What is a hernia?
What causes a hernia?
The aetiology of abdominal wall hernias is multifactorial. Factors including obesity, aging, chronic cough, and physical activity requiring frequent heavy lifting, such as construction work are thought to be implicated in their development. Furthermore, certain rare medical conditions such as collagen vascular disease or genetic defects involving connective tissue may also cause contribute to development of abdominal wall hernias.
What symptoms does a hernia cause?
Most hernias can be felt or even seen as bulges on the abdominal wall, particularly in thin individuals. They don’t always cause symptoms. Symptoms attributed to an abdominal wall hernia include pain, a feeling of pressure or a pulling sensation, especially during physical exercise or abdominal muscle straining.
If a patient with an abdominal wall hernia has any of the symptoms above, a consultation with a general surgeon is recommended as a surgical repair may be required.
Furthermore, on the emergency setting, hernias may present acutely with severe abdominal pain, persistent vomiting, skin redness over the hernia and inability of the patient opening their bowels or passing flatus. In this scenarios, intestine (usually small) may be trapped within the hernia defect and emergency surgery may be required to avoid further complications.
How is an abdominal wall hernia repaired?
In broad terms a hernia can be repaired by either the conventional open approach which involves an incision over the hernia or the more modern minimal access approach (laparoscopic surgery). The approach chosen may be affected by many factors including the type/size of hernia, emergency or elective setting, presence of large scars from previous abdominal surgery, patient comorbidities and the expertise of the surgeon.
The aim of the repair is to reduce the hernia contents back to the abdominal cavity and close the defect either with the use of mesh or sutures.
What are the possible complications following a hernia repair?
The complications that may be encountered following a hernia repair are those that may be encountered following any type of abdominal surgery [bleeding, infection (wound/chest) and injury to adjacent structures]. Procedure specific complications include recurrence of the hernia (rate varies depending on type of hernia/patient factors), fluid accumulation (seroma), mesh infection (rare), nerve injury which may cause altered skin sensation locally or less frequently chronic pain and post-operative difficulty with urination (mainly male patients).
What are the possible complications following a hernia repair?
This depends on the type and size of the hernia. In most cases following repair of hernias located in the groin and anterior abdominal wall (epigastrium/umbilicus) the patients spend 1 day in the hospital. They can mobilise on the day of the surgery and in cases where a laparoscopic method has been used they experience very mild post-operative pain.
In cases where a larger hernia is repaired (e.g. incisional hernia) the hospital stay may be up to 5-7 days. The general advice to patient regardless of the location of the hernia is to avoid strenuous exercising and heavy lifting for 6 weeks following the hernia repair.
What is the recovery following repair of a hernia?
This depends on the type and size of the hernia. In most cases following repair of hernias located in the groin and anterior abdominal wall (epigastrium/umbilicus) the patients spend 1 day in the hospital. They can mobilise on the day of the surgery and in cases where a laparoscopic method has been used they experience very mild post-operative pain.
In cases where a larger hernia is repaired (e.g. incisional hernia) the hospital stay may be up to 5-7 days. The general advice to patient regardless of the location of the hernia is to avoid strenuous exercising and heavy lifting for 6 weeks following the hernia repair.