A hernia is a lump caused by weakness in the front wall lining of the abdomen (the area covered by the midriff or tummy). It’s a very common condition which can affect men, women and children of any age.
A hernia is like a ruptured tyre – when the tyre wall separates, the inner tube pushes through the opening. In the same way, when a hernia develops in the abdominal wall, the abdominal lining can push through and create a ‘sac’. Tissue, such as part of the bowel, intestines or fat, can then drop into this sac in the weakened abdominal wall, causing a lump in the groin. This can be painful and – if left untreated – may cause serious intestinal problems.
What causes a hernia?
Hernias often occur in the groin because of a weakness in the wall of the abdomen. 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.
The walls of the abdomen can be weak either from birth, or may weaken over time due to stress and strain. In other cases, the abdominal wall can be put under sudden pressure from heavy lifting, sport or coughing. Overweight people may also develop a hernia.
Different types of hernia
There are a couple of different types of hernia.
If you have developed a bulge that disappears when you lie down or push against it, this is called a‘reducible hernia’. It’s not necessarily an urgent medical condition, but you should report it to your GP as you may need a hernia repair operation.
If the tissue (such as the intestine) gets trapped, you won’t be able to make the bulge disappear – this is known as a ‘non’reducible hernia’. It is often painful and will need to be reported to your GP without delay as surgery is promptly required.
A hernia will not go away on its own – only your GP or consultant can tell you if you have one and if it needs to be repaired in order to avoid it becoming bigger and more complicated.
What types of hernia repair are available?
Hernias have traditionally been repaired by the ‘open’ method of surgery.
More recently however, the ‘keyhole’ (or laparoscopic) method of repair has become increasingly popular.
The ‘open’ method
With this method, hernias are repaired by making an incision in the groin area under local or general anaesthetic. This incision is associated with more pain than the keyhole method and has a longer recovery period.
The ‘keyhole’ method
This method, also called a laparoscopic hernia repair, is the one favoured by Mr Jacob. It is carried out using 3 small incisions in the abdomen and is done with the assistance of a small camera, which allows the surgeon to view the operation on a screen in the operating theatre. This repair can only be done under general anaesthetic, but avoids any need for incisions in the groin area, resulting in less pain and a shorter recovery period, when compared to the traditional ‘open’ method.
Bilateral hernias (on both sides) can be repaired through the same small incisions.
‘Tension-free’ hernia repair
This does not involve pulling the muscles and ligaments together; instead, it involves placing a piece of sterile mesh over the weakened abdominal wall. The body tissue then grows through the mesh combining with it to form a strong and permanent repair. The mesh is made from a non-absorbable material and stays in your body permanently.
Many people can have a tension-free mesh repair carried out under local anaesthetic or epidural as a day case patient, and return home within a few hours of the operation. Otherwise, you will just be required to stay for one night.
As well as a short hospital stay, another benefit of tension-free repair is that patients experience minimal pain, which is normally addressed with mild painkillers. There are also fewer restrictions on returning to activities, with most patients resuming almost immediately on their return home.
Of the 500 hernia repair operations that Mr Jacob has performed, only 1 case has resulted in a recurrence of the condition.