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What is a hernia?
Hernias happen when an internal part of the body pushes through a weakness in surrounding muscle or tissue.
Hernias can happen anywhere in your body, but they can be found most commonly between your chest and hips. A hernia forms a lump which you should be able to push back in and which disappears when you lie down. The lump may appear if you cough or strain.
There are four main types of hernia:
- Inguinal hernias are where fatty tissue or part of your bowel pokes through into your groin. It is the most common type of hernia; it mainly affects men and is associated with ageing and repeated strain on the abdomen.
- Femoral hernias are less common but present in similar ways to inguinal hernias – and they affect more women than men.
- Umbilical hernias are where the lump appears near the belly button. It is most common in babies although adults can also be affected, mainly as the result of repeated strain.
- Hiatus hernias happen when part of your stomach squeezes up into your chest through a weakness in your diaphragm. This sort of hernia may cause heartburn in some people and is usually treated with medication.
- There are other different types of hernia, including incisional hernias which may need repair.
When is treatment recommended?
For most, hernias do not present with any symptoms other than the lump itself. However, if you experience a number of symptoms including sudden, severe pain, vomiting, constipation or wind, a tenderness in the area of the hernia and being unable to push the hernia back in, this may mean that your hernia has become ‘strangulated’ and you should seek immediate medical treatment.
If you suspect you have a hernia, your first port of call should be to your GP who can assess you. He or she may decide that you need treatment, in which case you will be referred for a surgical consultation.
What does the surgery involve?
We specialise in keyhole (laparoscopic) and open surgery; keyhole surgery uses smaller incisions (cuts) but is more difficult, involving several smaller cuts which allow the surgeon to use various special instruments to repair the hernia.
Between two and four small incisions are made through the abdominal wall through which the surgeon passes a thin telescope with a light on the end (called a laparoscope) and the instruments needed to carry out the procedure.
The laparoscope allows the surgeon to see the hernia and observe the surgery, which is done through the incisions using long thin instruments.
The hernia and/or hole are covered with mesh from within the abdomen and staples are used to fix the mesh to the muscle tissue.
For an open repair, a single cut is made over the hernia; the hernia is replaced within the abdomen (tummy) and repaired with a mesh. This technique is still the most common hernia repair technique in Britain.
How long does the surgery take?
The procedure takes between 30 and 45 minutes for a routine groin hernia, but potentially much longer for an incisional hernia.
How long will I be in hospital and what are the results of surgery?
In most cases you will go home on the day of surgery and our team will give you post-discharge advice and support to ensure that your hernia repair heals properly. We usually do not need to see you after the operation but will telephone you to make sure you are recovering well. If you have followed our advice you should make a full recovery in a few weeks.
What are the risks and complications?
Irrespective of what type of hernia repair you require, complications are more likely if you’re over 50, you have another illness (such as heart disease or breathing problems), you’re overweight or you smoke.
A pre-operative assessment is our opportunity to ensure that the procedure for which you have been referred is right for you. We’ll explain your treatment to you and make sure that you are well enough to go ahead with it. It is also your opportunity to meet the team who will care for you and to ask any questions.
We carry out all the necessary tests and examinations in one outpatient session, except for specialised imaging tests which may require a repeat visit. While this can take several hours, everything is done in one go to save frequent visits before surgery.
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