When we mention the term “hernia,” many Thai people are likely familiar with it. However, few truly understand what the condition means. Dr. Narasara Vittayapipat, a surgeon at the Advanced Surgery Technology Center (ASIT) at Phyathai 3 Hospital, is here to clarify and share important insights about this condition for everyone.
What Is a Hernia?
A hernia refers to the protrusion of an internal organ, typically a portion of the intestine, through a weakness in the abdominal wall. This often results in a noticeable bulge in the abdomen, particularly in the groin area. Hernias commonly occur during activities such as standing, walking, running, lifting heavy objects, coughing, sneezing, or exercising. In some cases, the bulge may descend into the scrotum.
The bulge can usually be pushed back into the abdomen when the patient lies down and gently compresses the area. However, in some instances, the bulge may not return, indicating a potentially serious condition (incarcerated or strangulated) that requires immediate medical attention.
Symptoms of a Hernia
The symptoms of a hernia can vary significantly. Some individuals may have a hernia without any noticeable symptoms, while others might experience pain in the groin area. This pain can appear suddenly or feel like a dull ache that comes and goes. Patients might also feel that their abdominal wall is weak or lax.
Severe and rapid pain may indicate a loss of blood supply to the intestine (strangulation), a condition that necessitates emergency surgery. Additionally, the symptoms may worsen or the bulge may become larger throughout the day, particularly after activities like prolonged standing, walking, coughing, or playing sports.
How Does a Hernia Occur?
The exact cause of a hernia is not fully understood, but several factors are believed to contribute to its development. A weakness in the abdominal wall is often a key factor. This weakness may stem from natural openings in the wall, such as those for the blood vessels supplying the testicles, which typically close during fetal development. In patients with hernias, this opening remains open, allowing the intestine to protrude.
Notably, certain risk factors increase the likelihood of developing a hernia, including smoking, chronic coughing, and an enlarged prostate.
Types of Hernias and Diagnosis
Hernias in the abdominal wall come in several forms:
- Inguinal Hernia: Occurs in the groin area.
- Femoral Hernia: Appears near the femoral artery in the thigh.
- Obturator Hernia: Develops in the pelvic region.
- Incisional Hernia: Arises from an incompletely closed surgical incision.
- Ventral Hernia: Occurs in the general abdominal wall.
- Umbilical Hernia: Forms at the belly button.
- Other Types: There are various other less common hernias.
How Are Hernias Diagnosed?
Diagnosis starts with a thorough medical history and physical examination. Doctors have specific procedures for examining hernias, especially if a bulge is visibly present in the abdominal wall. They will assess whether the bulge is indeed a hernia or if it could be another condition, such as swollen lymph nodes, lipomas, blocked sebaceous glands, tumors, or testicular cysts.
Is Surgery Necessary?
Hernias with a prominent bulge will not heal on their own. If left untreated, the hernia will likely increase in size over time. For those who have had a hernia for a long time or have a particularly large bulge, surgery becomes more complicated and poses a higher risk of postoperative complications. Moreover, if a hernia cannot be pushed back in, there is a risk of bowel obstruction, leading to loss of blood supply, tissue death, and potentially life-threatening situations.
Patients who do not undergo surgical treatment will have to cope with various symptoms that can significantly affect their daily lives. Activities like exercising, lifting objects, coughing, or even standing for long periods may become challenging or impossible. It’s clear that many people might already know the answer to whether surgery is the right choice when faced with a hernia.
Surgical Options for Hernia Repair
There are several surgical techniques available for hernia repair:
1. Open Surgery: This standard method involves making an incision of about 6-8 centimeters in the groin area where the hernia is located. Patients may receive general anesthesia or spinal/epidural anesthesia during the procedure.
2. Laparoscopic Surgery: This minimally invasive technique has numerous benefits, including smaller incisions, reduced pain, lower recurrence rates, fewer complications, and a shorter hospital stay.
Both methods are effective, but the choice of surgery often depends on the specific case and patient preferences.
Dr. Narasara Vittayapipat
Specialist in Laparoscopic Surgery
Advanced Surgical Technology Center (ASIT)
Phayathai 3 Hospital
