A hernia occurs when an organ slips through an opening in the muscle or the tissue that holds it in place. For example, the intestines (more often the small intestine) may protrude through a weakened area in the abdominal wall.
Hernias are most commonly seen in the abdomen, but they can also appear in the upper thigh and groin areas. Most hernias are not immediately life threatening; however, they will never heal on their own and they always require surgery to prevent potentially dangerous complications.
What is the cause of a hernia?
The main reason for developing a hernia is the increase of the pressure inside the abdomen (intra-abdominal pressure) which may be due to:
- Chronic coughing
- Heavy weight lifting
- The presence of fluid in the abdomen (ascites)
- Persistent coughing
- Prostate hyperplasia
Common Hernia Types
Inguinal Hernia: An inguinal hernia occurs when the intestines push through a weak spot or tear in the lower abdominal wall, often in the inguinal canal. Inguinal hernias may be present in one side (unilateral) or in both sides (bilateral) and they represent the most common form of hernias.
Umbilical Hernia: This hernia occurs in the umbilical area and, if not recognized and treated early, may enlarge tremendously. They are often seen in women after pregnancy. Hernias extending over the umbilicus (in the midline) are called epigastric hernias.
Incisional Hernia: Incisional hernias may occur after previous abdominal surgery. Your intestines may push through the incision scar or the surrounding, weakened tissue.
What Are the Symptoms of a Hernia?
The most common symptom of a hernia is a bulge or lump in the affected area. In case of an inguinal hernia, you may notice a lump on either side of your pubic bone (in the spot where your groin and thigh meet). It is more likely to feel (touch) the hernia when standing up.
How hernias can be treated?
Hernias can be treated only by surgery. The early surgical repair is the key to prevent any (potentially dangerous) complications of the disease. The organ protruding inside the hernia is reduced (returned inside the abdominal cavity) and the hernia defect or hole is covered with a synthetic material, called mesh.
What are the advantages of laparoscopic hernia repair?
The laparoscopic approach to hernia repair has clear advantages, including less acute and chronic postoperative pain, shorter recovery and earlier return to work. Therefore, laparoscopic hernia repair has a beneficial role in all types of hernias.
Laparoscopic hernia repair uses an instrument called laparoscope. Two to four small incisions are made through the abdominal wall, through which are passed the laparoscope (a thin telescope with a light on the end) and the surgical instruments. The incisions are small, so the whole technique is often called keyhole surgery. It is also often referred to as minimally invasive or minimal access surgery.
Especially for inguinal hernia repairs, the extraperitoneal endoscopic technique (TEP – Totally Extraperitoneal Repair), is considered as the optimal approach for definitive hernia repair. TEP is one of the safest techniques, since the procedure is performed outside the abdominal cavity, within the layers of the abdominal wall. Therefore, the operation restores the original anatomy by putting the mesh and strengthening the abdominal wall on its base.