Hernia Surgery

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Hernias

A hernia is the abnormal protrusion of tissue or an organ, such as fat or bowel, through a defect in the wall of the cavity in which it normally resides, most commonly the abdomen. Some hernias are present from birth, but many develop in later life. There are a number of risk factors for hernia development including conditions that increase pressure within the abdomen, such as a chronic cough, straining from constipation, difficulty urinating or heavy lifting, pregnancy and obesity. Factors that reduce the strength of the abdominal wall tissues including smoking, previous surgical incisions and certain diseases affecting collagen are also risk factors for hernia formation.

The most common site of hernias is in the groin area (inguinal or femoral hernias). Other common sites in the abdomen are at the navel (umbilical), below the breast bone in the midline (epigastric) or at the site of a previous operation (incisional).

Symptoms depend on the site of the hernia. A hernia may be noticed as a bulge or lump, which may always be present, or only when standing or straining. They may cause discomfort or pain. Untreated, hernias tend to get larger over time. Occasionally the contents of the hernia become trapped, which can result in an impairment of blood flow to the trapped tissue (strangulation), or if bowel is trapped, it may become blocked (obstruction). These situations require an emergency operation.

Surgical Repair

Hernias are repaired surgically to treat symptoms and prevent complications. In many cases, mesh is used in the repair to reduce the risk of the hernia recurring. The repair may be performed as an open procedure or as laparoscopic (‘keyhole’) surgery. The most suitable approach depends on a number of factors. In open surgery, an incision is made at the site of the hernia and the tissue defect is closed using sutures, with or without the aid of mesh. Laparoscopic repair is performed through small incisions and surgery is performed with the use of a telescope with a video camera attached. Mesh is used to repair the hernia defect.
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