Surgical Conditions

Hernias

A hernia is a weakness or defect in the abdominal wall. It may be present from birth, or develop over a period of time. If the defect is large enough, abdominal contents such as the bowels, may protrude through the defect causing a lump or bulge felt by the patient.

Hernias develop at certain sites which have a natural tendency to be weak; the groin, umbilicus (belly button), and previous surgical incisions.

Signs and Symptoms

• Lump in groin area when standing/straining & disappears when reclining
• Pain at the site of the lump, especially when lifting a heavy object
• Swelling of the scrotum
• Excruciating abdominal pain (if you have strangulation)
• Nausea, vomiting, loss of appetite & pain (if intestinal obstruction occurs)

Course of hernia

Once a hernia has developed, it will tend to enlarge and cause discomfort. If a loop of bowel gets caught in the hernia, it may become obstructed or its blood supply may be cut off. This could then become a life-threatening situation. Since hernias can be repaired effectively and with minimal risk, most surgeons therefore recommend that hernias be repaired when diagnosed, unless there is serious medical problem which makes it too risky.

Treatment

Hernia repair (Surgery)

The standard method of hernia repair involves making an incision in the abdominal wall. Normal healthy tissues are cut until the area of weakness is found. This area, the hernia, is then repaired with sutures. Often a prosthetic material, or another plastic material, is sutured in place to strengthen the area of weakness. Finally, the skin and other healthy tissues that were cut at the beginning are sutured back together to complete the repair.

Newer methods of hernia repair involve minimally invasive laparoscopic techniques (key-hole surgery). Advantages:

• Smaller incisions
• Faster recovery
• Faster return to work
• Faster return to regular activities
• Less pain and requirement for pain relief
• Lower risk of nerve injuries which can cause numbness or pain
• Less consequences of wound infection
• With groin hernias both sides can be fixed at the same time through 3 tiny holes. Up to 15% of patients will have hernias on both sides.

Laparoscopic techniques of hernia repair are especially attractive when patients are dealing with recurrent hernias or bilateral inguinal hernias.