A hernia is a common medical issue where a weakness in the abdominal wall through which abdominal contents can protrude. These weak points are often sites where vessels pass through, such as in the groin (inguinal) or at the belly button (umbilical). Previous operation sites may lead to a weakness causing an incisional hernia. Surgery is usually necessary to repair them.
Umbilical Hernia Treatment:
If a large defect needs attention, these may be repaired thorugh keyhole (laparoscopic) surgery, although some need a small incision and a mesh or suture repair.
Inguinal Hernia Treatment:
An inguinal hernia is a bulge through a weakness in the abdominal wall in the groin. Sometimes this type of hernia can affect both groins, this is known as bilateral. A weakness in the abdomen may be present from birth, which can lead to a predisposition to hernia formation in later life. In adults, a inguinal hernia can develop after strenuous physical activity or heavy lifting. A lump (hernia) often collapses, or sees a reduction, on lying flat and appears with standing, coughing or straining.
Inguinal hernias can affect both sexes, but are more common in men. Hernias have the potential to enlarge and lead to discomfort which can eventually lead to limited daily activity. If the hernia becomes irreducible (where it can’t be pushed back), a blockage of the bowel may occur leading to abdominal pain and vomiting. This is a sign that immediate action must be taken as the trapped bowel may lose its blood supply.
It is to be expected during a hernia treatment operation that a patient will require general anaesthetic for keyhole operation. Keyhole surgery consists of a small 1-2 cm cut made through the belly button allowing a camera to be placed inside. Carbon dioxide is then used to distend the abdominal wall to give the surgeon a view of the operative filed that is projected on to a television monitor. By using miniaturised instruments, an area behind the hernia is dissected free. The mesh is rolled up, placed into this pocket and then unraveled inside to cover the defect. The laparoscopic approach allows both groins to be inspected. If a clinically symptom less or occult defect is identified with the camera, both sides can be repaired using the same instruments. The operation takes around 40 to 50 minutes to perform, similar to the conventional open operation.
Keyhole surgery often results in a quicker recovery and return to every day activity compared with conventional surgery. These open operations require a skin cut in the groin, division and splaying of the outer most muscle layer to create a space for the mesh to be placed. The damaged tissue needs time to heal. In addition the nerve supply to the groin runs through the field of dissection of open surgery and pain, both in the short and long term, are greater in open mesh repairs compared to the keyhole operation.
Unfortunately, keyhole surgery is not suitable for everyone and surgery is tailored to each individual. For example, keyhole surgery requires a general anaesthetic and there is a minority of people in whom this will not be safe, and an open procedure under a local anaesthetic may be suitable.
Hernias don’t go away on their own, only surgery can repair a hernia. Many people are able to delay surgery for months or even years. Some people may never need surgery for a small hernia. However, over time, hernias tend to get bigger as the muscle wall of the belly gets weaker and more tissue bulges through.
Many doctors recommend surgery to prevent a rare but serious problem called strangulation. This occurs when a loop of intestine or a piece of fatty tissue is trapped inside the hernia and is cut off from its blood supply.
What happens before, during and after the Hernia Treatment?
Before the operation
As with any operation, making minor lifestyle changes such as losing weight and stopping smoking are very beneficial for recovery. If you know that you have problems with your blood pressure, heart, or lungs, ask your doctor to check that these are under control.
Ensure that you have a relative, partner or friend who can come with you to the hospital, take you home, and be around for the first day or so. You will not be required to shave the groin before surgery.
Your hospital stay
Although recovery time after keyhole surgery is shorter than conventional surgery, there is a likeliness of some discomfort with moving and walking. Pain can be relieved by taking regular painkilling tablets such as paracetamol or ibuprofen for the first day or so. It is encouraged that gentle movement is made early on after the operation to prevent stiffness. Occasionally patients may experience difficulty passing urine especially if there is a background of prostate trouble and if a bilateral hernia is repaired. If you cannot achieve a good urine flow after 6 hours, contact a medical professional. The small skin incisions are usually closed with a dissolvable stitch that melts away as the wounds heal. You will be able to shower or bathe as soon as you feel ready and salted water is not necessary. Patient can affect to be reviewed a couple of weeks after their operation to make sure that the treatment has been successful, by which time most are back at work.
After care
Patients are able to resume most activities as comfort permits and progressively strenuous activity is encouraged. Drink plenty of fluids and fibre to avoid constipation, which could lead to straining. You may resume sexual activities as soon as this feels comfortable. You can resume driving as soon as you feel safe to perform an emergency stop, usually within one to two week of surgery. Please check with your insurance company as policies can vary with different companies.
