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Hernias

Hernias

A hernia is a weakness in the usually strong abdominal muscle, which allows abdominal contents such as fat or bowel to push out.  This leads to a bulge which is usually more prominent when standing up or coughing.  Most of the time the bulge will go back in spontaneously, or may require manual pressure.  This may lead to discomfort or pain which is worse towards the end of the day.  Occasionally, the contents of the hernia may become trapped or ‘incarcerated’.  This can be a serious problem if bowel becomes trapped as it may lose its blood supply – it needs to be fixed urgently.

Risk factors for hernias forming include anything which increases the pressure inside the abdomen such as heavy manual labour, smoking, chronic coughing etc.

The most common area for hernia is the groin (Inguinal hernia), but they may also occur elsewhere in the abdomen such as the belly button, or in a poorly healed incision from a previous operation.

Laparoscopic or keyhole repair involves a small incision at the belly button, and two smaller incisions below that. A camera and instruments are inserted to pull the hernia back in and place a mesh over the hole from the inside.

The options for repair include open surgery with a cut on the tummy over the hernia to find the weakness and put a mesh, or laparoscopic (keyhole) surgery to put a camera inside the tummy and place a mesh from behind.

Bleeding and infection are risks of any surgery

Significant bleeding may track down into the scrotum and lead to bruising which will resolve on its own

There is the potential risk of injury to the structures in the groin canal such as the blood vessels, nerves, vas deferens (sperm tube), as well as injuring other organs such as intestine or bladder.

Some patients have difficulty urinating immediately after the surgery and may require a short-term catheter in the bladder for 24-48 hours

In the longer term there is a small risk of recurrence (the hernia coming back) and chronic pain may occur if a nerve is caught in the mesh

You may be able to go home the same day, or the following day.  You will be a bit uncomfortable for a few days after and may require some pain-killers.  You should be able to walk freely, but avoid any strenuous activity or heavy lifting for a few weeks afterwards.

Hernia

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