SPECIALIST IN HERNIA REPAIR

Hernias

A hernia can occur almost anywhere in the body, but most commonly happen in your abdomen between your chest and pelvis. It happens when there is a weakness in the muscle wall and an internal part or tissue of the body (a bit of fat, organ or bowel) pushes through.

The hernia presents as a lump which often appears or is noticed after a strenuous movement, straining or coughing. You should be able to push it back in and it may disappear when you lie down.

Although hernias generally do not present with other symptoms apart from the lump they can be painful and it is important to seek treatment as they can become strangulated and need urgent medical attention.

A strangulated hernia occurs when the defect through which the hernia has pushed is tight. This in turn can lead to the blood supply to whatever is in the hernia being cut off.

When this happens the tissue in the hernia becomes gangrenous and this leads to sepsis. Sometimes the bowel will obstruct. Thankfully strangulation is a rare event but it can prove fatal and usually presents as a surgical emergency which has a less positive outcome than a planned procedure. Timely repair of a hernia is therefore advisable.

If you experience sudden, severe pain from the hernia and it is tender to touch or the skin over it turns red then seek medical assistance immediately. Later signs of strangulation include vomiting, abdominal distension and pain and fever. These may indicate bowel obstruction.

There are a several different types of abdominal wall hernia, but the most common are the following:

Inguinal hernia

This is the most common type of hernia, accounting for approximately 70% of all hernias. They occur in the inguinal canal and present as a lump in the groin area. Men have an inherent anatomical weakness in the groin essentially due to the possession of testicles and the vast majority of inguinal hernias occur in men. Women do suffer with these hernias but infrequently.

You may feel a lump or swelling under the skin that disappears when you lie down. It may feel a bit uncomfortable and there may be strange sensation in the groin if you have been standing or walking for a long period of time. Occasionally they are painful. You should seek an expert opinion. Hernias will not resolve themselves and can become strangulated.

Open or keyhole techniques are available. Most people opt for a keyhole operation as it is a better procedure in most situations. Mr Stellakis is one of the most experienced keyhole inguinal hernia surgeons in the UK and Europe having performed over 2,000 of these operations. He performs on average three to four of these operations a week.

Inguinal Hernia treatment
Inguinal Hernia treatment

Inguinal hernia

This is the most common type of hernia, accounting for approximately 70% of all hernias. They occur in the inguinal canal and present as a lump in the groin area. Men have an inherent anatomical weakness in the groin essentially due to the possession of testicles and the vast majority of inguinal hernias occur in men. Women do suffer with these hernias but infrequently.

You may feel a lump or swelling under the skin that disappears when you lie down. It may feel a bit uncomfortable and there may be strange sensation in the groin if you have been standing or walking for a long period of time. Occasionally they are painful. You should seek an expert opinion. Hernias will not resolve themselves and can become strangulated.

Open or keyhole techniques are available. Most people opt for a keyhole operation as it is a better procedure in most situations. Mr Stellakis is one of the most experienced keyhole inguinal hernia surgeons in the UK and Europe having performed over 2,000 of these operations. He performs on average three to four of these operations a week.

Femoral Hernia treatment

Femoral hernia

A femoral hernia occurs in the lower groin and usually feels like a small lump next to the groin crease or near the top of the thigh. They are relatively uncommon, accounting for about 2% of all hernias and, typically, women are more likely to experience femoral hernias than men.

You may just feel a slight ache, but often there are no symptoms until they strangulate and almost half of all femoral hernias present as emergencies. We generally recommend repair on a semi-urgent basis a they are more likely to strangulate than any other hernia. These can be treated keyhole or open. The choice depends on a number of factors that should be discussed with you by your specialist.

Femoral Hernia treatment

Femoral hernia

A femoral hernia occurs in the lower groin and usually feels like a small lump next to the groin crease or near the top of the thigh. They are relatively uncommon, accounting for about 2% of all hernias and, typically, women are more likely to experience femoral hernias than men.

You may just feel a slight ache, but often there are no symptoms until they strangulate and almost half of all femoral hernias present as emergencies.

We generally recommend repair on a semi-urgent basis a they are more likely to strangulate than any other hernia. These can be treated keyhole or open. The choice depends on a number of factors that should be discussed with you by your specialist.

Umbilical and epigastric hernia

Umbilical hernias occur very close or through the naval. Sometimes the inside of the navel sticks out and is unsightly. If the swelling is positioned anywhere along the middle of your abdomen away from the naval they are called epigastric or ventral hernias.

Your abdominal muscle is actually composed of two paired muscles, known as the rectus muscles, separated by a band of connective tissue down the midline. These hernias push through this connective tissue.

An umbilical hernia can range in size from a small lump to a very large swelling, depending on how big a hole is formed. Although they are usually painless, they can continue to enlarge so early repair is often advised. Open surgery is generally better for these hernias.

Umbilical Hernia treatment
Umbilical Hernia treatment

Umbilical hernia

Umbilical hernias occur very close or through the naval. Sometimes the inside of the navel sticks out and is unsightly. If the swelling is positioned anywhere along the middle of your abdomen away from the naval they are called epigastric or ventral hernias.

Your abdominal muscle is actually composed of two paired muscles, known as the rectus muscles, separated by a band of connective tissue down the midline. These hernias push through this connective tissue.

An umbilical hernia can range in size from a small lump to a very large swelling, depending on how big a hole is formed. Although they are usually painless, they can continue to enlarge so early repair is often advised. Open surgery is generally better for these hernias.

Incisional Hernia treatment

Incisional hernia

An incisional hernia occurs when tissue pushes through a scar in the abdominal wall resulting from a previous surgical operation. The incision would have been made to access the inside of the abdomen, organs or bowel and typically results from procedures such as a caesarean section, appendix or bowel surgery.

During that procedure, the surgeon will have closed the layers of the abdominal wall with stitches, but if this fails to heal properly or is put under pressure at a later stage, a hernia can form.

These are common, and it is estimated that approximately 10 to 15% of abdominal surgeries can lead to an incisional hernia later on. Although an incisional hernia is rarely painful, they can become strangulated and therefore dangerous. They will also probably continue to enlarge over time, so repair is usually necessary. These are often the most difficult hernias to repair. Keyhole and open procedures exist to treat these hernias but the size and severity of the operation depends very much on the exact location of the hernia and most importantly its size.

Incisional Hernia treatment

Incisional hernia

An incisional hernia occurs when tissue pushes through a scar in the abdominal wall resulting from a previous surgical operation. The incision would have been made to access the inside of the abdomen, organs or bowel and typically results from procedures such as a caesarean section, appendix or bowel surgery.

During that procedure, the surgeon will have closed the layers of the abdominal wall with stitches, but if this fails to heal properly or is put under pressure at a later stage, a hernia can form.

These are common, and it is estimated that approximately 10 to 15% of abdominal surgeries can lead to an incisional hernia later on. Although an incisional hernia is rarely painful, they can become strangulated and therefore dangerous. They will also probably continue to enlarge over time, so repair is usually necessary. These are often the most difficult hernias to repair. Keyhole and open procedures exist to treat these hernias but the size and severity of the operation depends very much on the exact location of the hernia and most importantly its size.

Chronic pain after hernia repair

Rarely people who have had a hernia repair go on to get long-term pain in groin. This is much more common after ‘open’ procedures and is very rare after keyhole repairs. It can be caused by the mesh – but not always. If you think you have this pain after a repair, there are things that can be done, so please give the office a call. Mr Stellakis is one of a few surgeons who are experienced in mesh removal techniques.