What is a hernia?
A hernia occurs when an internal part of the body pushes through a weakness in the muscle or surrounding tissue wall. Your muscles are usually strong and tight enough to keep your intestines and organs in place, but a hernia can develop if there are any weak spots. The most common type is an inguinal hernia, which usually appears as a swelling or lump in your groin, or as an enlarged scrotum (the pouch containing the testicles). The swelling may be painful and the lump often appears when you're lifting something and disappears when you lie down. Other types of hernia include femoral hernia (also in the groin), umbilical hernia (near the tummy button), and epigastric hernia (high up in the tummy) and there are also some other rare hernias. An incisional hernia is a weakness in an old scar. The results of incisional hernia repair are better when the repair is performed by an expert surgeon with a lot of experience like Professor Lodge.
What causes a hernia?
A hernia usually occurs when fatty tissue or a part of your bowel, such as the intestine, pokes through a weakness in the muscles of the abdominal wall. In an inguinal hernia, it pushes through a weak spot in the surrounding muscle wall (the abdominal wall) into an area called the inguinal canal. Inguinal hernias occur mainly in men but they can also occur in women. Most are thought to result from ageing, although they can occur at any age. This is because as you get older, the muscles surrounding your abdomen (tummy) can become weaker. Hernias can sometimes appear suddenly after putting pressure on the abdomen, such as straining on the toilet if you have constipation or carrying and pushing heavy loads. They have also been linked to having a persistent, heavy cough.
When is surgery needed?
Most hernias should be repaired as there are risks associated with them. This is especially important if you have a hernia that causes pain, severe or persistent symptoms, or if any serious complications develop. Complications that can develop as a result of a hernia include:
Obstruction – where a section of the bowel becomes stuck in the hernia, causing nausea, vomiting and stomach pain, as well as a painful lump.
Strangulation – where a section of bowel becomes trapped and its blood supply is cut off; this requires emergency surgery within hours to release the trapped tissue and restore its blood supply, so it doesn't die.
Surgery gets rid of the hernia to prevent any serious complications, but there's a very small chance it could return after the operation.
What happens during surgery?
There are two ways a hernia repair can be performed and Professor Lodge will advise you which is best for you:
Open Surgery – where one cut is made over the hernia to allow the surgeon to push the lump back into the abdomen and then the defect is repaired internally with stitches or a small piece of artificial material called a mesh.
Laparoscopic (keyhole) Surgery – a technique where several smaller cuts are made in other parts of the tummy, allowing the surgeon to use various special instruments to repair the hernia again using an internal mesh.
There are advantages and disadvantages to both methods as every patient is different so treatment needs to be individualised.
How long does it take to recover?
Hernia surgery is routine for Professor Lodge, so you should be able to go home the same day or the day after surgery. Most people make a full recovery from hernia repair within three to six weeks, although return to normal activities including driving, work and light activities is usually possible within a few days.
What are the Risks?
Any operation carries risks, but thankfully these are rare with expertly performed hernia surgery. Risks depend on general levels of fitness and the type of hernia so Professor Lodge will be happy to explain all this in the clinic.