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Hernia

General SurgeryGastroenterology Hepatology

Hernia occurs when organs, tissues, or fat from within the body protrude through an opening or weak spot in the body wall, forming a visible lump or swelling, often accompanied by discomfort, bloating, pain, or other symptoms. Hernias typically do not resolve on their own and may require surgical treatment to repair the affected area and prevent dangerous complications such as intestinal obstruction or necrosis.

Factors

The causes of hernia typically include the following factors:

Torn abdominal wall	When the tissues of the abdominal wall become weak or develop a tear, it can create an opening for a hernia, allowing internal tissues or organs to pass through.
Overstressed	Applying too much force, such as lifting heavy objects, engaging in vigorous physical activity, coughing, or straining during bowel movements, can increase the pressure inside the abdominal wall, leading to the development of hernia at weak points.
Abdominal wall weakness	Factors like pregnancy, obesity, enlarged prostate, or scarring from abdominal surgeries can weaken the abdominal wall, making it more susceptible to hernia formation.
Abdominal wall weakness	Some individuals may have a genetic predisposition to hernias, as hernia tendencies can run in their families.
Physiological factors	The inguinal anatomy of males differs from that of females, making them more prone to developing inguinal hernias.
Abdominal wall conditions	If the path of testicular descent from the abdomen to the scrotum is not fully closed, it can lead to the formation of a hernia. This condition is an indirect inguinal hernia, allowing abdominal tissues or organs to pass through to the inguinal region or scrotum.

Types of Hernias

Inguinal Hernia
Occurs when a portion of the small intestine or fatty tissue protrudes through the muscles or tissues in the inguinal area, resulting in a bulge in the groin region. Inguinal hernias are more common in males due to differences in inguinal anatomy compared to females.
Femoral Hernia
Occurs at the junction between the thigh and the abdomen, typically affecting elderly females.
Umbilical Hernia
Happens when fat tissue or a part of the intestine protrudes through the abdominal wall around the navel (belly button).
Incisional Hernia
Occurs at the site of a previous surgical incision or scar.

Symptoms

The symptoms of hernia can vary depending on its type and severity. Common hernia symptoms include:

Visible lump: In many cases, the most prominent symptom is the appearance of a bow or swelling at the hernia site. The bump may be more noticeable when standing, coughing, or straining and may retract when lying down.
Discomfort or pain: Hernia can cause discomfort, dull ache, or sharp pain at the site of the lump. Pain may worsen during physical activity or when lifting heavy objects.
Weakness or pressure sensation: Some individuals with hernias may feel weakness or pressure at the hernia site, even without a visible lump.
Burning sensation: Hernia can lead to a burning sensation at the hernia site, especially when bending or straining.
Fullness or bloating: Some people may experience a sensation of fullness or bloating in the affected area.
Changes in bowel movements: Certain types of hernias, such as inguinal or femoral hernias, may be associated with changes in bowel movements, such as constipation or difficulty passing stools.
Nausea and vomiting: In severe cases where hernia causes bowel obstruction, symptoms may include nausea and vomiting.

However, not all hernias cause symptoms, and some individuals may only become aware of their hernia during a medical examination. If you suspect you have a hernia or experience any of the above symptoms, it's advisable to seek medical evaluation and treatment; significantly, if the symptoms worsen, sudden severe pain occurs, the hernia lump changes colour, or you cannot push the lump back into place.

Diagnosis and Treaments

Diagnosis
Doctors typically diagnose hernias by observing abnormal protrusions in the patient's abdomen. Suppose a patient's clinical symptoms are evident. In that case, further tests such as ultrasound or computed tomography (CT) scans and even barium enemas may be required to obtain a more accurate diagnosis and understand how the hernia affects intestinal function.

Treatment

Open Surgery	Doctor incurs the patient's skin and then places the protruding tissues back in their original position while repairing the hernia opening. Sometimes, doctors may use synthetic materials like mesh patches to reinforce the hernia site to prevent hernias from recurring.
Laparoscopic Surgery	It is similar to open surgery but less invasive due to being a minimally invasive technique. The doctor makes one or more small incisions in the abdomen and introduces laparoscopic instruments for the surgery.
Robotic Hernia Repair Surgery	Surgeon sits at a console in the operating room and performs the surgery by manipulating robotic arms. This approach allows for more precise procedures while reducing invasiveness.