A hernia is a medical condition where part of an organ or fatty tissue abnormally exits the cavity it usually resides, most common being the intestine exiting the abdominal cavity. This occurs when the organ part or fat tissue pushes through gap in weakened abdominal muscles, or any other gap surrounding the cavity.
Types of hernia
Depending on where the hernia exits the cavity, hernia can be classified into several types. The following is a non-exhaustive list of the most common types of hernia
- Inguinal hernia
This is the most common type of hernia that occurs when intestines exit the inguinal canals. These are passages in the lower abdomen/groin area which the spermatic cords (males) or the round ligament of the uterus (females) lie.
The intestines can more easily enter the groin area or scrotum in males via these canals. Inguinal hernia is more likely to occur in males as they have large inguinal canals compared to females.
- Umbilical hernia
The umbilical/navel region is another common area of weakness where hernias can occur. In this case, a lump may appear in the navel region, and the navel may become inverted/extruded.
- Surgical incision hernia
This occurs when a surgical wound fails to heal properly and leaves a weakness in the muscle wall. Organs can then push through these weaknesses and form hernias
Causes and risk factors
Hernia can be caused by a variety of factors, most of which are associated with excessive stress in the abdominal area. Some of these causes include:
- Improper posture when lifting heavy weights
- Intense coughing bouts
- Trauma to the abdominal wall
- Intense exercise stressing the abdomen
- Straining of abdominal muscles doing bowel movement
Additionally, there are some risk factors that can increase the chances of hernia occurring.:
- Inguinal hernia is more common in males
- Weakness of abdominal muscles from:
o lack of exercise.
o Smoking and tobacco consumption.
- History of surgery in abdomen or groin area.
Signs and Symptoms of hernia
Some common signs and symptoms of hernia include:
- A lump at the site of extrusion. This lump may be visible, or can be discerned via touch.
- Pain, dull aching or a sense of general discomfort in the area
- Redness and swelling from inflammation of the surrounding skin
- A “dragging”, “friction” or heavy sensation in the affected area, especially in inguinal hernias.
However, it is possible for mild hernias to be completely asymptomatic until further complications develop. It is hence wise for even healthy individuals to go for regular medical examinations.
Possible complications of hernia
Hernias, if left untreated, often cause chronic pain and discomfort. Patients often have their mobility limited, which may affect their lifestyle. In the long term, some of these complications may occur
- The extruded organ may become inflamed, causing intense pain and discomfort
- Restriction and obstruction of bowel movement
- Organ rupture and internal bleeding
- Strangulation and possibly tissue death, if blood flow to the extruded part becomes too obstructed.
- Accumulation of serous fluid inside the hernial sac
- In severe cases, the hernia may become irreducible, meaning that it cannot be repaired even without complex surgery.
Although minor hernia may not affect your lifestyle much, it is recommended to seek medical advice from a doctor given the potentially serious complications.
Procedure of hernia repair surgery
Hernia repair is a fairly straightforward surgery procedure wise. Firstly, local or general anaesthesia will be administered. The surgeon will then make an incision at or around the affected region and gently push the extruded organ back into the abdominal cavity. The gap/weakness may then be covered with a sterile mesh if applicable to strengthen it and prevent recurrences. This can be performed as an open surgery where the hernia is directly exposed with the incision. Alternatively, the laparoscopic approach may be used. This is done by inserting a laparoscope (a thin, telescope/camera-like medical instrument) under the skin via a small incision near the navel. The surgeon will use the video image from the laparoscope to repair the hernia under the skin without exposing it. The laparoscopic approach is usually performed under general anaesthesia exclusively.
Hernia repair surgery generally takes 30 to 120 minutes to perform, depending on individual conditions and complexity of the surgery. In most cases, the patient can be discharged on the same day after a few hours of observation.
Before the surgery, it is important to take note of the following:
- Smokers should cease cigarette and tobacco consumption for about 2 to 4 weeks prior to the surgery to reduce the risks of complications
- Inform the surgeon of any medication or health supplements you are taking. You may be asked to stop certain blood thinners to prevent excessive bleeding during the surgery.
- Inform the surgeon of any past/current ailments or surgeries in the region, such as those involving the urinary tract. Special arrangements may need to be made for you before and during the surgeon
The surgeon and our clinic staff will provide you with more detailed instructions. Please adhere to them closely.
Hernia repair generally has little downtime has the surgery site is usually inconspicuous. Patients typically feel comfortable enough to return to sedentary work within a week. However, strenuous activities and exercise should be avoided for about 4 to 6 weeks as advised by the doctor.
Also, you may be required to wear a compression garment for several weeks to reduce swelling and facilitate recovery after the surgery.
Similarly, our surgeon and clinic staff will provide you with detailed post-surgery instructions to facilitate your recovery. Please adhere to them closely.