What Is A Hernia?
The most common place for a hernia to occur is the abdominal wall. A hernia is a weakness in the abdominal wall that allows the contents of the abdominal cavity to protrude out. Most people with hernia complained of a protruding lump in the abdomen. Abdominal contents like omentum (fatty tissues in the abdomen) and small intestines may enter the hernia when the abdomen pressure increases.
Prolonged coughing, straining during urination, and constipation can increase pressure inside the abdomen and force omentum or small intestines into the hernia. These abdominal contents slip in and out of the hernia easily on most occasions (reducible hernia). However, an emergency can occur when these contents get stuck in the hernia and become strangulated (irreducible hernia).
What Are The
Different Types Of Hernia?
There are numerous types of hernias, with the more common ones being:
Inguinal Hernia
– The most common type of hernia, inguinal hernias affect men more frequently than women. It occurs in the groin area when an organ pushes through a weakened spot in the abdominal wall.Femoral Hernia
– Femoral hernias occur more commonly in women. They develop when tissue, such as fat or intestine, pushes through a weak spot in the groin or inner thigh. This condition may result from chronic straining during bowel movements and heavy lifting.Umbilical Hernia
– An umbilical hernia occurs when a piece of bowel or fatty tissue pushes through the abdomen near the navel (belly button). This is especially common in babies under 6 months old, but adults can develop them too.Incisional Hernia
– Surgery can leave a weak spot in the abdominal wall, leading to an incisional hernia. This occurs when tissue pushes through the unhealed scar. Risk factors include pregnancy or increased pressure on the abdomen too soon after surgery.Hiatal Hernia
– A hiatal hernia develops when the upper stomach pushes through the diaphragm, the muscle separating your chest and abdomen. This can cause heartburn, acid reflux (GERD), chest pain, bloating, and swallowing difficulties.
Less common types of hernias include epigastric, spigelian, and abdominal wall hernias.
What Are The
Symptoms Of Hernia?
The symptoms of the hernia depend on the severity of the hernia. Early hernia may not have symptoms at all. Patients may feel abdominal discomfort or pain upon exertion like prolonged walking or exercise. A protruding lump can be felt in the abdomen if the hernia is significant in size. The protruding lump typically disappears when the patient lies down. In a male patient with a large inguinal hernia, the groin lump may extend all the way down to the scrotum.
In an irreducible hernia, the pain can be excruciating. If the intestines are involved in the irreducible hernia, the blood supply to the intestines may be cut off and result in a dead bowel in a few hours. This is an emergency and surgery should be performed as soon as possible.
How Is
Hernia Diagnosed?
Diagnosing a hernia involves a doctor’s assessment of medical history, symptoms, and physical examination. The doctor will examine the affected area and check for the presence of any bulges. Sometimes, they may also ask you to cough or strain to see if the hernia becomes more noticeable.
While a physical exam is often enough to diagnose a hernia, imaging tests may sometimes be required for a more definitive diagnosis or to gather additional information. These tests may include ultrasounds, CT scans, or MRI scans.
What Are The Treatment Options
For Hernia?
The general recommendation is that all hernia should be surgically repaired, except in very old and frail patients. For patients who are not fit to undergo hernia surgery, they have to wear a truss to keep the hernia in check. For patients who are fit, surgical repair should be performed to relieve the discomfort and prevent complications from occurring.
Hernia Surgery
Singapore
Most hernias do not heal on their own. Left untreated, they can grow larger and lead to serious problems like organ obstruction or strangulation (when the blood supply is cut off). The most effective way to fix a hernia is through surgery. Common types of hernia surgery include:
Herniorrhaphy
– The surgeon makes an incision and gently pushes the displaced organ back to its original position. Afterwards, the hernia sac is removed and the edges of the weakened muscle or tissue are stitched together to prevent the hernia from recurring.Hernioplasty
– This type of hernia surgery follows the same steps as herniorrhaphy. However, instead of using sutures, a flat, sterile mesh is used to reinforce the weakened muscle or tissue.Herniotomy
– This type involves the removal of the hernia sac only.
Open Hernia Surgery
The conventional method to repair the hernia is via the open method. This is performed via a 4 to 5-cm incision at the hernia site. A non-absorbable mesh is commonly placed to reinforce the repair.
Laparoscopic Hernia Repair
The key-hole (laparoscopic) method to repair a hernia has become very popular over the past 10 years. With a few small incisions, there is little pain after surgery and the recovery is fast. Laparoscopic hernia repair is now routinely offered to patients as an alternative to open repair.
Robotic Hernia Surgery
Robotic-assisted hernia surgery is also minimally invasive in nature. Using a console, the surgeon controls robotic arms with high levels of precision and dexterity, guided by advanced 3D visualisation. This allows for more precise movements with smaller incisions, reduced pain, and a potentially lower risk of complications.
What Happens During
Hernia Repair Surgery?
During the surgery, you may be given general anaesthesia or local anaesthesia with sedation, so that you do not feel any pain. Afterwards, the surgical area will be sterilised and incisions will be made depending on the surgical approach that will be used.
The surgeon will then perform the repair using stitches or synthetic mesh to reinforce and strengthen the closure. Lastly, the incisions are closed with sutures or staples, and the area is bandaged.
Recovery After
Hernia Surgery
Depending on the type of surgery, you might be discharged the same day or stay for a night or two. Most patients can resume normal activities within 1-2 weeks.
You may feel some temporary pain and discomfort, bruising, and swelling around the incision site, which can be managed with pain relief medications. You will also receive instructions regarding activity restrictions and wound care to facilitate healing. Follow-up appointments with your doctor will be scheduled to monitor your healing progress.
Risks Of
Hernia Repair Surgery
A hernia repair surgery, like any medical procedure, may carry potential risks. While these are minimised in the hands of an experienced surgeon, they can include infection or damage to nearby organs. Fluid accumulation near the hernia is another possible short-term complication. In rare cases, hernia recurrence, chronic pain, or mesh-related problems might occur.
That said, hernia repair surgery is an overall safe and effective procedure with a high success rate. Your surgeon will discuss these risks with you beforehand and take steps to minimise them.
FAQs on
Hernia Surgery
Do I need mesh for my hernia repair?
Mesh is not always necessary for hernia repair. However, for larger or more complex hernias, mesh reinforcement is typically used to strengthen the repair and reduce the risk of recurrence.Do hernias cause constipation?
A large or strangulated hernia can cause constipation by physically blocking the passage of stool through the intestines. This is a serious complication and requires immediate medical attention.What if I have a hernia and I’m pregnant?
For small hernias, doctors may recommend watchful waiting to monitor the hernia. However, surgery during pregnancy may be required in cases of strangulated hernias. It is best to talk to your doctor for personalised guidance.
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