Hernias are protrusions of part or whole of an organ or other bodily structure through the wall that normally contains it. In Latin it means a rupture.
For example bowel is normally contained within the abdominal cavity. When it protrudes through a hole in the wall of this cavity it forms a hernia.
We only deal with hernias that protrude through the abdominal wall. The vast majority of hernias protrude through holes, which are already present in the abdominal wall.
While there are lots of ways of repairing a hernia we specialize in Local anesthetic ambulatory hernias repairs with early mobilization.
The most common hernias are groin and umbilical hernias.
Technically speaking there are 2 types of groin hernias inguinal and femoral.
These are most common types of hernias (almost 70% of abdominal wall hernias). They protrude through the inguinal canal which is a canal created in the groin when the testicle descends down into the scrotum. Not surprisingly it is most common in men. However the canal exists in women as well and hence it can also occur in women.
It presents initially as a small lump in the groin, which left untreated can grow much larger and extend down into the scrotum. The lump tends to be above your groin crease. Often the lump will disappear on lying down or can be manipulated back in.
In most people it may cause only mild symptoms or aching especially on straining. If however it starts aching regularly or start hurting you should call your GP.
If however the lump cannot be reduced becomes harder and starts becoming very painful then it is an emergency and you should either see the emergency GP or go to A&E. this suggests strangulation or incarceration. Fortunately this only happens rarely.
This differs from an inguinal hernia as it is slightly lower at the top of your thighs as opposed to the lower abdomen. It protrudes through a hole next to the femoral artery and vein just below your groin crease. Only 6% or groin hernias are femoral hernias. They are more common in women, and have a higher risk of strangulation.
Umbilical (belly button) and Midline hernias
These are hernias in the midline of your abdomen. The vast majority are in or around you umbilicus (belly button). Our abdomen is formed by the meeting and fusion of 2 sheaths of muscle coming together in the midline. Occasionally there are tiny holes left behind which can manifest as hernias in adult life. The umbilicus is the weakest area and hence has the most holes.
These are hernias created after an abdominal operation of incision. The initial operation could be any operation to get to an internal organ such as bowel or the womb or a kidney operation. If the internal stitches come apart or fails to heal then a hernia can form through the weakened area.
There are other types of abdominal wall hernias which are much rarer and can be discussed individually during consultation.
We do not treat hiatus hernias which is an internal hernia and is treated very differently.
The only treatment for a hernia is surgery. In some cases however we could decide not to operate if for example your health was generally poor. The vast majority should have their hernias operated on when soon after diagnosis at a time which is convenient. If however it is causing symptoms it should be seen to as soon as possible. However if there are any signs of strangulation then it would require emergency surgery.
In all hernias the surgery involves reducing the hernias (pushing it all back in) and then stitching a nylon mesh in place to strengthen the area, so it does not recur.