A hernia is when part of the bowel or fatty tissue pushes through a weak spot in the abdominal wall, usually showing as a bulge in the groin, around the belly button or at an old scar. Laparoscopic hernia repair puts the bulge back and strengthens the wall, often with a surgical mesh, through small openings. In Amman, an examination decides whether your hernia can be watched or needs repair.
Note: If a hernia becomes very painful, firm and cannot be pushed back, or comes with vomiting, a swollen tummy or a change in skin colour over it, go to the emergency department straight away.
When is hernia repair considered?
Hernia repair may be suggested if you have:
- A bulge in the groin, around the belly button or at an old scar that gets bigger when you stand or cough
- Pain, heaviness or a dragging feeling at the bulge, especially when lifting
- A hernia that is growing or getting in the way of work and daily life
- A hernia that is hard to push back in
- A type of hernia your doctor feels carries a higher risk of complications
What is a hernia and why does it happen?
A hernia happens when the muscles or tissues of the abdominal wall become weak at one spot.
- Inguinal (groin) hernia: one of the most common types
- Umbilical hernia, at or near the belly button
- Incisional hernia, at the site of an earlier operation
- Things that raise pressure inside the abdomen include heavy lifting, long-term coughing, long-term constipation, being overweight and pregnancy
- A hernia does not usually go away on its own and may grow over time
Diagnosis
A hernia is usually diagnosed by examination. Your doctor may ask you to stand or cough to see and feel the bulge.
If the diagnosis is not clear, your doctor may request a scan.
- Ultrasound scan
- In some cases, a CT or MRI scan
Treatment options
Options are listed from the simplest to the most invasive:
The choice of repair depends on the type and size of the hernia, your general health and any previous operations. Your surgeon will discuss what suits your case.
- Watchful waiting: some small hernias that cause no symptoms can be monitored with your doctor, as long as you know the warning signs.
- Reducing strain on the abdomen: treating constipation and chronic cough, avoiding heavy lifting and keeping a healthy weight. These steps do not fix the hernia but may ease symptoms.
- Laparoscopic hernia repair: the bulge is put back and the wall strengthened, often with a mesh, through small openings under general anaesthetic.
- Open repair: done through a cut over the hernia, and may suit some cases or types of hernia.
- Emergency surgery: needed if the hernia becomes trapped or its blood supply is cut off.
What to expect on the day and after
Keyhole repair is usually done under general anaesthetic. Many patients go home the same day, while some stay one night, depending on their case.
- You may feel soreness or tightness at the repair and around the small cuts, which eases gradually
- Some swelling or mild bruising is common
- Gentle walking early on is encouraged
- Avoid heavy lifting and hard exercise for the period your surgeon advises
- Recovery and return to work vary, and your surgeon will explain what to expect in your case
- Contact your doctor if you get a fever, worsening pain, redness or discharge from a wound, or trouble passing urine
When to book an appointment
Book an assessment if you notice:
- A new bulge in the groin, abdomen or around the belly button
- A bulge that appears when you stand or cough and disappears when you lie down
- Pain or heaviness at a known bulge
- A bulge at the site of an old operation scar
- A known hernia that is growing or bothering you more