Hernia surgery (inguinal, umbilical, ventral, femoral, incisional)

A hernia occurs when an organ or tissue is pushed out through a weak area of muscle. It most often affects the abdomen.

Your specialist may recommend hernia surgery, or hernioplasty, if your hernia is affecting your quality of life. During the procedure, the displaced tissue is returned to where it should be and the weak area of muscle is stitched up or reinforced with a small piece of mesh.

Inguinal hernia surgery

Inguinal hernias are the most common type and typically affect men far more than women. They present as a small bulge on either side of the groin. This bulge is generally fatty tissue or a part of the bowel such as the intestine. In men, an inguinal hernia can sometimes cause a swollen or enlarged scrotum.

Correcting an inguinal hernia is a routine operation that involves an incision being made in the groin. This procedure can be performed either as laparoscopic/keyhole or through open surgery. Inguinal hernia repair is usually undertaken when the patient is under general anaesthesia.

Inguinal hernia repair is required if the patient finds that the hernia is having an impact on their quality of life, or to prevent dangerous side effects such as obstruction or strangulation, which both need urgent medical attention if they occur.

Obesity, lifting heavy objects, constipation, coughing and COPD (chronic obstructive pulmonary disease) are all potential causes of an inguinal hernia.

In the majority of patients, a full recovery is expected within six weeks, and light activities can commence again two weeks post-surgery.

Umbilical hernia surgery

Umbilical hernia surgery is a relatively simple procedure and generally takes around 20-30 minutes. It is performed under general anaesthetic and involves a small 2cm-3cm incision being made at the base of the belly button and the lump being pushed back into the tummy. If the hernia is strangulated, dead tissue may be cut out. 

Muscles at the weak spot in the abdominal wall are stitched together and dissolvable stitches are used to close the wound. In adults, a mesh patch may be used to strengthen the area instead. Umbilical hernia surgery is often a day case operation, but if the hernia is more severe, a fine drainage tube may be needed, which generally requires the patient to stay in hospital until it is removed. 

Ventral hernia surgery

Ventral hernias usually appear on the front of the tummy wall. Increasing age, obesity and heavy lifting can all contribute to the occurrence of a ventral hernia. A key sign of this type of hernia is a bulge under the skin. Pain when urinating, lifting heavy objects and coughing are also potential symptoms of a ventral hernia.  

The two main procedures for this type of hernia are keyhole or open surgery. During laparoscopy (keyhole surgery), three or four small cuts are made so that the surgeon can insert a telescope and some instruments. The abdomen is inflated with gas so that the abdominal wall can be viewed and accessed. A piece of mesh is placed to cover the hernia, preventing the fatty tissue or bowel section that was causing the hernia from pushing through the muscle weakness. Finally, stitches close the wound. Open surgery involves an incision being made over the hernia and mesh being stitched into place to prevent a re-occurrence.  

Recovery from ventral hernia repair generally takes between seven and 14 days (depending on the size), and you should not drive for at least seven to 10 days. Heavy lifting should be avoided for a minimum of six weeks.  

Femoral hernia surgery

A femoral hernia is less common than other types of hernia. Instead of typically affecting the belly button or abdominal area, they often appear as a lump in the groin or the upper inner part of the thigh. This lump appears in the femoral canal after pushing through a weak spot in the abdominal wall. Coughing and straining often lead to this type of hernia appearing, whereas it reduces or disappears when the patient is relaxed.  

It is notable that femoral hernias, unlike inguinal hernias, impact more women than men, especially older females. Pushing too hard when emptying your bowels, as well as lifting heavy objects can be common causes of a femoral hernia.  

Laparoscopic/keyhole and open surgery are both effective ways to eliminate a femoral hernia. Generally, most femoral hernia repair patients recover fully within six weeks. 

Incisional hernia surgery

An incisional hernia is the result of a weakness around an incision that has previously been made during surgery to the abdominal wall. Muscles do not always fully recover during an operation, and this lack of healing causes an incisional hernia. It usually appears around scar tissue, anywhere from the breastbone down to the groin. Patients that have previously undergone a caesarean section or an appendicectomy may experience an incisional hernia.

Symptoms include nausea and/or vomiting, a fever, an aching sensation and a change in bowel habits. Patients can often feel a lump on their abdominal wall.

Incisional hernias are most commonly experienced from three to six months post-surgery. Normally, general anaesthetic is used during the surgery and once again, both laparoscopic surgery and open surgery can be performed. If you believe that you have an incisional hernia, it is recommended that you see a GP or specialist as soon as possible, as incisional hernias generally increase in size over time.

To find out more or make an appointment with Mr Hornung, please call 0161 495 6148