Hernia

– The information has been reviewed by Dr. Yang Pei Cheung, George

Epidemiology

Hernias are a common disease among young children, mostly occurring in males. Due to an unclosed congenital canal in male groins, about 27% of men will suffer from hernias. Women have a lower risk of suffering from this disease, at a rate of about 3%.

What are Hernias？

Hernias, also known as “intestinal prolapses”, refer to masses formed by protruding internal organs from the abdominal wall. Most hernias will not heal on their own and cannot be treated with medication. As such, surgery is the only cure. If left untreated, the hernia has a change of growing in size. If the protruding organ becomes “stuck”, it will affect the flow and blood supply of the intestines. It may also cause serious complications such as intestinal infarction or bowel necrosis.

Symptoms

The initial symptoms of hernias are not obvious, and may only show if the patient yells, exerts force when in the toilet, exercises, or stands for a long time. If the patient lies down or rubs the on the protruding area, the lump should naturally disappear.

Hemispherical bump on the lower abdomen
Swelling of inner thigh
Coughing or discomfort and pain after standing for a long time
Severe abdominal pain
Fever
Nausea

Causes + Risk Factors

Hernias are caused by weak spots within the lower abdomen, navel, abdominal wall, groin, and groin area. When the abdomen is continually compressed, part of the small intestine soft tissue may protrude and become clamped. This will cause pain and swelling in the protruding soft tissue. Traditionally, many patients experience an “outbreak” when coughing, bending over, or moving heavy objects. Clinally, it has been found that many females who have hernias use improper posture and exertion when practicing yoga, sit-ups or waist exercises.

Risk Factors

Congenital defects in the abdominal wall structure
Abdominal muscles weaken due to surgical scars or aging
Long-term constipation which increases abdominal pressure
Postpartum loose skin around the stomach

How are Hernias diagnosed + Treatment

Hernia patients typically exhibit obvious clinical symptoms. When the patient is standing, a prominent protrusion in the abdomen can be seen which retracts when lying down. The protrusion may also be seen when the patient coughs, which can be easily diagnosed by a doctor. If the patient’s clinical symptoms are not obvious, the doctor may perform advanced examinations such as ultrasound or computer scans to obtain a more accurate diagnosis.

Treatment

Surgical techniques for hernia surgery are highly developed, especially in the common case of inguinal hernia which occurs between the abdomen and legs and is mostly treated with minimally invasive surgery. Delaying medical treatment may worsen the condition, and may cause intestinal infarction or necrosis, which sharply increases the risk of surgery. Thus, it is best to treat hernias as soon as possible.

Minimally Invasive Hernia Repair

The doctor will open three small holes (approximately 0.5 to 1 cm wide) in the patient’s abdomen. A slim surgical instrument will be inserted to pull the small intestine back into the abdominal cavity. A synthetic mesh will be placed to fill the weakened area to reduce any future risk of recurrence. As the wounds created by the surgery are small, the risk of wound infection is greatly reduced. Generally, patients can be discharged on the same day. Doctors may also check other abdominal positions with endoscopic instruments to ensure there are no other hernias in other areas of the abdomen.

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