Overview
A hernia occurs when internal organs within a body cavity protrude through a defect or an area of weakness in the muscular wall of the cavity. This is a very common surgical condition.
Depending on the location and the causes, there are different types of hernia.
- Inguinal Hernia
- Umbilical Hernia
- Incisional Hernia
Symptoms
Inguinal Hernia
Patients typically complain of a lump at the groin. The lump ‘disappears’ when lying down, but appears when standing up, coughing or sneezing.
The lump may be small in the beginning, but usually grows larger with time. Over time, it may cause an ache or discomfort in the groin.
Umbilical Hernia
This type of hernia occurs over or around the umbilicus. Patients typically complain of a lump directly over or around the belly button.
The belly button appears to pop out when standing
The lump disappears when lying down
Incisional Hernia
This type of hernia occurs at the site of a surgical scar.
When to Seek Treatment
If the lump becomes painful and does not ‘disappear’ on lying down, this may signal an emergency situation such as incarceration (trapped contents) or strangulation (compromised blood flow). Urgent medical attention is needed if this occurs.
Diagnosis
The diagnosis is usually made by physical examination.
Occasionally an ultrasound, CT scan, or MRI scan may be necessary.
Treatment
Hernias cannot be treated with medication. Surgery to repair the hernia is the only definitive form of treatment.
A surgical operation to repair the hernia involves putting in a mesh, which is a net-like material to repair the defect or the hole in the muscular wall and strengthen the abdominal wall muscles. A hernia repair can be performed laparoscopically or by traditional open surgery.
Laparoscopic Hernia Repair
This operation is performed through small incisions made on the abdominal area. These cuts range in size from 5mm-1cm. Usually, 3 incisions are needed. The aim is to reduce the hernia by pushing the contents back into the abdominal cavity and covering up the defect with a surgical mesh. This is a very common operation.
It is a minimally invasive operation resulting in less pain, faster recovery, earlier return to normal activities, and a shorter hospital stay compared to an open operation.
Open Hernia Repair
This operation is performed through an incision directly over the hernia. The aim is to reduce the hernia by pushing the contents back into the abdominal cavity and to cover up the defect using a surgical mesh. This is a very common operation that typically requires one hospitalisation day.
Causes
Congenital hernia
Injury or surgery to the abdominal wall
Risk Factors
- Male
- Increased age
- Obesity
- Multiple pregnancies
- Fluid in the abdominal cavity (ascites)
