Hernia refers to a protrusion of an organ through the wall of the cavity containing that organ. It might occur either through the natural openings like inguinal canal or femoral canal or it may occur due to weakness of the sheath or the musculature. Hernia may be congenital, that is, present since birth or acquired, that is, acquired during the lifetime due to certain living or working conditions.

Types of Hernia

Common hernias seen in practice are:

INGUINAL HERNIA(or Groin Hernia)

Commonly occurs in males. Congenital - Present since birth. Acquired- Acquired during the lifetime. The common conditions leading to this type of hernia are-

• Lifting of heavy weights.
• Doing strenuous exercises.
• Later in life when the abdominal musculature becomes weak.
• In certain pre-existing medical conditions likebronchial asthma, chronic constipation and urinary bladder outlet obstruction.

FEMORAL HERNIA

Occurs below the inguinal ligament and through the Femoral Canal. This commonly occurs in females.

VENTRAL HERNIA

Occurs through the anterior abdominal wall. They are either Congenital (mostly umbilical hernia through the umbilicus) or acquired. The causes for this include:

• When increased amount of fat acts as a pile driver in obese patients, it leads to a defect in the sheath and thus leads to hernia formation.

Hernia which occurs over a scar is called incisional hernia. Causes are

• Poor musculature of the patient.
• Wound infection after the surgery.

Treatment

Through ages, the treatment of hernia has gone through various changes and modifications. Significant changes that have taken place in the treatment of hernia are:

Open Surgery with Mesh - This is practiced worldwide.

Laparoscopic surgery (Keyhole surgery) with mesh - This is being done in advanced centres with excellent results.

Most of the hernias can be treated by Laparoscopy. In this procedure, small 3-4 holes are made in the abdomen depending on the site and size of hernia. A telescope is inserted through one of the holes and very specialized laparoscopic instruments through the other holes. Watching on a TV monitor the surgery is carried out and a mesh is placed at the site.

Advantages of Laparoscopy

• No long scar, so better cosmetic results.
• Early recovery - Either side of a bilateral inguinal hernia can be managed by the same 3 holes.
• Fast recovery & early return to work.
• No restriction of lifting heavy weights subsequently.
• Less than 1% recurrence rate