A hernia is a defect in the abdominal wall through part of the abdominal contents (often bowel or fat) protrudes. The commonest types of hernia are in the groin, called an inguinal hernia, or a femoral hernia. Hernias also occur at the umbilicus (belly button). Hernias maybe due to congenital weakness, increasing age and are sometimes related to heavy work (lifting).
If an inguinal/umbilical hernia is not painful it is best left alone. For larger hernia repair is usually recommended. If a hernia causes pain, usually due to abdominal contents becoming temporarily caught in the hernia, repair is recommended. If the contents become blocked and have their blood supply cut off (“strangulated”) an emergency operation is required.
Femoral hernia are rarer and are more likely to strangulate, so that surgery is usually recommended before this complication occurs.
There are other types of hernia such as incisional (ie in an old abdominal wound), parastomal or internal. These are more complex issues and it is hard to generalize on how they should be treated.
The procedure usually needs a general anaesthetic. Most hernia repairs involve the patient staying in hospital overnight, although some surgeons send most of their patients home the same day.
If the procedure was an emergency, particularly if there was some bowel repaired several days in hospital may be needed.
The surgery used to always involve a cut (“incision”) over the hernia and stitching the edges of the weakness together, sometimes using other local tissues or mesh to strengthen the repair. Now it is possible to do the procedure laparoscopically (“keyhole”). This involves putting telescopes into the abdominal cavity and sewing a piece of mesh over the inside of the weak spot. There is no agreement that the recurrence rate is any lower with this approach.
Although there are different item numbers for open and laparoscopic hernia repair the MBS Rebates are identical, which suggests that there is no reason for a higher cost for the laparoscopic. My Dr Bill combines the cost data for both approaches.
Unfortunately a small number of patients have ongoing pain after the surgery, sometimes due to entrapment of a nerve during the procedure.