Overview
Between 2015-2016, over 62,000 Australians underwent hernia procedures. Luckily, hernia repair is a quick and safe surgical procedure with minimal recovery time.
While most hernias aren’t life-threatening, they, unfortunately, do not go away with time and often require surgery.
If your doctor has diagnosed you with a hernia, our surgical team at the Centre for Gastrointestinal Health are specialists in hernia repair and ensure the best possible outcomes from your procedure.
What is a Hernia?
A hernia is when fatty tissue or organs push through an opening in the connective tissue or muscle wall that initially held it in place. This results in a lump forming, which is called a hernia. The pouch that contains the fatty tissue or organ is called the hernial sac. For example, if the tissue in your abdominal wall is weakened, your intestines can push through and create a noticeable bulge in your lower abdomen.
The normal location for hernias is around your abdominal area, which is between your chest and hips. However, you can also find them around your groin and upper thigh.
The location of your hernia can indicate its type.
Types of Hernias
There are several types of hernias. Some common ones that you are likely to find are:
- Inguinal hernia: the most common type of hernia and occurs due to a weak spot in the low abdominal wall, called the inguinal canal. It is most common in men.
- Femoral hernia: found in your lower groin, below the inguinal canal, and occur as a result of the natural weakening of the femoral canal.
- Hiatal hernia: occurs when your stomach pushes through your diaphragm and protrudes into your chest cavity, this can often cause a burning sensation called gastroesophageal reflux or chronic heartburn at night.
- Umbilical hernia: common in babies or children and occurs when their intestines protrude from the belly button region. These hernias often go away as their abdominal wall strengthens with age.
- Incisional hernia: occurs at the site of a previous surgical incision, which weakens the muscle wall and creates an opening for organs to budge.
How do Hernias Develop?
Hernias develop as a result of a weakness or muscle strain in the abdominal wall. Depending on the cause, a hernia can occur in a singular event or over an extended period of time.
The ways that can you develop a hernia are:
- Straining when urinating or passing bowel movements (particularly if you are constipated)
- Damage from an injury or surgery which weakens or strains the abdominal muscles (e.g. C-Section)
- Strenuous exercise
- Chronic coughing
- Congenital condition (inherited hernia conditions)
- Strain from pregnancy (more likely if you have had multiple pregnancies)
- Strain from being overweight or obese
- Fluid in the abdomen and ascites
You are also more likely to develop a hernia if you have experienced premature birth, cystic fibrosis, or regularly smoke.
If you are worried that you may have a hernia, the first step is to see your local GP for a physical examination.
Can I Prevent a Hernia?
You can’t always prevent hernias from developing, especially if you have a family history of the condition or have recently had surgery.
Although, you can decrease your risk of getting a hernia with a few small lifestyle changes that reduce the strain inflicted on your muscular wall.
Some lifestyle changes you can consider include:
- Stop smoking
- See a doctor when sick to avoid a persistent coughing
- Strengthen the muscles of your abdomen
- Avoid lifting weights that are too heavy for you (always try to lift with your legs and not your back)
- Avoid straining during urination or bowel movements
- Consume high-fibre foods to minimise the chance of constipation
Hernia Diagnosis
Your local GP will feel for a bulge around your abdomen and groin when conducting a physical examination. They may ask you to stand and then cough or strain to see if the bulge increases in size.
Your GP can also use imaging tools to observe the hernia. This will require you to have either an abdominal ultrasound, a CT scan or an MRI.
If your GP thinks that you may have a hiatal hernia, you will have to complete an endoscopy so they can assess your stomach internally. An endoscopy is when a doctor places a tube that is attached with a small camera down your throat and into your stomach.
Once diagnosed, your GP may refer you to a specialist such as the Centre for Gastrointestinal Health to discuss hernia repair procedure options.
How is a Hernia Repaired?
There are multiple procedures available depending on the size, type and regularity of your hernia. The two most common types of hernia repair procedures are:
- Laparoscopic hernia repair surgery
- Open hernia repair surgery
- Robotic hernia repair
In extreme cases, an abdominal wall reconstruction may be necessary.
Laparoscopic hernia repair surgery
Laparoscopic surgery is a minimally invasive repair where the surgeon makes three small incisions and inserts a laparoscope into your abdomen. A laparoscope is a thin rod attached with a camera and a light that helps the surgeon find the hernia sac.
To create space in the internal region, the surgeon will also inflate your abdomen with carbon dioxide (a non-toxic gas) to find the hernia and the weak point in the internal muscle layer.
Once located, the surgeon will slip the protruding organ back into place and sew the area shut. Sometimes it may be necessary to place a synthetic mesh on the abdominal wall to help strengthen the tissue.
The tiny incisions are then closed by either surgical tape or a few stitches.
Depending on the size of the hernia, the procedure should take between 30-60 minutes. You will be asleep for the entire procedure under general anesthesia.
Open hernia repair surgery
Open hernia repair involves the surgeon making one 5-10cm incision over the bulge.
The protruding fatty tissue or organ is then gently slipped back into place, and the opening in the abdominal wall is sewn shut.
