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Universe Leung - General Surgeon

Private Service, General Surgery

Hernias

A hernia exists where part of the abdominal wall is weakened, and the contents of the abdomen push through to the outside. This is most commonly seen in the groin area but can occur in other places. The need for surgery depends on symptoms, and risk of complications. While the lump that the patient feels may come and go, the actual hernia will not resolve by itself, and surgery is the only definitive cure.

Surgical treatment is usually quite straightforward and involves returning the abdominal contents to the inside and then reinforcing the abdominal wall in some way. Hernia operations are usually done under general anaesthesia ("asleep"), but some patients may have them done awake, under spinal anaesthesia or even local anaesthesia. Some patients will stay overnight in hospital, while others can go home the same say (daystay surgery).

 

Inguinal and Femoral Hernia (Groin Hernia)

Groin hernias can be repaired via an open or laparoscopic approach. In open surgery an incision is made over the region of the hernia, the hernia is pushed back into position ("reducing" the hernia), and the weakness in the abdominal wall repaired. In laparoscopic surgery, usually 3 small incisions are made to allow a narrow tube with a tiny camera (laparoscope) to be inserted, and small instruments inserted to reduce the hernia and repair the weakness.

There are pros and cons to each approach. The use of prosthetic mesh is common and your surgeon can discuss the benefits and risks of using mesh.

 

Umbilical and Epigastric Hernia
Hernias can occur around or above the umbilicus (belly button). Most of these are repaired by making an incision over the hernia, reducing it and repairing the weakness in the abdominal wall. The use of prosthetic mesh is common and your surgeon can discuss the benefits and risks of using mesh.

 

Incisional Hernia
Incision hernias occur under a site of previous abdominal wall surgery, including incisions in the midline of the abdomen, above the pubis (such as after caesarean section or gynaecological surgery), and ports sites from previous laparoscopy. These can be repaired in an open fashion, or laparoscopically. The use of prosthetic mesh is common and your surgeon can discuss the benefits and risks of using mesh.

 

Diaphragmatic Hernia

Diaphragmatic hernias occur through the diaphragm. This may allow some abdominal organs to push through the weakness into the chest. A special type of diaphragmatic hernia is a hiatus hernia, which is very common and may or may not need surgery. Repair of diaphragmatic hernias may be done open or laparoscopically, and is often more complex than abdominal wall hernias.

 

Recurrent Hernia

Hernias can come back after surgical repair, sometimes months or years later. These can be repaired again, using a similar or different method.

This page was last updated at 12:31PM on October 26, 2021.