A hernia occurs when 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 balloon-like sac. This can allow a loop of intestine or abdominal tissue to push into the sac. The hernia can cause severe pain and other potentially serious problems that could require emergency surgery.

Both men and women can get a hernia.

You may be born with a hernia (congenital) or develop one over time.

A hernia does not get better over time, nor will it go away by itself.

No.

Hernias vary in location and size and in the symptoms they cause. Common locations for hernias are the groin (inguinal Hernia and less commonly Femoral hernia), Umbilical region (belly button hernia) and epigastrium (midline hernia above the belly button). Another common location is at the site of a previous surgical incision (incisional hernia).

Hiatal Hernia is another common form of hernia but this does not cause a visible lump on the abdomen because the hernia occurs in the diaphragm muscle and the protrusion of abdominal contents is into the chest. Hiatal hernias are discussed in the section on Hiatal hernia surgery and anti-reflux surgery.

Hernia varies in size from pea-sized to containing the entire abdominal contents and every size in between. The size of a hernia is one of the factors that determine how extensive the surgery required to repair it.

Other factors that can influence the complexity of hernia repair are previous abdominal surgeries and previous hernia repairs.

Laparoscopic or Keyhole hernia surgery is a method of hernia repair using a small telescope with a camera attached for vision and small ports for operative workings. Carbon dioxide is insufflated to give working space to perform the hernia repair.

Keyhole surgery allows smaller incisions which results in less post operative pain and less risk of post-operative wound infections.

For laparoscopic Inguinal hernia repair there is usually one 12mm incision at the Umbilicus (Belly Button) and two 5mm incisions in the lower Abdomen.

For incisional hernia the number of incisions and position of the incision vary according to size and position of the hernia

Open or traditional hernia repair involves an incision in the region of the hernia allowing direct visualisation of the hernia to be repaired. In inguinal hernia repair, an incision of 7 to 10cm is usually required. This method of hernia repair is very safe and has stood the test of time. In many cases, an open repair is still the most appropriate surgical choice.

Several factors influence the type of hernia required for the individual patient.

1. Location of hernia

2. Size of the hernia

3. Previous surgery

4. Overall general health of the patient

Your surgeon will assess you and advise the appropriate surgery specifically tailored to your hernia

Yes, the aim of the surgery is for a permanent repair. All hernias can recur over time but with the use of permanent re-enforcement/scaffolding material for your repair (mesh), this significantly reduces the risk of the hernia recurring.

Risks for surgery can be divided into general risks (associated with any surgery) and Specific risks.

General risks include cardio-vascular complications (heart attack, stroke), respiratory complications (pneumonia, partial lung collapse), thrombo-embolic events (blood clots) and anaphylaxis (severe allergic reactions). These are very rare occurrences in hernia surgery.

In some patients who have a complex medical history or a complex hernia these risks may be more relevant, and your surgeon will discuss this with you.

Specific risks include inadvertent bowel, bladder or vascular injury. These are rare but serious complications that may require more extensive surgery and a prolonged stay in hospital.

Less rare but less serious complications include post-operative Haematoma (collection of old blood beneath the wound or internally), infected mesh and wound infection.

The most common minor problems post hernia surgery are bowel and bladder issues and and pain that persists for longer than a few days. These are discussed further in the post-operative instructions.

They time to return to work depends on the size and complexity of the hernia repair, the type of work and individual patient factors.

For routine inguinal hernia repair:

Most people will be able to return to desk jobs at one week.

Active jobs requiring frequent movement, car travel and light duties (lifting up to 12kg) could be 2-3 weeks.

Jobs involving heavy manual work and heavy lifting could be 6 weeks.

Early return to light physical activity is encouraged after all hernia surgery.

This includes walking from day 1 post-operatively, starting with short distances, building up to normal walking distances at one week. The same goes for light stretching.

Swimming is an excellent recovery exercise and can be undertaken after 2 weeks (providing the wounds have healed without issues).

Exercise bike riding is also encouraged after 2 weeks.

Other forms of exercise that can be undertaken after 2 weeks includes low impact core work such as Pilates, and Yoga, light limb weights, light jogging and Sexual Intercourse.

Activities that should be avoided for the first 6 weeks include Heavy Lifting, Weighted squats, abdominal crunches and sports that require explosive rotational movement such as Golf, Tennis and Surfing.

After most routine hernia repairs, it is safe to drive a car short distances at 5 days postoperatively.

The important test is that you can brake quickly if required and you are no longer taking strong painkillers.

Travelling long distances in a car as passenger or driver is not advised until 2 weeks post-operatively.

Short Haul Air Travel should be safe after one week.

Long Haul Flights should not be undertaken ideally for 3 weeks post surgery.