There are rarely any serious complications which can arise after hernia treatment. It is common for scrotal swelling to happen after surgery, due to the carbon dioxide, as this can stretch the abdominal cavity and diaphram and refer pain to the shoulder tip. Both of these resolve quickly and spontaneously. Patients may experience difficulty when passing urine post operation, however this is common and usually is resolved quickly. Occasionally a tube into the bladder (a Catheter) is required as a temporary measure. Surgery may unmask an existing problem with the prostate that should have attention at some stage anyway. Bruising is common and resolves spontaneously. A tender lump may appear in the days after surgery, this may be a collection of fluid called a seroma that can easily be drained. Occasionally infection at the port sites may develop needing antibiotics. Longer term there is about a 1 to 4% chance the hernia may recur. Chronic groin pain occurs in a similar percentage although this is much less than encountered with the open conventional approach.
Key hole hernia surgery achieves a more rapid recovery and return to every day activity compared with conventional surgery. These open operations require a skin cut in the groin, division and splaying of the outer most muscle layer to create a space for the mesh to be placed. This damaged tissue needs time to heal. In addition the nerve supply to the groin runs through the field of dissection of open surgery and pain, both in the short and long term, are greater in open mesh repairs compared to the key hole operation.
Keyhole surgery is not suitable for everyone and hernia surgery is tailored to the individual. For example, keyhole hernia surgery requires a general anaesthetic and there is a minority of people in whom this will not be safe and an open procedure under a local anaesthetic may be more suitable.
A hernia most usually presents as a lump or swelling in the groin. The lump often disappears when lying and reappears on standing, coughing or straining. Occasionally pressure is needed to push the lump back and it may be associated with s gurgling or clicking sensation. A sense of dull ache may be reported. Often groin pain can be associated with a hernia in the absence of a palpable lump and a scan may be necessary for clarification.
A hernia is a blow out injury that occurs at a site of weakness in the abdominal wall leading to a protrusion of the lyning of the abdominal cavity called the peritoneum. This protrusion is akin to the inner tube of a bike wheel pushing through a hole or weakness in the tyre wall. creating a bulge. Areas of weakness include the groin (inguinal hernia), the belly button (umbilical hernia) and separation of a surgical wound (incisional hernia). The weakness can be compounded by those who partake in heavy lifting, in the elderly, in obese people and those with certain medical conditions.
Although you may not need to give up on exercise completely, you may need to modify your usual routine. You should avoid taking part in high intensity workouts such as lifting weights, exercises that involve pulling or pushing, or high contact activities like wrestling or football. This is to help put less pressure on the abdomen. You can consider alternative workouts such as yoga, walking, swimming, water aerobics or biking. Low impact movements are less likely to worsen the state of the hernia and its symptoms.
The recommended hernia repair surgery is a laparoscopic surgery, which involves making smaller incisions compared to an open surgery. Laparoscopic surgery is minimally invasive, has fewer associated risks, and recovery is much faster. However, the type of surgery that is performed is dependent on your situation.
Recovery time for double hernia surgery can vary for each patient depending on their condition. Around a week to a fortnight following key hole surgery normal activities such as driving and light exercise can resume but heavy lifting and strenuous activity may take a little longer. It is always recommended to seek your doctor’s advice before doing anything strenuous.
Laparoscopic hernia repair surgery usually takes about 30 to 45 minutes to complete. You will also likely be able to go home on the same day.
The main symptom is a visible bulge in your groin area. There are two types of hernias, hernias that go back and forth through the opening in the abdomen, and hernias that cannot be moved back into the abdomen (incarcerated hernia).
Symptoms of hernias that go back and forth are: a bulge that increases in size when you strain and disappears when you lie down, sudden pain in your groin or scrotum when exercising or straining, and a feeling of weakness, pressure, burning, or aching in your groin or scrotum.
Symptoms of incarcerated hernias are: sever pain and redness, pain that keeps getting worse, fever, rapid heart rate, and nausea and vomiting.
Yes, definitely. If your hernia is not causing you any pain or discomfort, it is possible to still lead a normal life. Although there is a risk of an emergency from any hernia such as incarceration or strangulation, a painless hernia will usually (but not always) start causing discomfort before an emergency.
Most hernias need surgical repair but not always right away. If you have a small or mild hernia that only comes out occasionally, you might be advised to wait and watch. Hernias do tend to worsen over time, which is why providers recommend repairing them.
You and your doctor may put off surgery if:
1. The hernia is small and you don’t have any symptoms, or if the symptoms don’t bother you much.
2. The hernia can be pushed back into the belly or it goes away when you lie down. If it cannot be pushed back, surgery must be done sooner.