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Hernia

What is Hernia?

A hernia is a condition in which an organ becomes displaced and protrudes through a cavity in the surrounding tissue (fascia) or muscle containing it. It is caused by a combination of fascia or muscle weakness and excessive pressure. Here, the strain is what pushes the organ through an opening (weak spot).

Improper lifting of heavy loads, chronic diarrhoea or constipation, persistent coughing or sneezing, obesity, smoking and overall poor nutrition can all contribute to hernias. Age, pregnancy, injuries and surgery may result in muscle weakness, which, in turn, leads to hernias.

Hernia
Hernias not only result in an unsightly bulge; it may even result in complications should the organ get trapped in the cavity.
Seek medical attention should you notice symptoms.

Types of Hernias

There are several types of hernias, the most common of which are:
  • Inguinal hernia – Accounting for around 70% of all hernias, inguinal hernias occur when the intestine or bladder protrudes through the lower abdominal wall or the inguinal canal in the groin, which houses the spermatic cord that supports the testicles (men) and the ligament that keeps the uterus in place (women). This type is more common in men than women.
  • Hiatal hernia – This occurs when the upper part of the stomach juts out of the abdominal cavity through the esophageal hiatus, an opening in the diaphragm that holds the esophagus and vagus nerve.
  • Umbilical hernia – Common in newborns and babies under 6 months, umbilical hernias develop when part of the small intestine squeezes out of the abdominal wall near the navel (belly button). It is harmless and typically goes away on its own by the time the child reaches one year old.
  • Femoral hernia – Similar to inguinal hernias, femoral hernias occur in the groin, but these more commonly affect women, especially those who are pregnant or obese. This type of hernia happens when the intestine pushes out of the lower abdominal wall and into the femoral canal in the upper thigh.
  • Incisional hernia – This occurs when the intestine protrudes out of the abdominal wall via a previous incision or weakened tissues and muscles in an old surgical site.

Types of Hernia Surgery

Hernias may be painless and asymptomatic, or may only cause mild to moderate discomfort. However, apart from umbilical hernias, most types of hernias do not go away on their own, and left untreated, can lead to serious complications.

A hernia may be repaired in two ways:

Herniorrhaphy (Tissue Repair)


Traditionally performed via open surgery, herniorrhaphy involves creating an incision over the site of the hernia. The displaced organ is manually placed back to its normal position, and the opening from which the organ protruded is stitched closed. The initial incision is also sutured and applied with dressings to facilitate healing. Herniorrhaphy may be done laparoscopically.

Hernioplasty (Mesh Repair)


For larger hernias where the displaced organ cannot be pushed back through the cavity, the hernial sac may be repaired by covering it with a surgical mesh. This process, called hernioplasty, stitches a mesh patch made of animal tissue or polypropylene over the cavity. This patch will then be used by the damaged or weakened tissues and muscles as a support during regrowth. Similar to herniorrhaphy, hernioplasty can be performed via laparoscopic surgery.
In the hands of an experienced surgeon, hernia repair is an extremely safe and established procedure.

Risks of Hernia Surgery

As with most surgical procedures, however, hernia repair comes with possible risks. These include:
  • blood clotting
  • pain and swelling
  • mesh pain and infection
  • excessive bleeding or infection at the surgical site
  • tissue, nerve or organ damage
  • recurrence of hernia
  • seroma or fistula formation
  • hemorrhage at the incision site
  • negative reaction to sedatives

Post-Surgical Care

For the first few days following hernia repair, pain and swelling around the surgical site are expected. These can be managed with simple rest or medicines, and typically go away within a week.
In some cases, the patient may be prescribed to wear an abdominal binder or bandage to provide support to the abdominal and hip areas. These, plus additional dressings, may need to be worn 24/7 or replaced, according to the doctor’s advice.
Light exercises and sexual activities may be resumed after one or two weeks. By now, many patients will also able to go back to work and resume their regular routines. However, patients should refrain from strenuous activities and heavy lifting for at least 4 to 6 weeks after the treatment.
Ho Kok Sun Colorectal is a one-stop colon and rectum centre specializing in the management of colorectal conditions such as hernias, haemorrhoids , colorectal polyps and colon cancer .

Our Colorectal Surgeon
Dr Ho Kok Sun Colorectal white logo
Dr Ho Kok Sun
Colorectal & General Surgeon
MBBS (Singapore), M Med (Gen Surg) (Singapore), FRCSEd (Gen Surg), FAMS
Dr Ho Kok Sun has been treating hernias for over a decade and was the past President of the ASEAN Society of Colorectal Surgeons and the Society of Colorectal Surgeons (Singapore), as well as a founding member of the Eurasian Colorectal Technologies Association. Dr Ho was actively involved in the training of medical students and residents, and has published widely in reputable journals and book chapters. He believes that treatment should always be personalised to the patient’s needs.

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Ho Kok Sun Colorectal Pte Ltd

Colorectal Surgeon

3 Mount Elizabeth,
Mount Elizabeth Medical Centre
#12-09, Singapore 228510

Fax: (+65) 6737 2389

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