What is a Hernia?

A hernia arises when muscles of the inner lining of an organ or tissue become weak. Due to this weakening, they bulge or protrude outwards through their outer-lining, forming a balloon-like sac. The most common types of hernias are those of the abdomen, and their treatment often requires open or laparoscopic surgery.

What causes a Hernia?

A hernia may develop in infants, children and adults as well. Abdominal hernias are more commonly seen in males, but females are also at risk.

The most common causes of developing and aggravating a hernia include:

• 
  Straining
  
• 
  Coughing violently
  
• 
  Strained bowel movements (e.g. during constipation)
  
• 
  Lifting heavy objects
  

What are the symptoms of a Hernia?

The symptoms that develop with a hernia include:

• 
  Occasional or constant pain or discomfort
  
• 
  Swelling in the affected area, which may decrease with time and in some cases may not be apparent at all.
  
• 
  Sensing pain while lifting objects
  
• 
  A vague localized aching
  
• 
  Nausea
  
• 
  Constipation
  

How is a Hernia diagnosed?

In order to diagnose a hernia, the doctor will check for bulges and any swelling in the area of discomfort. Pressure will be applied on the bulge to check whether it retracts (in the case of a hernia) or remains stiff. The type and severity of the symptoms will also be considered. An ultrasound is usually performed as a confirmatory test.

What are the types of Hernia?

Hernias are classified according to the region where they occur:

• 
  Inguinal Hernia: Most common, occurring in the groin region. Other types, namely indirect, direct, and femoral hernias may also co-exist in this region.
  
• 
  Ventral hernia: Above the midline of the abdomen.
  
• 
  Umbilical hernia: Within the navel.
  
• 
  Other types include Epigastric, Incisional, Lumbar, Hiatal, and Spigelian.
  

Why should a Hernia be treated?

There are many reasons why a hernia should be surgically treated or repaired. These include:

• 
  The intestines may get caught in the sac caused by the hernia. This will result in bowel obstruction and will eventually cut off the blood supply to the bowel. Unless immediate surgical measures are not taken, the affected area may die. This ultimately leads to peritonitis which can be life-threatening.
  
• 
  In males, the pain experienced in the groin region due to heavy lifting or prolonged standing may transfer to the testicles.
  
• 
  Strained movements and constant pain can cause difficulty in performing even the most basic chores
  
• 
  Progressive enlargement of the hernia results in increased complications and makes repair difficult.
  

How is a Hernia surgically treated?

There are two methods of Hernia surgery at Arlington. These are Open Surgery and Laparoscopic Surgery. What procedure is to be performed depends on the patient's medical state and the surgeons preference.

Hernia surgery basically involves pushing the bulging tissue back in place and strengthening the surrounding tissue.

What are the preparations before the surgery?

Always provide a complete medical history before any surgical procedure. Be sure to mention any medication (aspirin, blood-thinners) that you may be taking or any allergies you may have. You may be asked to stop any or all medication before the surgery. It is also recommended that nothing should be eaten at least 6-8 hours before the surgery.

Open Inguinal Hernia Repair

General anesthesia or spinal anesthesia is administered for this surgery. The procedure is relatively painless.

• 
  A long incision is made in the groin region.
  
• 
  The hernia is then separated from the surrounding healthy tissue.
  
• 
  The hernia sac is removed and the protruding intestines are pushed back into the abdomen.
  
• 
  Herniorrhapy: the point where the hernia was bulging outwards may be repaired by sewing the edges of the healthy tissue together. This is usually done for small hernias and in situations where no additional stress will be caused to the healthy tissue by the stictches.
  
• 
  Hernioplasty: A more appropriate approach is using synthetic materials to repair hernias. This works well for large as well as recurring hernias. After pushing the hernia back into its place, the weakened area is closed by sewing patches over it. The use of patches reduces tension in the wall as in the case of stitching.
  

Recovery

People can often go home the day of the surgery. Complete recovery takes about three weeks after which normal chores can be resumed. Strenuous activity and lifting should be avoided for at least six weeks.

Laparoscopic Inguinal Hernia Repair

The procedure is performed under general anesthesia, and is like any other laparoscopic procedure.

• • 
    Three to four small incisions are made in the abdomen or just underneath the navel.
    
  • 
    A laparoscope is inserted through one of the incisions and other surgical instruments are inserted via the other.
    
  • 
    Air may be pumped into the abdomen to inflate it so that the surgeon has more room to work and a clearer view of the organs.
    
  • 
    The hernia is repaired using the same methods as those of open surgery.
    

Recovery

 

Most people can go home the same day. It takes at least one to two weeks for full recovery. Strenuous activity should be avoided for at least four weeks. This procedure is less painful and less invasive as compared to open surgery.

Are there any risks?

Complications are very uncommon in both these procedures. However, the risks relating to hernia surgery include:

• 
  Damage to blood vessles
  
• 
  Damage to organs
  
• 
  Nerve damage
  
• 
  Chronic pain in the operated area
  
• 
  Recurrence of the hernia
  
• 
  Testicular damage