The surgeon will then re-enforce the weakened muscle layer with a synthetic mesh patch before closing the original incision with stitches.
The hernia surgery takes around 45 minutes and is performed under general anesthesia.
Robotic hernia repair
Robotic hernia repair is similar to laparoscopic surgery as they both use a few small incisions to complete the procedure. Similarly, the surgeon finds the hernia and slips the organs back into place before sewing the weakened tissue shut.
However, this hernia surgery is different as it uses robotic technology to provide clear three-dimensional images of the internal structures of the abdomen. The surgeon completes the entire procedure through a control console.
A benefit of robotic hernia repair is that the surgeon can easily use stitches to sew the weakened tissue and apply the surgical mesh effectively.
The procedure takes approximately 30-45 minutes, and you will be under general anesthesia for its entirety.
Abdominal wall reconstruction
An abdominal wall reconstruction is most commonly for patients who have had previous unsuccessful repair procedures and have a hernia defect.
A surgeon will make a long incision in the hernia area and then restructure the internal tissues to support the weakened muscle layer. The restructuring of internal tissues requires the surgeon to separate and reorganise the abdominal wall layers into a natural position.
As a result, the surgeon will restore the structural and functional integrity of the abdominal wall to ensure that no more hernias can emerge.
Complex hernia repairs can take between 2-6 hours. However, you will be under general anesthesia the whole time.
Why is Laparoscopic Hernia Surgery Recommended?
Laparoscopic surgery is the preferred treatment due to its minimally invasive procedure. While open surgery is still effective, studies have indicated that laparoscopic techniques are more favourable.
The benefits of laparoscopic hernia surgery are:
- Less post-operative pain due to the smaller incisions
- Faster recovery time
- Faster discharge from hospital
- Ability to return to work faster
- Minimal scarring from the small incisions (0.6-1.3cm in size)
Why Should I Repair my Hernia?
If you’re an adult, hernias are unlikely to leave the body naturally or go away with time. Therefore, it is important to repair your hernia as soon as possible before they start to inflict damage on your body.
For instance, by ignoring a hernia you can increase the chance of bowel obstruction, which can cause life-threatening conditions and severe pain.
Avoiding hernia repair will also increase daily discomfort, particularly when standing for long periods of time or walking over large distances. The chronic pain will also impact any activity that places your body under strain, such as lifting heavy objects. For inguinal hernias, discomfort may emerge from your testicular region.
Furthermore, the longer you wait for a repair procedure, the larger the hernia sac can grow. Very large hernias are more challenging to repair and can increase your chances of serious complications during and after the procedure.
After Hernia Repair
You will be able to leave the hospital on the same day as your surgery. However, different recovery guidelines depend on the type of surgery that you underwent.
Unless advised otherwise by your surgeon, if you underwent a underwent keyhole surgery (laparoscopic or robotic hernia repair), you should:
- Take pain medication as instructed
- Remove your bandage 24 hours after your operation
- Book an appointment with your GP 5 days after the procedure for a wound examination
- Resume normal activities in 1-2 weeks (when comfortable)
If you underwent open surgery, you should:
- Take pain medication as instructed
- Take a shower 48 hours following the operation
- Use an ice-pack to reduce swelling and pain over the wound
- Book an appointment with your GP 5 days after the procedure for a wound examination
- Increase your walking gradually over the first few days
- Return to normal activities in 2-4 weeks (when comfortable)
- Avoid heavy lifting for 6 weeks
Hernia Repair Complications
Although the incidence of post-operation problems are minimal, there have been some reported complications that emerge from both keyhole surgery and open surgery.
These complications include:
- Reaction to general anaesthesia (e.g. cardiac irregularities or anaphylactic shock)
- Reappearing hernias (only in 5% of cases)
- Infection from the surgical mesh or wound
- Nerve damage
- Long-term discomfort
- Bowel obstruction or trauma
- Urinary retention
- Building up of blood supply (haematoma) or fluid (seroma)
The best practice is to attend check-up appointments with your GP following your surgery to ensure that the wound is healing and there are no complications.
At the Centre for Gastrointestinal Health, our specialists can provide personalised services for your hernia repair to ensure the fastest and safest recovery. Contact us today to talk about your hernia management and treatment.
FAQs
How Long Does it Take to Recover From a Hernia Operation?
Your recovery time will depend on the type of hernia repair surgery. You should always consult your local GP or surgeon before returning to normal activities. The general guidelines are 1-2 weeks for minimally invasive keyhole surgery (laparoscopic surgery or robotic hernia repair) and 2-4 weeks for open surgery.
Is Hernia Repair Covered by Medicare Australia?
Yes. Australian residents who access repair procedures as a public patient will be covered by Medicare. If you have private health insurance, get in touch with your provider to see how much they will cover.
How Much Does Hernia Repair Cost?
The average cost for hernia repair is $5,610, however, the exact costing will depend on your individual circumstances so it is best to consult our specialists for further details.
Is Hernia Repair a Major Surgery?
Although hernia repair is a common procedure, it is considered a major surgery. However, the likelihood of complications are minimal.
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