1. Inguinal hernia – the intestine or bladder protrudes through the abdominal wall or into the groin is called inguinal hernia (inner groin hernia). This occurs mostly in men.
2. Incisional hernia – this results from incision due to the previous surgery. In incisional hernia, the intestine pushes through the abdominal wall at previous surgical site. This occurs most commonly in elderly or obese people that have inactive lifestyle especially after surgery.
3. Femoral hernia – tissue that protrudes from the lower belly into the upper thigh below the groin crease results in femoral hernia. Femoral hernia is most common in obese or pregnant women.
4. Umbilical or belly button hernia – this occurs when a part of the small intestine passes through the abdominal wall near the belly button (navel). This is very common in newborns, obese women or women with many children.
5. Hiatal hernia – A hiatus hernia occurs when the opening in the diaphragm which allows the oesophagus to pass from the chest into the abdomen becomes too wide and allows the stomach to slip into the chest.
An increase in pressure in the abdomen can result in hernia like lifting heavy weights without stabilizing the abdominal muscles, diarrhea, and constipation, persistent coughing or sneezing etc. Poor nutrition, obesity, unhealthy lifestyle and excessive smoking can also weaken muscles, resulting in hernia.
Some of the common symptoms of hernia may include:
• A bulge in the groin area or in the abdomen
• Pain while lifting heavy objects
• Burning sensation or dull pain
Most of the hernia surgeries can be done as an outpatient procedure. Doctor may perform some tests before the surgery including blood tests, medical evaluation, EKG etc. patient will be asked to stop taking the medications like blood thinners to avoid any excessive bleeding during the operation and should also quit smoking at least two weeks prior to the surgery. Surgery for hernia can be done in two ways, either through open surgery or through laparoscopy.
1. Open surgery method – patient will be given local or spinal anesthesia to numb the lower part of the body or in some cases, general anesthesia through intravenous line to make the patient fall asleep. Surgeon will then make an incision in the abdominal skin and either gently push the hernia back into the place and tie it off or remove it completely. Weak muscle area and Incisions will be closed with the stitches. If a patient has larger hernia then surgeon may add a piece of flexible mesh for extra support and to keep the hernia from coming back.
2. Laparoscopic or keyhole surgery – in this, patient will be given general anesthesia and the abdominal cavity will be inflated with a harmless gas to get the better look of the organs and to make space for surgeon to work. Surgeon will make some small incisions near the hernia to insert a laparoscope (a thin probe with a light and tiny camera at the end of the probe) which guides the surgeon through the images to repair the hernia with mesh. The incisions will be stapled or closed with stitches. This whole technique is also called minimally invasive surgery.
After surgery, patient will be shifted to recovery room for observation for few hours. Patient will be send home once he/she is awake and able to walk, drink fluids, urinate etc. There can be some soreness at least for 24 to 48 hours after the operation. Patient can get back to normal activities such as showering, walking, climbing stairs, driving or working etc within a week. Regular follow up with doctor should be done to see the healing progress.
All surgeries have some risk and complications associated with it. Laparoscopic hernia surgery is normally safe but also involves some common risks that may include:
• Adverse reaction to anesthesia
• Injury to bladder, intestine, blood vessels, nerves
• Infection at wound site
• Blood clots
• Persistent pain
• Recurrence of hernia
Patient should inform doctor immediately in case he or she may experience:
• High fever or chills
• Excessive bleeding
• Pain that cannot be relived with medications
• Nausea and vomiting
• Difficulty in urinating
• Persistent cough
• Shortness of breath
• Pus formation in any incision
• Unable to eat or drink
• Redness or swelling
Doctor may also recommend wearing a corset or binder to support the hernia and keep it in place. This may also help in easing the pain or any discomfort. But this is done only under the guidance of the doctor as use of these supportive garments can also worsen the hernia sometimes.