Hernia Repair Surgery

A hernia is a tear in the muscle or tissue that allows part of your fatty tissue or internal organs to protrude through a weak place in the surrounding connective tissue or muscle wall.  They are commonly seen in the stomach, and certain activities such as bending or lifting heavy objects can worsen the condition.  If this occurs, you may require hernia repair surgery.

Many hernias occur in the abdomen between the chest and hips, but they can also appear in the upper thigh and groin area.  Although they are not life threatening, they do not disappear on their own and often require hernia repair surgery to prevent dangerous complications.

Types of Hernia

Inguinal Hernia

These are the most common types of hernia and occur when the intestines push through a weak spot or tear in the lower abdominal wall, often into the inguinal canal. They are more common in men as the inguinal canal is found in the groin, the area where the spermatic cord passes from the abdomen to the scrotum.  The testicles descend through the inguinal canal shortly after birth, with the canal supposedly closing almost completely behind them.  However, if the canal does not close properly, it can leave the area weakened and more vulnerable to developing a hernia later in life.

Learn more in inguinal hernias here

Femoral Hernia

A femoral hernia occurs when tissue pushes through a weak point in the lower abdomen where there is space for the femoral artery and vein to pass from the abdomen into the thigh.  It usually feels like a small to medium sized lump in the groin and is more common in women due to their wider bone structure.  Due to the close proximity of the femoral artery and vein, it is possible that the hernia could block blood flow to and from the leg, and so surgery is usually required to correct this type of hernia.

Learn more on femoral hernias here

Hiatal Hernia

A hiatal hernia occurs when an individual’s stomach protrudes up through a weak point in the diaphragm; the muscle that separates the lungs from the abdominal organs and help you breathe by contracting and drawing air into the lungs.  This type of hernia is most common in people age 50 and above. If a child develops a hiatal hernia, it is generally caused by a congenital birth defect.

Umbilical Hernia

Umbilical hernias generally occur in babies and young children when their intestines protrude through the abdominal wall near the bellow button.  They are more noticeable when the child is crying, when you are more likely to notice a bulge in or near the child’s belly button.  Unlike other hernias, umbilical hernias are the only type that often go away without any treatment, because the abdominal wall muscles get stronger as the baby/child grows.  However, if the hernia has not gone by the time the child is age 5, surgery is typically recommended to correct it.

Learn more on umbilical hernias here

Epigastric Hernia

An epigastric hernia occurs in the epigastric region of the abdomen, located above the bellow button and below the ribcage.  Signs of an epigastric hernia include pressure on the abdominal wall, particularly when you cough, laugh or strain.

Learn more on epigastric hernias here

Incisional Hernia

Incisional hernias can occur following stomach surgery that involves an incision down the middle of the stomach.  If the surgical wound did not heal completely, the patient is more susceptible to developing this type of hernia.  Another term used for an incisional hernia is a ventral hernia, although not all ventral hernias are incisional hernias.

Ventral Hernia

A ventral hernia occurs when the tissue protrudes through an opening in the muscles of the abdomen.  The size of the hernia is usually larger when you are standing, compared to when you are lying down.  Ventral hernias are usually acquired at some point during your lifetime rather than at birth. Common causes include obesity, strenuous activity and pregnancy.  They can also occur at the site of a surgical wound and can happen due to surgical scarring or weakness of the abdominal muscles at the surgical site.

Causes of a Hernia

The cause of a hernia varies depending on the type of hernia, but in general, muscle weakness and strain are the main reasons why you might develop a hernia.  When pressure occurs in the same area as a weakened muscle or tissue, a hernia is likely to form.  They can develop quickly or over a period of time.  Common causes of muscle weakness or strain include:

• Damage or injury from surgery (an organ or tissue pushing through an incision)
• Strenuous exercise such as lifting weights
• Picking up heavy objects, particularly if lifting them in the wrong way with weak muscles
• Obesity and poor diet
• Smoking
• A family history of hernias
• Ageing
• Strained movement such as sneezing, coughing and constipation
• Multiple pregnancies
• Fluid in the abdomen
• A congenital condition that occurs during development in the uterus and is present at birth
• Tumours or masses in the abdomen

Symptoms of a Hernia

The most common symptom of a hernia is a bulge or lump where it has pushed through, usually in the groin or abdomen.  Other symptoms can include:

• A burning sensation due to inflammation in the region
• A sharp or tearing pain, particularly if it is caused through heavy lifting
• A feeling of fullness
• A cough and chest pain
• Heartburn
• Difficulty swallowing
• Nausea and vomiting
• Constipation

Diagnosing a Hernia

A hernia is most commonly diagnosed with a physical examination.  During the examination, your doctor will feel for a bulge in the abdomen or groin area; this will usually increase in size when you stand, strain or cough.  Your doctor will also take a medical history and ask you a range of questions.  These can include:

• When you first noticed the bulge or lump
• Whether there was something, in particular that you think caused it
• Your lifestyle, including leisure activities and how often you exercise
• Whether there is a history of hernias in your family
• Your employment and if your job involves any heavy lifting
• Whether you have undergone any previous surgeries in the groin or abdomen region
• Any other symptoms you are experiencing

Your doctor may also request imaging tests to further assess your condition and cause. These may include:

• X-rays
• MRI Scan
• Ultrasound
• Endoscopy

Treatment for Hernias

Treatment options depend on the type of hernia you have and your overall health.  If your hernia is not very large and causing you no pain, lifestyle adjustments will be recommended, such as eating a healthy diet high in fibre, stopping smoking and getting plenty of exercise.  If your hernia does not improve or is growing larger and causing pain, your doctor will likely recommend hernia repair surgery.

