5 Things you need to know about Hernias – Mr Sabu Jacob Consultant General Surgeon
In this months Ask the Expert article featured in West Essex Life magazine Mr Sabu Jacob Consultant General and Vascular Surgeon at The Holly Private Hospital discusses 5 things you need to know about Hernias, how they are diagnosed and treated. You can read the full article below.
Mr Jacob runs a FREE hernia and varicose veins walk-in clinic at The Holly Private Hospital on Saturday mornings.
What is a hernia?
A hernia is a lump caused by weakness in the front wall or lining of the abdomen (the area covered by the midriff or tummy). It is a very common condition which can affect men, women or children at any age.
A hernia is just like a ruptured tyre. When the tyre wall separates, the inner tube can push through the opening. When a hernia develops in the abdominal wall, the abdominal lining can push through creating a sac. Tissue such as part of the bowel can drop into this sac causing a lump in the groin.
This lump is more noticeable when standing up. Lying down allows the tissue in the sac to go back to its normal position and the lump will temporarily disappear.
What causes a hernia?
Hernias commonly occur in the groin area because of inborn weaknesses in the abdominal wall. These weaknesses are due to blood vessels and other tissue passing through gaps in the abdominal wall. If these gaps are widened they allow the inner lining of the abdomen to push through the wall and form a hernia.
Hernias can be caused by the abdominal wall being weak from birth, often appearing on both sides of the groin. In other people the weakness in the wall may only appear in later life because it takes time for the sac to enlarge enough for tissue to drop into it.
The wall may weaken over time due to stress and strain, or in other cases be put under sudden pressure from heavy lifting, sports or coughing.
Overweight people are also more likely to develop a hernia.
What happens when you have a hernia?
The hernia forms in a weakened abdominal wall. At the weak spot, the hernia sac or bulge may fill with part of the intestines, fat or other tissue.
This often causes some pain. If left untreated hernias may cause serious intestinal problems. When a hernia first develops you may not be able to see the bulge, but you may feel burning or tingling in the groin. You may feel some pain when straining through lifting, coughing or passing urine.
If you have developed a bulge but it disappears when you lie down or push against it, this is called a reducible hernia. You are not in immediate danger, but you probably need a hernia repair and should consult your GP.
If the intestine gets trapped you won’t be able to make the bulge disappear. This is a non-reducible hernia. This is often painful and you need prompt surgery and should see a doctor as soon as possible.
What should I do about my hernia?
Only your doctor can tell you if you do have a hernia. Once you have a hernia, it will not go away on its own. Some people wear a truss, but these are best avoided. It is better to have your hernia repaired before it gets bigger and more complicated.
How can I get my hernia repaired?
If you think you have a hernia, you should see your doctor as soon as possible so that you can be accurately diagnosed. You and your doctor can decide together when your hernia should be repaired.
What are the types of hernia repair currently available?
Hernias have traditionally been repaired by open surgery. More recently, keyhole (or laparoscopy) repair has become increasingly popular. Both repairs use the tension free method which involves using a synthetic polypropylene mesh to repair the defect in the abdominal wall. This mesh stays in your body for the rest of your life as it is made from a non-absorbable material.
The open method of hernia repair is carried out by an incision in the groin area and is performed under either a local or general anaesthetic. The incision in the groin is more painful than the keyhole method of hernia repair and also has a longer recovery period.
What does the laparoscopic / key hole repair of hernia involve?
Laparoscopic / keyhole hernia repair is carried out using three small incisions in the abdomen and is done with the assistance of a small camera allowing the surgeon to visualise the abdomen on a television screen. It can only be done under a general anaesthetic but avoids groin incision, and therefore results in less pain and quicker recovery period when compared to the traditional open methods of hernia repair.
What happens if I have a hernia on both sides (bilateral hernia)?
Bilateral groin hernias can be repaired through the same three small incisions.
The recurrence rate for a hernia repaired with mesh is now less than 2% in open hernia and less than 1% in the keyhole approach.
In addition to the free walk in hernia clinics on Saturday mornings, Mr Jacob also holds clinics at The Holly Private Hospital on the 2nd Thursday of every month. To book an appointment please call 0208 936 1201 or enquire online.