Hernia Surgery

What is a hernia?
A hernia is caused by a weakness in the abdominal wall muscles. This weakness allows the contents of the abdomen to bulge through the gap and form a lump under the skin, which can be seen or felt by the patient. The lump is usually more prominent when coughing or straining, as these activities raise the pressure in the abdomen and force the contents out through the weakness in the wall.

Although hernias can occur anywhere in the abdominal wall, some sites are more common than others.

The weakness in the wall can be present at birth, although the hernia may not be noticeable until much later. Men are more likely to get certain types of hernias (inguinal hernias) because of the spermatic cord making a hole in the wall of the abdomen.

• Hernias are very common.
• They affect an estimated 2 – 3 % of the population at any one time.
• Over 110,000 hernia repairs are done every year in the UK .
• The reason for repairing a hernia is that over time they tend to get bigger. They do not get better on their own.
• There is a small risk that an untreated hernia might ‘strangulate’. Repairing the hernia eliminates this risk.
• To date, there are no methods of repairing a hernia that do not require an operation.
• Most doctors feel that hernias should be repaired by some sort of surgery.

The different types of abdominal wall hernia

Inguinal Hernias are the most common type of hernia. They usually are noticed as a lump in the groin, which may be painless or tender. Usually the lump is 'reducible' - which means it can be pushed back in. A big inguinal hernia can extend into the scrotum. When a hernia occurs for the first time it is said to be a 'primary' hernia. Occasionally a hernia can recur after an operation to repair it (recurrent hernia). This occurs less commonly these days than in the days before mesh repairs became available.

Femoral Hernias are more common in women than men. They are important because they are quite likely to strangulate and should be repaired promptly. The lump is usually felt in the top of the thigh, below the groin crease.

Epigastric Hernias are caused by weaknesses of the abdominal wall at the front. They are felt as a lump in the upper abdomen, above the belly button. They tend to occur more frequently in middle aged people and can affect either men or women.

Umbilical Hernias occur around the umbilicus, or belly button. The bulge pokes out through the weakness in the abdomen left by the remnants of the umbilical cord. Incisional Hernias occur through scars caused by previous surgical incisions in the abdomen. The defects can often be quite large and sometimes difficult to repair.

Incisional Hernias occur through scars caused by previous surgical incisions in the abdomen. The defects can often be quite large and sometimes difficult to repair.

Occasionally a hernia can recur after an operation to repair it (recurrent hernia). This occurs less commonly these days than in the days before mesh repairs became available.

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