Hernia

A hernia is where Innards protrude through a weakness in the outer covering. This could be anywhere, such as fat bulging through the muscle of the lower eyelid causing eyebags or most commonly bowel protruding through the abdominal wall

There are several different types of abdominal wall hernia, with the most common being Inguinal hernia, when part of the bowel squeezes through the lower abdomen into the groin. This is mainly associated in men with a weakness of the testicular canal and can be initiated by the repetitive strain of coughing raising pressure in the abdomen. Although most of these types of hernias are thought to be a result of ageing, they can occur at any age, even babies.

The muscles in the abdomen become weaker, making the chances of an Inguinal hernia more likely. The extra strain of carrying or lifting heavy weights increase pressure within the abdomen or a just a persistent cough is enough to create an inguinal hernia.

A hernia repair or removal surgery is recommended if you have troublesome discomfort or the contents of the hernia becomes stuck pain and will not reduce back into the abdomen. These are early symptoms of bowel obstruction and may lead on to nausea, vomiting and severe pain. Eventually, the blood supply to the bowel is cut off and an emergency surgery is required.

At this point, we should mention the separation of the rectus muscles during pregnancy termed Diastasis or divarication of the recti muscles. It often remains after pregnancy and causes the unsightly bulge as the stomach muscles are tensed. Fortunately, the complication of strangulation does not occur. We treat this on its own or part of an abdominal reduction (abdominoplasty).

Other types of hernia include:

Hiatus Hernia – when the part of the stomach pushes into the chest through the diaphragm causing indigestion
Spigelian hernia – part of the bowel pushes between the edge of the abdominal muscles,
Femoral hernia – part of the bowel pushes through below the groin, mostly in women. These strangulate easily and need urgent surgery.
Incisional hernia – tissue pushes through a weak surgical wound in the abdominal wall.
Epigastric hernia – part of the bowel or fatty tissue pushes through the centre of abdomen, below the breastbone.
+ Umbilical hernia – a common hernia of the tummy button in children or after the pressures of pregnancy.

It’s important to receive a medical diagnosis from a doctor if hernia is suspected.

At Cadogan Clinic, our surgeons use all the best techniques for repairing or removing hernias, all of which require some form of anaesthetic. During your consultation you will be advised on whether you will need a local or TIVA, our gentle form of general anaesthetic, and which surgical technique is needed for your specific case.  This will all be done as a Day Case.

Treatment is recommended when you have a hernia that is causing you symptoms of pain, severe or worsening symptoms, and when serious complications occur.

Serious complications that require immediate medical attention at a hospital include:

+ Obstruction: Hernias can normally be reduced back into the abdominal cavity, however when the bowel becomes stuck back into the inguinal canal problems arise. Symptoms can include increasing pain, nausea, vomiting and a very tender lump in your groin area.

+ Strangulation: If the obstruction is allowed to remain, then eventually the blood supply is cut off due to due to a trapped section of bowel. This requires immediate medical intervention to release the trapped tissue before the bowel dies.

At Cadogan Clinic we repair hernias through open surgery, where an incision is made which allows the surgeon to push the lump back into the abdomen. This is always performed as a day case procedure. You will be able to return to your daily activities within a few days and should be fully recovered within a month.

Hernia repair and hernia removal are routine surgeries that have very few risks. It is possible that even after hernia surgery, the hernia can return.

Other complications are unusual, but you should know:

+ There will be some swelling and bruising in the testicles or at the base of the penis for men.
+ Numbness or discomfort in the groin area if a nerve becomes trapped or damaged during surgery.

Depending on the type of hernia you have, and the surgical treatment required, you will be able to go home the same day of the surgery. You should be able to return to your daily activities within a few days of surgery and should have a full recovery within a month. Your surgeon will prescribe you painkillers for any pain and discomfort you may have.

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