Overview
What Is A Hernia ?
A hernia is a defect in the abdominal wall, in which the inside layers of the abdominal muscle have weakened resulting in a bulge or tear. In the same way that an inner tube pushes through a damaged tire, the inner lining of the abdomen pushes through the weakened area of the abdominal wall to form a small bubble or balloon-like sac. When a loop of intestine or abdominal tissue pushes into the sac, severe pain and other potentially serious complications can result.
Both men and women can get a hernia. Some hernias are present at birth (congenital), while others develop over time. A hernia does not get better over time; a hernia will not go away by itself. Hernias most commonly occur in the groin ('inguinal hernias'), around the belly button ('umbilical hernias'), and near the site of a previous surgical operation ('incisional hernias').
About Inguinal Hernia Repair
An inguinal hernia is a lump in the groin that occurs when part of your gut (intestine) pushes through a weakness in the muscles of the abdominal wall. Inguinal hernias are most common in boys and men. They may be present at birth or develop later in life. Straining, heavy lifting, coughing or being overweight increases the pressure within the abdomen, and this puts strain on the muscles in the groin area.
A hernia isn't dangerous in itself, but if it isn't treated it's likely to get larger and become more uncomfortable. There is a risk that the gut will get trapped inside cutting off the blood supply to the hernia contents (strangulation), causing life-threatening conditions such as gangrene and peritonitis. It may result in the gut becoming blocked (obstructed).
Diagnosis
Your GP will ask your about your symptoms and examine you. He or she may also ask you about your medical history. If you have a swelling in your groin that appears when you stand up, lift or strain, you may have a hernia. Your GP will usually recommend that you have an inguinal hernia repair.
Preparing For Your Operation
Your surgeon will explain how to prepare for your operation. For example if you smoke you will be asked to stop, as smoking increases your risk of getting a wound infection and slows your recovery.
The operation is usually done as a day case under general anaesthesia. This means you will be asleep during the operation. Alternatively you may prefer to have the surgery under local anaesthesia. This completely blocks the feeling from the area and you will stay awake during the operation. You may also be given a sedative to help you relax.
Your surgeon will advise which type of anaesthesia is most suitable for you. If you are having general anaesthesia, you will be asked to follow fasting instructions. Typically you must not eat or drink for about six hours beforehand. However, some anaesthetists allow occasional sips of water until two hours before a general anaesthetic.
At the hospital your nurse may do some tests such as checking your heart rate and blood pressure, and testing your urine.
Your surgeon will usually ask you to sign a consent form. This confirms that you understand the risks, benefits and possible alternatives to the operation and have given your permission for it to go ahead. You may be asked to wear compression stockings to help prevent blood clots forming in the veins in your legs. You may need to have an injection of an anti-clotting medicine called heparin as well as, or instead of, stockings.
About The Operation
The operation takes 30 to 50 minutes depending on the technique used. There are two main types of inguinal hernia repair - open and keyhole (laparoscopic). Your surgeon will recommend which is suitable for you.
Open Surgery
Open surgery is the most common way to repair an inguinal hernia.
Once the anaesthetic has taken effect, your surgeon will make a single cut (about 5 to 10cm long) in your groin, and push the bulge back into place. He or she will usually attach a synthetic mesh over the weak spot to strengthen the wall of the abdomen, before closing the cut with dissolvable stitches.
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