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Hernia

What is a hernia?

A hernia develops when tissue or organs, such as intestines, protrude through a weakened section of the abdominal wall, forming a lump in the abdomen or groin. 1

Hernias are typically classified into the below sub-types:

  • Inguinal hernia – the bowel or abdominal tissue protrudes through a weakened section of abdominal wall in the upper groin region (inguinal canal)1
  • Femoral hernia – the bowel or abdominal tissue protrudes through a weakened section of abdominal wall in the lower groin region (femoral canal)1
  • Umbilical hernia – the bowel or abdominal tissue protrudes through a weakened section of abdominal wall near the naval (belly button)1
  • Hiatal hernia – a section of the upper stomach protrudes through the oesophageal hiatus opening in the diaphragm2
  • Incisional hernia – the bowel or abdominal tissue protrudes through a surgical incision in the abdominal wall1

 

Signs and symptoms of hernias

Symptoms of hernias can depend on the severity and location and some people may experience no symptoms.

However, common signs and symptoms include:1,2

  • A lump or bulge (hernia) in the abdomen or groin, which emerges when standing up and disappears upon lying down
  • Frequent pain or discomfort, particularly when heavy lifting, coughing, or straining
  • A heavy, pulling sensation near the lump

 

Diagnosis

If experiencing signs and symptoms of a hernia, it is important to visit a clinician for a diagnosis and treatment plan. Your clinician will perform a physical examination of the abdomen or groin area to examine the lump or bulge.2 Diagnostic tools may include an ultrasound, CT or MRI scan.2

Treatment

Surgery is recommended for most hernias to prevent complications like obstruction of the bowel and strangulation of the tissues. However, umbilical and hiatus hernias may be observed or treated with medication. Most abdominal hernias can be surgically repaired.

This may include:

  • Laparoscopic hernia repair – a series of small incisions are made in the abdomen to remove or repair the hernia defect using synthetic mesh. A laparoscope is inserted through one incision to examine the hernia. Laparoscopic instruments are inserted through other incisions to reduce or repair the hernia.2
  • Open hernia repair – an incision is made in the abdomen to re-position the protruding tissue and repair the weakened area of the abdomen wall with synthetic mesh. This surgical method may be performed under local, spinal or general anesthetic and the opening is repaired with mesh.2

 

Frequently asked questions

What causes hernias?

Certain risk factors can play a role in the development of hernias. These include:

  • Family history of hernias
  • Congenital conditions
  • Increased abdominal pressure including heavy lifting, frequent coughing, obesity, pregnancy or constipation
  • Weakened abdominal muscles due to surgeries
  • Ageing
What are the benefits to laparoscopic surgery in comparison to open surgery?

Laparoscopic surgery is performed through several small incisions to the abdomen, usually 0.5cm to 1cm in size, while open surgery involves a much larger incision. Laparoscopic surgery reduces postoperative pain and the amount of analgesia required compared to open surgery, leading to a faster recovery and early return to your normal lifestyle.

References

For a full list of references, click here.
  1. healthdirect (2019). Hernias. Accessed on 18 November 2019 from https://www.healthdirect.gov.au/hernias
  2. Mayo Clinic (2019). Hiatal Hernia. Accessed on 18 November 2019 from https://www.mayoclinic.org/diseases-conditions/hiatal-hernia/symptoms-causes/syc-20373379

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