A hernia, sometimes referred to as a rupture, occurs when a part of an internal organ, sometimes the bowel, pushes through a weak point in the abdominal wall. If left untreated, the split in the muscle widens and greater amounts of tissue or organs are pushed through the opening, forming a sac. This visible lump or bulge is one of the key characteristics of a hernia.
The weakened abdominal wall can be present at birth or may develop later in life. The most common site is the groin, but hernias can also form in other areas, such as the navel. If the lump can be gently pushed back through the abdominal wall, it is known as a reducible hernia. If the lump resists manual pressure, it is a non-reducible hernia, which can mean serious complications.
Both forms of hernia require surgical repair. Approximately 40,000 Australians have their hernias surgically repaired every year, making this one of the most common operations.
The abdominal wall isn’t a solid sheet of muscle; it is made up of different layers. Certain areas are structurally weaker than others and therefore more likely to develop hernias. The different types of hernia include:
Different types of hernia
Inguinal – occurring in the groin. This is the most common type of hernia, and twenty times more common in men than in women. It is likely that about 1 in 20 men will develop an inguinal hernia. The inguinal canal is in the groin. The first signs of a hernia are discomfort and/or a lump. It is common for men to develop a hernia.
Femoral – occurring high on the thigh, where the leg joins the body. Similar to the events that cause an inguinal hernia, intestines force their way through the weak muscle ring at the femoral canal until they protrude. This herniated section of bowel is at risk of strangulation, which is a serious complication requiring urgent medical attention. Femoral hernias are more common in women.
Umbilical – a portion of the gut pushes through a muscular weakness near the navel, or belly button. This type of hernia is more common in newborns. Overweight women, or those who have had several pregnancies, are also at increased risk.
Incisional – after abdominal surgery, the site of repair will always be structurally weaker. Sometimes, the intestines can push through the closed incision, causing a hernia.
What do I need to know about this procedure?
Open surgery is performed under a general, spinal or local anaesthetic to repair the weakness in the abdominal wall. The various procedures used depend on the location of the hernia, but may include opening the abdomen and using stitches and nylon meshes to close and reinforce the weakened section of muscle. Inguinal hernias can be repaired using laparoscopic surgery. A slender instrument known as a laparoscope is inserted and the hernia repaired from the inside. This eliminates the need for large abdominal incisions.
The lump will be relieved by the surgery which may also relieve discomfort in the area. Planned surgical treatment of a hernia is much safer than leaving the hernia until an emergency happens.