Hernia

There are several types of hernias, the most common of which are:

• Inguinal hernia - Accounting for around 70% of all hernias, inguinal hernias occur when the intestine or bladder protrudes through the lower abdominal wall or the inguinal canal in the groin, which houses the spermatic cord that supports the testicles (men) and the ligament that keeps the uterus in place (women). This type is more common in men than women.
• Hiatal hernia - This occurs when the upper part of the stomach juts out of the abdominal cavity through the esophageal hiatus, an opening in the diaphragm that holds the esophagus and vagus nerve.
• Umbilical hernia - Common in newborns and babies under 6 months, umbilical hernias develop when part of the small intestine squeezes out of the abdominal wall near the navel (belly button). It is harmless and typically goes away on its own by the time the child reaches one year old.
• Femoral hernia - Similar to inguinal hernias, femoral hernias occur in the groin, but these more commonly affect women, especially those who are pregnant or obese. This type of hernia happens when the intestine pushes out of the lower abdominal wall and into the femoral canal in the upper thigh.
• Incisional hernia - This occurs when the intestine protrudes out of the abdominal wall via a previous incision or weakened tissues and muscles in an old surgical site.

Hernias may be painless and asymptomatic, or may only cause mild to moderate discomfort. However, apart from umbilical hernias, most types of hernias do not go away on their own, and left untreated, can lead to serious complications.

A hernia may be repaired by two types of hernia surgery:

• Herniorrhaphy (Tissue Repair)Traditionally performed via open surgery, herniorrhaphy involves creating an incision over the site of the hernia. The displaced organ is manually placed back to its normal position, and the opening from which the organ protruded is stitched closed. The initial incision is also sutured and applied with dressings to facilitate healing. Herniorrhaphy may be done laparoscopically.
• Hernioplasty (Mesh Repair)For larger hernias where the displaced organ cannot be pushed back through the cavity, the hernial sac may be repaired by covering it with a surgical mesh. This process, called hernioplasty, stitches a mesh patch made of animal tissue or polypropylene over the cavity. This patch will then be used by the damaged or weakened tissues and muscles as a support during regrowth. Similar to herniorrhaphy, hernioplasty can be performed via laparoscopic surgery.

As with most surgical procedures, however, hernia repair comes with possible risks. These include:

• blood clotting
• pain and swelling
• mesh pain and infection
• excessive bleeding or infection at the surgical site
• tissue, nerve or organ damage
• recurrence of hernia
• seroma or fistula formation
• haemorrhage at the incision site
• negative reaction to sedatives