What is a Hernia?

A hernia occurs when an internal organ (usually intestine) or fatty tissue pushes through a weak spot in the muscle or fascia that normally holds it in place. This creates a visible or palpable bulge that may be more prominent when standing, coughing, or straining.

Types of Hernia

Inguinal hernia (groin): Most common type, especially in men.

Umbilical hernia: At or near the belly button. Common in babies (many self-resolve) and in adult women, especially after pregnancy.

Incisional hernia: At the site of a previous surgical incision.

Ventral hernia: In the abdominal wall, other than umbilical.

Femoral hernia: In the upper thigh area, more common in women. Higher risk of complications.

Hiatal hernia: Upper stomach pushes through the diaphragm. Managed differently from wall hernias.

Symptoms

  • Visible or palpable bulge in groin, abdomen, or near old scar
  • Bulge more prominent with standing, coughing, straining
  • Dragging, aching, or burning sensation
  • Discomfort worsened by lifting or physical activity
  • Sometimes bowel symptoms if intestine is involved
  • Sudden severe pain, redness, and inability to reduce the bulge: possible strangulation, medical emergency

Causes and Risk Factors

  • Weakness in abdominal wall (congenital or acquired)
  • Age
  • Chronic cough
  • Chronic constipation
  • Heavy lifting
  • Obesity
  • Pregnancy
  • Previous abdominal surgery
  • Smoking (weakens connective tissue)

When to See a Specialist

  • Any visible or palpable bulge in the groin or abdomen
  • Discomfort with straining, lifting, or coughing
  • History of previous hernia repair with new symptoms

Emergency: sudden severe pain, redness, hardness of the bulge, vomiting, or inability to push the bulge back requires immediate medical attention.

Diagnosis

Diagnosis is usually clinical, based on examination while standing and with the patient bearing down. Imaging (ultrasound, CT scan) may be used for complex, recurrent, or occult hernias.

Treatment

Watchful Waiting

For small, asymptomatic hernias in older patients where surgical risk outweighs benefit. Decision individualised.

Surgical Repair (Herniorrhaphy or Hernioplasty)

Most symptomatic hernias require repair. Options:

Open mesh repair: Traditional approach with a small incision over the hernia, reduction of the hernia contents, and placement of mesh to reinforce the weakened area.

  • Duration: 45 to 90 minutes typically
  • Anaesthesia: spinal, epidural, or general
  • Hospital stay: same day or overnight
  • Recovery: 1 to 3 weeks

Laparoscopic mesh repair: Minimally invasive approach through small ports, with mesh placement from inside the abdominal wall.

  • Faster recovery, less pain
  • Better cosmesis
  • Preferred for bilateral, recurrent, or select complex hernias
  • Performed at Shri Manmukund Hospital by expert visiting laparoscopic surgeons in coordination with our team

Choice of approach depends on your hernia type, size, prior surgeries, and general health. Open mesh repair is performed by our on-site surgical team. Laparoscopic repair is provided through coordination with visiting laparoscopic specialists at our facility, so you can access advanced surgical care at the same trusted hospital where your consultation, pre-operative evaluation, and post-operative recovery take place.

Recovery

  • Rest for 1 to 2 days after procedure
  • Avoid heavy lifting for 4 to 6 weeks
  • Return to office work: 1 to 2 weeks
  • Return to physical work: 4 to 6 weeks
  • Follow-up at 1 week, 6 weeks, and 6 months

Prevention

  • Maintain healthy weight
  • Treat chronic cough or constipation
  • Use proper lifting technique
  • Strengthen core muscles gradually
  • Do not smoke

Related Conditions

Hydrocele | Abscess