur in many areas of the body but the commonest area is the groin
Types of hernia
There are many types of herniae. Herniae are usually defined by their body location and content (where the lump is in the body and by what is contained within it). Examples are:
- Inguinal Hernia - commonest hernia in the groin area in both males and females. More common in males than females. More common on the right hand side than the left. Can be congenital (present since birth) and present as a toddler or infant with a swollen scrotum. In adults, inguinal herniae are usually acquired from repeated stress and strain including heavy lifting.
- Femoral Hernia - Second commonest hernia in the groin area in males and females. This hernia is more common in females than males because the female pelvis is slightly wider than male pelvis. Femoral herniae are more likely than inguinal herniae to get stuck (incarcerated) and strangulate (blocked blood supply). When found it is advised that they are repaired as soon as practical.
- Obturator Hernia - rarest form of the groin herniae. Usually discovered in elderly females or incidentally during a laparoscopic groin hernia repair for the other types of groin herniae. Can occasionally cause bowel obstruction.
Other abdominal herniae:
- Umbilical Hernia - usually starts as a small bulge in the belly button
- Epigastric Hernia - hernia in the midline between the belly button and the breast bone.
- Spigelian Hernia - positioned anywhere along the outer edge of the rectus muscle (the six pack muscle) but usually below the belly button.
- Ventral Hernia - a large hernia arising in the midline between the rectus (six pack muscles)
- Incisional Hernia - often in the midline but can be at any location previously used to operatively access the abdominal cavity.
“Hernias can develop over time or may have been there since birth. They can be caused by lifting heavy items, chronic constipation or continual sneezing or coughing. Being overweight, bad diet, and smoking all weaken your muscles and increase the risk of a hernia.”
How do I know I have a hernia?
One of the tell-tale signs of a hernia is a lump that appears when standing or on effort and disappears when you’re lying down. You may also have pain or discomfort at the site of the hernia, especially when you’re lifting something heavy.
Other important symptoms and signs are:
- If a lump becomes acutely painful it may be a sign of incarceration (being stuck).
- If a hernia becomes hot, red and tender as well then this indicates strangulation and is a surgical emergency. A strangulated part of the bowel can become gangrenous within 4 hours.
Will I need surgery?
Herniae should be comprehensively assessed and treated accordingly. As a general rule, if a hernia is symptomatic and you are fit for surgery, then it should be repaired.
Small hernias are most often dealt with by relatively simple surgery. An experienced surgeon will help decide between and open or a minimally invasive keyhole approach. After fixing the hernia, a prosthetic material or mesh is often sewn in to strengthen the weakened area.
"Newer surgical techniques have made hernia repair much easier. Minimally invasive laparoscopic techniques, also called keyhole surgery, require just a few small incisions. It means less damage to surrounding tissue and faster recovery. With groin hernias, both sides can be fixed at the same time using just three small holes."
Other advantages of keyhole surgery include:
- Reduced pain and less need for pain relief
- Reduced risk of nerve injuries and chronic pain
- Reduced likelihood of wound infection
- Earlier return to normal activities
The Upper GI West approach to surgery
Hernia pain can be debilitating. Our highly skilled team at Upper GI West ensures you have access to the most up-to-date treatment options. We are there for you from diagnosis and assessment, through to surgery and management of your condition and support after your surgery.