Hernia Repair - Incisional, Umbilical, Inguinal

What is a Hernia?

A hernia is a weakness or tear in the abdominal muscles or connective tissue which allows fatty tissue or an organ such as the intestines to protrude through the weak area or spot.

Characteristics of Hernia

• Can be congenital or develop over time
• Forms as a noticeable bulge under the skin
• Results in significant sharp and immediate or a dull pain along with discomfort to the patient
• Severe, continuous pain, redness, and tenderness are signs that the hernia may be entrapped or strangulated
• Symptoms become worse on when strain is put on the area including standing for long periods, during
• urination or a bowel movement, or on lifting heavy objects
• Most common types of hernia are inguinal (inner groin), incisional (resulting from an incision), femoral (outer
• groin), umbilical (belly button), and hiatal (upper stomach)

Inguinal Hernias

Inguinal hernia occurs in the groin (lower abdomen) when intestine or bladder protrudes through abdominal wall or into the inguinal canal in the groin. Inguinal hernia is more common in males due to natural weakness of the area that raises the risk of development of inguinal hernia.

Incisional Hernia

An incisional hernia occurs at the site of a previous surgical incision when intestine pushes through the weak point. Although it may occur in any individual who had surgery but elderly and overweight individuals are at higher risk. It can develop weeks, months or even years after the initial surgery.

Umbilical Hernia

Umbilical hernia occurs when a part of small intestine protrudes through the already weakened area near the navel where umbilical cord was attached. It can affect women and men but most commonly affects new born children. Obese women or women who have had many children are at higher risk of developing umbilical hernia.

Laparoscopic Hernia Repair

Laparoscopic hernia repair is almost similar to other laparoscopic procedures and is performed under general anaesthesia with only a small cut (incision) made near the hernia location. Carbon dioxide gas is inserted in to the abdomen to inflate it air so that the surgeon can clearly see the abdominal (belly) organs.

A laparoscope is inserted through the incision and surgeon locates the exact hernia while viewing the organs on a monitor attached to the other end of laparoscope. The instruments needed to repair the hernia are inserted through other small incisions and finally a special mesh is placed over the defect to reinforce the abdominal wall.

Advantages of Laparoscopic surgery over Open hernia repair

• Laparoscopic hernia repair causes less pain
• Open surgery takes long while laparoscopic procedure is quick and takes less time
• Patient needs a shorter hospital stay after laparoscopic repair
• Patient is able to return to work more quickly after laparoscopic repair than after open repair surgery
• Recurrent hernia can be easily repaired using laparoscopic techniques than using open surgery
• Laparoscopic procedure allows checking as well as repair of a second hernia on the opposite side at the time of the same operation
• Smaller incisions in laparoscopy are cosmetically better as compared to large incisions of open surgery
• Recurrence of hernia is much less after a laparoscopic repair as the mesh is placed ‘inside’ the abdomen