FAQ hernia – Dr. A.N.K. Abayajeewa, Senior Consultant Surgeon.

What is a hernia?.

Hernia is a protrusion of contents of a cavity through a hole or weakness of its wall. 

This commonly occurs in relation to abdomen (tummy), and its contents protrude through the muscle layers in the groin region (inguinal hernia) or naval (Umbilical hernia).

Why do hernias occur?.

Hernia commonly occur due to muscle weakness. This could be caused by obesity or lack of exercise. 

This is also common after abdominal surgery such as caesarean operation (incisional hernia). 

Rarely it can be due to a birth defect in musculature (congenital hernia).

What are the symptoms of a hernia?.

In the initial phase one could see and feel a lump in these regions which expands with coughing and straining (cough impulse) . This may be associated with discomfort or pain.

This lump will reduce or disappear completely when lying down.

But with advanced or complicated hernias this manurer may not be possible.

What are the complications of a hernia?.

The initial symptoms may be pain or discomfort while being active. Eg. Discomfort in the groin during walking. With increase in size hernia may interfere with daily activities.

Hernia contents such as bowels can also get stuck in the hernia cavity. This can cause intense pain. It could also lead to bowel obstruction causing vomiting and constipation. 

If the blood supply to the bowel gets compromised its called a strangulated hernia which is a surgical emergency.

What investigations are necessary to diagnose a hernia?

Most of the hernias are diagnosed clinically. In the very early phase, investigations such as ultrasound scans may be necessary to diagnose a hernia. CT scans are rarely indicated for complicated hernias.

Can hernias be cured with medicines?.

Few types of hernias can be managed with out surgery using devices such as hernia belts. But majority of hernias will need surgical correction.

What are the treatment options?.

Majority of hernias will need surgical correction. This frequently involves use of a surgical mesh which is placed inside the body after repair of the hernia. Some instances suturing alone will suffice to repair the hernia specially if the hernia is small.

What are the types of anaesthesia used in hernia repair?.

Hernias can be operated using local anaesthesia, general anaesthesia or spinal anaesthesia.

Most of uncomplicated groin hernias can be repaired using local anaesthesia which involves injecting a drug that will make the area numb.

Hernias are also operated with spinal anaesthesia (making lower half of the body numb) or general anaesthesia where the patient is put in to sleep by anaesthetic agents.

How log will the operation last?

Hernia operations usually take from 45-90 minutes on average. Some large hernias can take up to 2-3 hours!.

What is the duration of hospitalisation?.

Most of the patients can be discharged the same day (Day surgery). Patients are advised to get admitted approximately 2 hours prior to the surgery. The discharge is done generally 6 hours after the operation when the anaesthetic effects are waned off.

Patients with large hernias or other medical complications are usually kept overnight for observation.

When can I get back to work after hernia surgery?

Usually 1-2 days of leave from work is sufficient after most of uncomplicated hernia repairs. That means if the surgery is done on a Friday, it is possible to get back to work on Monday. This may be longer for large hernias or patients with medical issues.

It is usually advised to avoid strenuous physical activities (ie weight lifting) for a further 3 month on average.

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