Abdominal Wall Hernias

A hernia is when muscle, tissue or organs push through a weakness in your abdominal wall. They often appear as a bulge under your skin. Anybody can get a hernia – although they are more common when we get older.

What causes a hernia?

When part of your abdominal wall and surrounding muscles is weakened – possibly because of a previous surgery or other factors including age, being overweight or constant straining – it can make it susceptible to a hernia. Hernias are when other muscle, fatty tissues or internal organ/s squeeze through a weakness in the abdominal wall to create a tear or bulge.

Hernias usually appear as a lump under the skin. They may bulge in and out when you strain, cough or sneeze. Hernias are not usually painful however they do not go away on their own. Surgery is often needed to repair a hernia to avoid more serious complications.

For example, there is a risk of the hernia becoming ‘strangulated’ where the blood supply to the trapped tissues is cut off. This is a very painful and dangerous condition that may require emergency surgery.

Types of abdominal hernia

Different types of hernia are more common in men, women and infants:

• Inguinal hernia – where a weakness in the lower abdominal wall causes muscle to bulge into the inguinal canal in the groin. Men are more prone to inguinal hernias due to a natural weakness in this area.

• Femoral hernia – this type of hernia occurs at the site of femoral artery at the top of the upper thigh. Women are more prone to femoral hernias, especially if you are pregnant or considered overweight or obese.

• Umbilical hernia – occurs where there is an abdominal wall weakness near your belly button. This type of hernia is most common in newborns and women after several pregnancies. Being overweight or obese are also common contributing factors.

• Epigastric hernia – hernias that appear in the area between your sternum and belly button (the epigastric region of the abdominal wall) are called epigastric hernias. This type of hernia is seen in both infants and adults.

• Incisional hernia – any previous surgery where an incision is made in your abdominal wall can cause weak spots where the intestine can push through the surgical site. This type of hernia is often seen in elderly or overweight people following abdominal surgery.

Step by step: hernia repair surgery

• Surgery to repair a hernia can be done using keyhole (laparoscopic) surgery or an open incision in the abdominal wall

• Under general anaesthetic, Dr Hopkins will attempt to repair the natural muscle and abdominal wall tissue by sewing the tissues back together.

• A thin mesh is often placed on the abdominal wall to promote tissue repair and provide a lasting closure of the tear.

• Hernia repair surgery with keyhole surgery usually takes 1 hour to complete and you can usually go home the next day.  

• Surgery for more complex hernias (eg incisional hernias) may require more advanced surgical techniques and a longer hospital stay to ensure the wound is healing correctly. 

After surgery: what to expect

Depending on the type of hernia repair, you may be able to go home the next day or may need to stay in hospital for a few days while your wounds heal.

Full recovery after surgery for hernia repair is usually 3-4 weeks. You will need to take care to avoid any straining or heavy lifting that may put pressure on the hernia repair to minimise the risk of the hernia coming back.