A hernia is an unsightly bulge detected usually over the lower abdomen or groin, though it may occur over other parts of the abdominal wall also. This happens due to protrusion of abdominal contents like gut or omentum through a defect or weakness in the abdominal wall. The bulge or hernia appears in the upright posture or on straining and reduces spontaneously on lying down. In longstanding cases, a manual reduction is required.
The protrusion of hernia is associated with dragging discomfort or pain. Many conditions can result in a hernia. A congenital defect in the groin, excessive straining in people with constipation, chronic cough, prostate problems and heavy weight lifters are important risk factors.
Hernia needs surgical treatment, especially when it is large or symptomatic. Many people neglect their hernia for years till they develop complications and undergo emergency surgery.
What are the complications of a groin hernia?
A hernia may become irreducible when it cannot be pushed back or reduced. If it contains intestine, this may get obstructed. Strangulation is a serious complication in which the blood supply to the hernia contents is blocked. This is a very painful condition and requires emergency surgery.
What are the methods of hernia surgery?
Conventional groin hernia repair is done by open surgery during which a polypropylene or polyester mesh is used to reinforce the weakness in the abdominal wall. For this surgery, a 5 to 6 centimeter incision is made. The modern method of hernia surgery is done laparoscopically. In the laparoscopic surgery, small cuts of 5 or 10 millimeter are made and hernia is repaired. The main advantage of laparoscopic repair is that it has less incidence of post-operative pain resulting in earlier return to work. So the recovery of the patient is faster. Cosmetically also, laparoscopic repair is preferred. The main disadvantage is that it is slightly more expensive in comparison to open repair.
Dr. Uday Singh Dadhwal
(Specialist General Surgery)
Bahrain Specialist Hospital