Abdominal Wall Hernias

What is an abdominal wall hernia?

Abdominal wall consists of strong muscles, meant to keep the internal organs and tissues in place. However any weakness in the abdominal wall can result in abnormal bulging of a tissue or organ from that weak spot in abdominal wall. This condition is called abdominal hernia.

There are several different types of abdominal wall hernias depending upon the location where the abdominal wall is weak or torn.

What are the symptoms of abdominal wall hernias?

Abdominal hernias can be mostly asymptomatic, however they may present with symptoms such as:

  • A bulge anywhere on trunk. It can range from small and unnoticeable or large and visible depending upon extent of damage and weakness. The bulge can appear and become obvious on coughing or straining
  • Pain around the hernia
  • A bulge with pulling sensation around it

Abdominal wall hernias can form a sac, having a loop or fat tissue that can usually be tucked back in. This can be dangerous, especially if it becomes strangulated or twisted which is an emergency as necrosis of trapped tissue may occur.

Should I see a doctor?

See a doctor if you’re having any symptoms related to hernia. Hernias can usually be diagnosed just by history and physical examination during which you be asked to cough so that doctor can see the bulging.

Mostly, hernias are reducible, i.e. its contents can be pushed back into the abdominal cavity. There can be situations in which the hernia gets trapped, twisted or strangulated and won’t go back in. This is an emergency and the trapped tissue may get damaged permanently and is extremely painful. Go to the hospital emergency department if this situation happens.

How are hernias treated?

Not all hernias need to be repaired right away. Discuss in detail with your surgeon about best possible option in your specific case. Mostly hernia repairs are done in two ways, depending upon the size, location, general health of patient and whether the hernia is being repaired for the first time or is repeated attempt. If the hernia was strangulated and some part of intestine trapped in it has died, the surgeon would have to remove that piece of bowel and anastomose (join) the ends back.

The methods are:

Open surgery

During open surgery, incision is made near the hernia. Any stuck tissue inside the hernia is removed if it’s dead; otherwise healthy tissue is pushed back in its normal place. This is followed by sewing the layers of abdominal wall together, making sure there is no possibility of herniation again. This process is called "Herniorraphy".

Sometimes a mesh is placed along the herniation spot to support the abdominal wall, process called "Hernioplasty".

Laparoscopic surgery

Laparoscopic surgery demands very small incisions as compared to open surgery. The surgeon inserts tools into the body through those incisions near the hernia and while using a laparoscope (camera) the surgeon uses tools inserted inside to repair the hernia by simply stitching or by using a mesh.

Post operation recovery and care is different for each type of hernia repair. Discuss in detail with your doctor regarding what to expect after surgery in your specific case.