Overview

A hernia is a condition where the intestine, other organs, or fatty tissue pushes through a weakened area in the muscles or connective tissue. While hernias can develop in different parts of the body, such as the abdomen, belly button, or upper thigh/groin area, they are most commonly seen in the groin region. Some hernias may be present at birth, while others develop later in life. Although hernias can be asymptomatic, they can also cause mild to severe pain. Surgery is the only way to cure a hernia, as it does not resolve on its own.

Types of Hernia

There are several types of hernias, including:

  1. Inguinal Hernias: These are the most common types occurring in the groin area. Inguinal hernias can be of two types:

    • Direct Inguinal Hernia: Caused by weakness in the floor of the inguinal canal and often seen in elderly individuals with chronic conditions that increase intra-abdominal pressure.

    • Indirect Inguinal Hernia: Occurs when the inguinal canal fails to close before birth, resulting in a hernia appearing in a male’s scrotum or a female’s vaginal opening. Indirect hernias are more common in males.

  2. Femoral Hernia: These hernias occur below the groin crease and are more prevalent in women. They are associated with weakness in the lower groin region, often due to pregnancy and childbirth.

  3. Umbilical Hernia: This type of hernia develops when part of the intestine protrudes through the umbilical opening in the abdominal muscles. It can occur in infants shortly after birth and may resolve by three or four years of age.

  4. Hiatus Hernia: This occurs when part of the stomach protrudes into the chest through the diaphragm. Treatment may not be necessary if the patient is symptomless.

Other types of hernia include Incisional Hernia, Epigastric Hernia, Spigelian Hernia, and Muscle hernia.

Hernia Symptoms

Some common signs include:

  • Noticeable bulge or protrusion that appears when standing or straining and disappears when lying down

  • Increased bulge while coughing or sneezing

  • Pain experienced while lifting weights

  • Dull aching sensation

  • A vague feeling of fullness

  • Nausea and constipation

  • Swelling and pain in the testicles (in the case of inguinal hernias)

  • Heartburn

  • Difficulty swallowing

Hernia Causes

The exact aetiology of a hernia is often unknown, but the following factors can contribute to its development. These include:

  • Chronic constipation

  • Chronic cough

  • Cystic fibrosis

  • Excess weight or obesity

  • Heavy lifting

  • Straining during bowel movements

  • Poor nutrition

  • Smoking

  • Overexertion

  • Fluid accumulation in the abdomen

  • Undescended testicles

  • Previous abdominal surgeries (Ventral/Incisional Hernia)

Hernia Diagnosis

A hernia is typically diagnosed through a physical examination. The patient may be asked to cough or strain to observe any bulges or protrusions. Ultrasound or CT scan may be used to confirm the diagnosis.

Hernia Treatment

Surgery is the primary treatment option for hernias. If left untreated, a hernia can increase in size and may lead to intestinal obstruction or strangulation. There are three types of hernia surgery:

  • Open Surgery: It involves making a large incision to access the hernia, placing the protruded tissue back into place, and using stitches to close the weakened area. In some cases, a non-absorbable mesh may be used to reinforce the weakened spot.

  • Laparoscopic Surgery (Keyhole Surgery): This is a minimally invasive procedure where a laparoscope is inserted through small incisions to view the internal organs. Fewer stitches are required, and the recovery time is usually faster compared to open surgery.

  • Robotic Surgery: This advanced form of surgery involves using robots to perform the procedure with high precision and accuracy. Robotic surgery provides a 3D view of the structures inside the abdomen, enhancing surgical outcomes.