What is a hernia?
A hernia is a lump that occurs when some of the contents of the abdomen push through a weakness in the muscles of the abdominal wall. The aim of a hernia repair operation is to push the intestine back in place and strengthen the abdominal wall.
If you do not have your hernia treated it can become larger and uncomfortable. In some cases, part of the intestine can get twisted inside the hernia, cutting off the blood supply. This is known as a strangulated hernia and, although rare, would need emergency surgery.
There are a number of different types of hernia:
Umbilical hernia
When the hernia occurs at the navel (belly button), it is called an umbilical hernia.
In children, umbilical hernias often heal without surgical treatment. But an operation may be needed if the hernia doesn’t go away within a couple of years. If an adult develops an umbilical hernia, surgical treatment is usually recommended, as the hernia will not get better on its own.
The operation is usually done as a day-case, with no overnight stay in hospital. Umbilical hernia repair is usually performed under general anaesthesia, which means you will be asleep during the procedure and will feel no pain. Small umbilical hernias can sometimes be repaired under local anaesthesia, which means you will be awake but the area will be completely numb.
Once the anaesthetic has taken effect, the surgeon makes an incision just below your belly button. The surgeon will then push the bulge back into the abdomen and use dissolvable stitches to close the gap in the abdominal wall. Usually a piece of mesh is stitched in place to strengthen the repair. The skin incision is then closed with more stitches. Alternatively, if stitches aren’t needed, paper strips will be used. The wound will be covered with a waterproof dressing.
The operation usually takes about 45 minutes.
Inguinal hernia and femoral hernia
When the hernia occurs in the groin it is either an inguinal or femoral hernia.
Inguinal hernia
In some cases, the operation is an open repair, which involves a small cut in the groin. Alternatively, laparoscopic (keyhole) surgery may be recommended. Your surgeon will discuss which is the most suitable approach for you.
The operation may be done under general anaesthesia, which means you will be asleep during the procedure. The open repair can also be done under epidural or regional (local) anaesthesia. This means you will be awake during the operation but the groin area will be completely numb.
The operation is usually done as a day-case, but some patients may need to stay overnight in hospital.
Open inguinal hernia repair
A single cut (about 5 to 10cm long) is made in your groin, and the bulge is pushed back into place. Your surgeon may stitch a synthetic mesh over the weak spot to strengthen the wall of the abdomen. The skin cut is then closed with dissolvable stitches.
Laparoscopic inguinal hernia repair
About two or three small cuts (1 to 2cm long) are made on your lower abdomen and groin under general anaesthesia. Your surgeon will insert a tube-like telescopic camera to view the hernia either by looking directly through this, or at pictures it sends to a video screen. The hernia is repaired using specially designed surgical instruments passed through the other cuts. A synthetic mesh may also be used to strengthen the wall of the abdomen. The skin cuts are closed with dissolvable stitches.
The operation takes 30 to 50 minutes.
Femoral hernia
When the hernia is forced from the abdomen through the femoral canal, it is called a femoral hernia. All femoral hernias require an operation to repair them because of the high risk of serious problems if they are left untreated.
Femoral hernia repair is carried out under general or regional anaesthesia and is normally carried out as a day-case, although sometimes an overnight stay may be necessary.
A single cut (about 10cm long) is made in your groin or abdomen, the femoral canal is opened and the bulge is returned. Your surgeon may stitch a synthetic mesh to the femoral canal to strengthen it.
Alternatively a laparoscopic approach may be used.
Incisional hernia
An incisional hernia results from a weakness in the abdominal wall caused by previous surgery to that site. It usually happens within two years after the initial surgery.
An incisional hernia repair is usually done under general anaesthesia, and as a day-case, with no overnight stay.
Your surgeon will make a cut in your abdomen and carefully put the hernia back into place. For larger incisional hernias, a synthetic mesh may be stitched over the weak spot to strengthen the wall of the abdomen. The cut is then closed with stitches.
Your surgeon will explain the benefits and risks of having your hernia repaired, and will discuss any alternatives to the procedure.
Immediately after surgery, you are likely to have some pain, swelling and bruising in the abdomen and/or groin area. These side-effects can be milder after key-hole surgery, and usually clear up during the first week, without further treatment.
Hernia repair is a commonly performed and generally safe surgical procedure. For most people, the benefits are much greater than the disadvantages. However, all surgery carries an element of risk.
The possible complications of any operation include an unexpected reaction to the anaesthetic or developing a blood clot, usually in a vein in the leg (deep vein thrombosis – DVT).
Other complications include infection, which can be treated with antibiotics, and excessive bleeding, which may require further surgery. There is a small risk of damage to nearby organs and tissues during the operation.
In the longer term, there is a small chance of continuing pain or numbness around the area. It is uncommon, but possible, for the hernia to reappear. These are called recurrent hernias.
The chance of complications and recurrence of your hernia depends on the exact type of operation you are having and other factors such as your general health. You should ask your surgeon to explain how any risks apply to you.
To find out more about having hernia surgery in a Spire Healthcare hospital, please call our treatment enquiry team on 0800 434 6600.
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