Hernia

What is a hernia?

A hernia is a weakness in the wall of the abdomen which allows a pouch of fatty tissue or bowel to push through.  This causes a swelling which can change size as the contents slide in an out of the pouch.  If these contents can be pushed back, the hernia is called ‘reducible’.  If they can’t be pushed back, it is called ‘irreducible’.

Common sites for hernias to occur

Common sites for hernias to occur

 

What is the difference between the hernia?

The different sorts of hernia refer to where they are in the body.
For example: see picture

How is the hernia caused?

A weakness in the muscles is the basic problem.  This can be:

  • Congenital, as when a baby is born with a hernia or
  • The weakness can develop in later life due to over straining.

What happens if the hernia is not treated?

If your bowel becomes blocked, you will have abdominal pain and may start vomiting, in which case you must contact your GP immediately.  Or, if the hernia becomes painful, tender and red, it may have become strangulated and you must contact your GP immediately.

What treatment is there?

The ideal treatment for a hernia is surgical repair.  However, because of age or other medical reasons, your hernia may not be suitable for surgery.  If the contents of any inguinal hernia can be reduced (returned into the abdominal cavity) a truss may be more suitable.

What is a truss?

A truss can only be used for reducible inguinal hernias.  It is a pad that you wear over the place where there is weakness in the muscle wall.  If you wear it when you are walking around, it prevents the pouch from pushing through the weakness. Very rarely this is advised.

Is there anything I should watch out for when using a truss?

If the truss is not holding back the swelling, you should see your doctor.  You may need:

  • an operation or
  • the truss changed for a more effective one.

What happens during a surgical repair?

We do this operation in hospital under either local or general anaesthetic.

Two surgical options are available:

1.    Open Repair
2.    Laparoscopic repair(TAPP)- to discuss this repair please contact the specialist

Open repair

We usually make the incision near the site of the swelling.
The contents of the pouch are put back inside the abdomen.
The pouch is removed.

The weakness in the muscle wall is then strengthened with stitches or a patch of nylon material

Is there anything I should watch out after my operation?

1.    There will be some discomfort and tenderness where the cut are made.  Simple painkilling tablets relieve most of the discomfort.  Follow the instructions carefully.
2.    It is important that you try to walk normally as soon as possible.  This will help you to overcome the stoop which comes naturally from having had an operation in that part of your body.

What complications can occur?

Most patients experience no complications.  However, some patients have bruising.

Will I need to have my stitches taken out?

The skin stitches are usually dissolvable.  If not, we will tell you when to have them removed.  This is usually after 7-10 days.

What can I go back to work?

This depends on the type of hernia being repaired and the method of repair used.  For most hernia you can return to work of full activity when you feel able, but most people need at least a couple of weeks to fully recover.

Aru offers hernia repairs under Local anaesthetic or General anaesthetic at Duchy Hospital, Truro or Probus surgery. Laparoscopic techniques are also offered by him at the Duchy Hospital.  These are offered based on individual circumstanses and patient choice and  can be discussed at your consultation.

Videos of Interest

Laparoscopic Inguinal Hernia Repair(TAPP)