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Hernia Surgery

Hernia disease refers to a condition where an organ or fatty tissue squeezes through a weak spot in a surrounding muscle or connective tissue called fascia. The most common types of hernias occur in the abdomen, but they can also appear in the upper thigh, belly button, and groin areas.

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What Causes a Hernia?

A hernia occurs when a weakness or a preexisting opening in your muscle or connective tissue allows an organ or other tissue to push through the barrier. Sometimes the weakness or opening is present at birth, but usually it develops during your lifetime.

Common Types of Hernias Dr Kaushal Surgically Repairs:

  • Overview: The most common type of hernia, inguinal hernias, occur when part of the intestine protrudes through a weak spot in the abdominal muscles, often appearing in the inguinal canal in the groin area.
  • Causes: They can be present at birth (indirect) or develop over time due to repeated strain on the abdominal and groin areas (direct).
  • Symptoms: A bulge on either side of the pubic bone, pain or discomfort in the groin, especially when bending over, coughing, or lifting. Sometimes, men may notice a swollen scrotum.
  • Treatment: Surgical procedures are the primary treatment. The surgery can be open or laparoscopic, with mesh often used to reinforce the abdominal wall.
  • Overview: This type occurs when part of the stomach pushes up into the chest cavity through an opening in the diaphragm.
  • Causes: Hiatal hernias are often caused by a weakened diaphragm muscle and increased pressure within the abdomen from coughing, straining during bowel movements, or heavy lifting.
  • Symptoms: Heartburn, belching, difficulty swallowing, and occasionally chest pain. Some are asymptomatic.
  • Treatment: Lifestyle changes and medications can often manage symptoms, but surgery may be needed if the hernia is large or becomes strangulated.
  • Overview: These hernias appear at the belly button (umbilicus) and are especially common in infants but can affect adults as well.
  • Causes: In infants, they result from an incomplete closure of the abdominal wall. In adults, repeated strain on this area can cause the hernia.
  • Symptoms: A noticeable bulge at the navel, which may become more evident when the infant cries or strains. In adults, discomfort and pain may occur.
  • Treatment: Many infant umbilical hernias close on their own by age 1 or 2. Persistent or hernias in adults require surgical repair.
  • Overview: Similar to inguinal hernias, femoral hernias occur when tissue pushes through the wall of the femoral canal. They are more common in women, especially those who are pregnant or obese.
  • Causes: The causes can include childbirth, obesity, heavy lifting, or chronic coughing.
  • Symptoms: A bulge near the groin or thigh, discomfort when standing up or lifting heavy objects. Complications can be severe if the intestine becomes strangulated.
  • Treatment: Surgical repair is necessary to prevent complications.
  • Overview: These occur at the site of a previous abdominal surgery.
  • Causes: Caused by the weakening of the abdominal wall due to surgery, these hernias may arise from poor wound healing, infection, or excess strain during recovery.
  • Symptoms: A bulge near a surgical scar, pain, and discomfort at the site, especially when straining or lifting.
  • Treatment: Usually requires surgical repair to correct, often with mesh reinforcement.
  • Overview: Occurring between the belly button and the lower part of the rib cage in the midline of the abdomen, these hernias result from a weakness in the abdominal wall.
  • Causes: Overexertion, obesity, or it may be present from birth.
  • Symptoms: A lump or swelling in the area, which may be painless or painful.
  • Treatment: Generally requires surgery to repair, particularly if symptomatic.
  • Overview: These are rare hernias occurring along the edge of the rectus abdominis muscle.
  • Causes: They are caused by a weakness in the spigelian fascia layer.
  • Symptoms: A bulge or pain at the site, often difficult to diagnose due to their location.
  • Treatment: Surgery is the recommended treatment.
  • Overview: A type of hernia that occurs in the anterior abdominal wall where muscle is thin or weak.
  • Causes: Can be congenital or more commonly due to abdominal surgeries leading to weaknesses in the abdominal wall, obesity, pregnancy, or activities that increase intra-abdominal pressure.
  • Symptoms: A bulge in the abdominal wall, pain, and discomfort, particularly with coughing, exertion, or standing for long periods.
  • Treatment: Options include watchful waiting for small, asymptomatic hernias, but most cases are treated with surgical repair, which may involve mesh placement to strengthen the abdominal wall.
  • Overview: A type of hernia that occurs in the anterior abdominal wall where muscle is thin or weak.
  • Causes: Can be congenital or more commonly due to abdominal surgeries leading to weaknesses in the abdominal wall, obesity, pregnancy, or activities that increase intra-abdominal pressure.
  • Symptoms: A bulge in the abdominal wall, pain, and discomfort, particularly with coughing, exertion, or standing for long periods.
  • Treatment: Options include watchful waiting for small, asymptomatic hernias, but most cases are treated with surgical repair, which may involve mesh placement to strengthen the abdominal wall.

Postoperative Care

  • Pain Management: Some discomfort is common after hernia surgery, and pain management might include medications or other methods.
  • Activity Restrictions: Patients are usually advised to avoid heavy lifting and strenuous activity for a specified period post-surgery.
  • Wound Care: Proper care of incisions is important to prevent infection and ensure proper healing.

Recovery

Recovery time varies depending on the type of surgery performed and the individual’s health. Many people return to light activity within a few days to a week after surgery. Complete recovery might take longer, typically a few weeks.

All surgeries carry some risk, including infection, damage to nearby organs, recurrence of the hernia, and complications related to anaesthesia.

Dr Devesh Kaushal is a Specialist General Surgeon and a Fellow of the Royal Australian College of Surgeons (FRACS).

Dr Kaushal offers 15+ years of experience and holds a Master of Surgery Degree, as well as being fully certified in gastroscopy and colonoscopy by the Gastroenterology Society of Australia (GESA).

Dr Kaushal takes an empathetic, warm-hearted and friendly approach to patient care and is completely dedicated to patient outcomes.

He consults and operates across Souther-Western Sydney.

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