A hernia or “rupture” is a weakness or defect that allows a structure to protrude from one space to another. It may cause a lump that comes and goes (often with coughing or straining) with discomfort or pain. Rarely sickness and vomiting can occur if bowel becomes trapped in the defect. If this happens an emergency situation can rapidly develop that necessitates urgent action (refer your self to Accident and Emergency or call “999”).
The groin is the most common place for a hernia (inguinal). Hernias also commonly occur around the belly button (paraumbilical) and above it (epigastric). They also occur in the region of previous surgical scars or injuries (incisional). Hernias can recur at the site of a previous repair (recurrence).
Treatment of hernias in this area may be by key-hole or open surgery. It involves reinforcement of the weakness by insertion of a synthetic material called a “mesh”. Hernias that occur in both groins simultaneously or at the site of a previous open repair are easier to repair by a key-hole operation. Some patients that have key-hole surgery recover quicker than with an open surgery. There are some rare complications specific to key-hole repair that should be considered when deciding which one to have.
The area around the naval or above this can become weak and cause paraumbilical or epigastric hernias respectively. These can often be approached by a key-hole or open method. Key-hole surgery has an advantage in that it keeps the scar away from the naval which is not a very clean area. Insertion of a prosthetic mesh is then possible in order to keep the chance of recurrence as low as possible. Sometimes a collection of fluid called a seroma can occur under the skin after surgery. Recurrence of the hernia may occur.
A proportion of hernias will recur and cause symptoms. Repairing these can be a bit more difficult than first time around with a higher risk of complications. Recurrent hernias can be repaired by open or key-hole surgery – the choice depends on the size of the defect, its location and previous surgery. Mr Hayden has considerable experience with performing laparoscopic (key-hole) repair of recurrent groin and incisional hernias.