Hernias

A hernia is a protrusion of the peritoneum through a gap in the load-bearing layer of the abdominal wall. This is usually caused by a weakness in the abdominal wall. This creates a gap in the abdominal wall and the peritoneum or intestines can emerge in the form of a pouch of tissue. The peritoneum lines the abdominal cavity, enclosing and protecting the organs. The content of the hernia or pouch extruding through the abdominal wall is known as a hernial sac. It may contain parts of organs, such as the intestine.

Hernias can also occur in different parts of the body. Depending on the location, a distinction is made between groin, thigh, umbilical and upper abdominal hernias. However, the abdominal hernia is the most common. Men are affected much more frequently than women.

Abdominal hernia

In men, the abdominal hernia (guinal hernia) is one of the most common conditions requiring surgery.

Causes and symptoms

In most cases, the exact cause cannot be determined. Experience has shown that weakened connective tissue is partly responsible.

Hernias are often only noticed by chance. For example, you might feel a bulge in your groin area while washing in the shower. Otherwise, those affected may notice symptoms in the groin when lifting heavy loads or when coughing, sneezing or clenching.

Diagnosis

It is usually easy for a specialist to diagnose a hernia. An ultrasound examination can also be carried out as a supportive measure.

Treatment

Treatment is surgical, whereby the procedure is usually minimally invasive (endoscopic). In addition, adult patients are often treated via a mesh insert, which means they can resume full load-bearing straight away (depending on the intensity of the pain).

This surgical procedure lasts between 30 and 90 minutes and is performed under local or general anaesthesia, depending on the method used.

If the surgery is done properly, the risk of recurrence of the hernia is very low.

Hospital stay

In most cases, patients spend one to two nights in the hospital – depending on their general condition and age.

Causes of a hernia

Gaps in the abdominal wall are the result of weaknesses in the connective tissue or muscles. Sometimes these weaknesses are congenital. However, it is more common for them to develop over the course of life – for example due to a genetic weakness of the connective tissue and muscle, or following abdominal surgery.

Symptoms of a hernia

The first symptom of a hernia is often a bulge in the abdominal wall, which you can see and feel. Pain is relatively rare, but coughing and clenching intensifies the condition. If you lie down, on the other hand, the extruding pouch slips back into the abdominal cavity and the bulge disappears (reposition).

If the pouch becomes larger over time, the hernia can become trapped (incarceration), in which case it can no longer subside on its own. If this happens, the organs in the abdominal sac may be damaged and injured. It is therefore advisable to have the hernia examined and evaluated by an expert. 

Treatment of hernias

The treatment and removal of hernias is carried out via a surgical procedure in which the extruding pouch is pushed back into the abdomen or removed. The gap in the abdominal wall is usually closed up and the body’s own tissue reinforced with a plastic mesh. In most cases, a plastic mesh is used to prevent recurrence and to strengthen the affected area of the abdominal wall.

The type of procedure used depends on the size and position of the hernia. Surgery is usually minimally invasive, i.e. laporoscopy or robot-assisted surgery. The range of treatments also includes open surgery techniques, which are occasionally necessary depending on the damage to the abdominal wall.

It is advisable to undergo early surgical treatment for hernias, especially inguinal hernias. This decision should be made on an individual basis after taking into account all factors such as symptoms, risks and pre-existing conditions.

FAQs

How do you identify an intestinal rupture or hernia?

Hernias are often visible externally, as the hernial sac protrudes and is visible.

How can you prevent a hernia?

As there are several different types of hernia that can occur, there is no general method of prevention. Hernias are often associated with weakness of connective tissue and excess weight. Weight loss can have a positive effect, but it cannot prevent a hernia.

Is it possible to treat hernias using a compression bandage?

No, that will not work. On the contrary, such measures can cause side effects such as pressure lesions. They are rarely used anymore.

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