There are 2 types of surgery for the removal of hernias:

Laparoscopic Surgery

Laparoscopic (keyhole) surgery is a minimally invasive procedure where the surgeon will inflate your abdomen with a harmless gas to in order to gain a better look at your organs.  Small incisions are made near the affected area and a thin tube with a light and camera on the end (laparoscope) is inserted through them.  Images from the camera are then projected onto a monitor in the operating theatre to help guide the surgeon in repairing the hernia with a surgical mesh.  The purpose of the mesh is to act as a support for the weakened muscle or tissue.  Your surgeon will either use a temporary mesh that will absorb over time, working to strengthen your muscles and tissue, or a permanent mesh that provides long-term muscle support.

Open Surgery

If your hernia is very large, your surgeon will carry out your procedure using open surgery.  The surgeon will make an incision into your skin to open up the area for better viewing.  The hernia will either be pushed back into place, tied off or removed.  The weak muscles where the hernia pushed through are then stitches and surgical mesh is applied for extra support if required.  Your incision is then stitched and dressed.

You will be given a general anaesthetic before hernia repair surgery so you are asleep throughout the procedure and will not feel any pain.

Post-Operative Recovery

Hernia repair surgery is usually carried out as a day case procedure, so you should be able to go home the same day, provided there are no complications.  However, you will need someone to take you home, as you will not be able to drive for the first week following surgery.

Recovery from hernia repair surgery typically takes between 4-6 weeks, depending on whether you had open or laparoscopic surgery.  Recovery is generally faster with laparoscopic surgery, and patients can usually return to their normal routine approximately 1 week sooner than patients who had open surgery.

It is important that you follow the post-operative instructions once you return home; this involves getting plenty of rest, allowing the area to heal and taking light exercise such as short walks.  It is recommended that you have someone stay with you for the first few days following your surgery, as you will be limited in the activities you can undertake around the home.

It is likely that you will feel tired or confused for the first 2-3 days following your surgery.  This can be a side-effect of the general anaesthetic or prescribed pain medication.  During this period, you should not drive, drink alcohol or make any major decisions.

You should be able to return to work approximately 1-2 weeks following hernia repair surgery, although if your job is strenuous you will probably need to take about 4 weeks off work.

After 2 weeks, you should be able to return to light exercise such as jogging, cycling and swimming, and by week 4, you can return to all activities, including contact sports and lifting weights.  You may still experience a little pain, but this will eventually subside.

Risks and Complications

Hernia repair surgery is a very safe procedure, but as with all invasive surgery, complications can arise.  These include:

• Infection at the wound site
• Blood clots
• Chronic pain
• Nerve damage
• Recurrence of hernia
• Bladder injury
• Bowel perforation or obstruction
• Rejection of surgical mesh

If you experience any of the below symptoms, it is important that you contact your doctor immediately:

• A high fever above 101^oF
• Increased redness from the incision
• Pus oozing from the wound site
• Excessive pain, swelling or bruising
• Stiffness in the abdomen
• Nausea, vomiting or other flu-like symptoms
• Difficulty urinating or passing stools
• Excessive gas

Outlook after Hernia Repair Surgery

Although hernia repair surgery is considered a very successful procedure, hernias can return.  It is therefore important that you minimise your risk of recurrence by following these guidelines:

• Maintain a healthy weight
• Stop smoking to reduce the risk of a recurrent cough
• Eat a healthy diet rich in fibre to reduce your risk of constipation
• Exercise regularly
• Use proper lifting techniques, particularly when lifting heavy objects

If signs and symptoms of a hernia do appear, contact your doctor immediately before it gets any worse.

Need Help?

Hernia repair surgery is available at One Ashford Hospital.  We also offer a number of other procedures, including, Gallbladder Removal surgery,  Haemorrhoid Removal surgery and Varicose Vein Removal.  We can book you in to see a specialist General Surgeon for an initial consultation, usually within 48 hours.

One Ashford Hospital is well placed to see patients for hernia repair surgery from Ashford, Canterbury, Maidstone, Dover, Folkestone and all surrounding areas of Kent.  Call us on 01233 423000 to find out more.

You can use your private medical insurance or pay for your Hernia Repair Surgery treatment. We offer competitive, fixed price packages. If you are using your health insurance, please contact your insurer first for approval and let them know you’d like to be treated at either the One Ashford Hospital or One Hatfield Hospital.

Why One Healthcare

• Modern purpose-built hospital opened in March 2016 (Ashford) December 2017 (Hatfield)
• Fast access to diagnostics including MRI, X-ray and Ultrasound
• 0% and low finance options**
• Private, spacious, en-suite rooms
• Specialist Physiotherapy and nursing teams
• Little or no waiting time
• ‘Ultra clean air’ theatres
• Freshly prepared food
• Calm, dignified experience

**Terms and conditions apply

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