About Hernia

Hernias impact about 15% to 20% of the world population. In India, nearly 1.5 to 2 million cases of inguinal hernias are reported annually. Men are more likely to develop inguinal hernias—they make up 90% of those surgeries. Femoral hernias, while less common overall, occur more frequently in women, who account for 70% of such procedures. Among males, the lifetime risk for inguinal hernia is approximately 27%, whereas it's only 3% in females. Umbilical hernias are more typical in infants and women with multiple pregnancies.

What Is a Hernia?

A hernia happens when an organ or fatty tissue squeezes through a weak spot in the muscle or fascia. These weak areas might result from increased abdominal pressure, injury, or natural muscular thinning. Common hernias include inguinal, umbilical, femoral, hiatal, and incisional types. Hernias often produce discomfort and a visible bulge, especially during physical strain.

Types of Hernia 
Some of the most common hernias include:

• Inguinal Hernia: Representing 75% of all hernias globally, this occurs when intestines push through the abdominal wall in the groin region. It can be:
  • Direct Inguinal Hernia
  • Indirect Inguinal Hernia Factors include straining, aging, injury, or previous surgeries.
• Hiatal Hernia: The stomach pushes through the diaphragm into the chest cavity.
• Umbilical Hernia: Occurs around the belly button; often observed in newborns and multiparous women.
• Femoral Hernia: Appears in the upper thigh; more common in women, especially with excess weight or pregnancy.
• Obturator Hernia: Rare and internal; often missed on clinical exam. Seen more in elderly, underweight women.
• Other Types:
  • Spigelian: Through layers of abdominal muscles
  • Diastasis Recti: Separation of abdominal muscles
  • Incisional: After abdominal surgery
  • Diaphragmatic: Organs move into chest via diaphragm defect

Hernias may be congenital or develop over time due to stress or injury.

Hernia : Signs and Symptoms

Typical signs include:

• A bulge that enlarges on straining or coughing
• Sharp or aching pain in the groin or abdomen
• Nausea, vomiting (in complicated cases)
• A sensation of heaviness or weakness
• Swelling or pressure around the hernia site

Symptoms may vary depending on the type and location of hernia.

Hernia Causes

Common Causes Several contributing factors:

• Excessive lifting or manual labor
• Repeated coughing or sneezing
• Obesity or pregnancy
• Chronic constipation
• Abdominal injury or previous surgeries
• Birth defects or genetic weakness
• Poor core strength

Hernia Risk Factors

Your risk is higher if you have:

• Advanced age
• Male gender (especially for inguinal type)
• Obesity or sudden weight loss
• Chronic respiratory conditions
• History of abdominal surgeries
• Family history of hernia
• Heavy lifting jobs
• Cystic fibrosis or ascites
• Prematurity or low birth weight
• Enlarged prostate

Complications of Untreated Hernias Ignoring a hernia can lead to:

• Strangulation: Tissue death from cut-off blood supply
• Incarceration: Trapped tissue that can’t be pushed back
• Bowel blockage: Leads to vomiting and abdominal pain
• Severe swelling and pain
• Infections or abscess formation

Hernia Diagnosis

How Hernias Are Diagnosed Diagnostic methods include:

• Clinical exam
• Ultrasound or CT/MRI scans
• Blood tests if complications are suspected
• Upper GI endoscopy (for hiatal hernia)

Hernia Treatment at MASSH PROLIFE, Ludhiana

Conservative Options:

• Lifestyle advice: weight control, managing constipation
• Regular monitoring for small, painless hernias

Surgical Options:

• Open Surgery: Direct repair through a larger incision
• Advanced Laparoscopic Surgery: Small incisions and a camera-guided mesh placement ensure less pain, smaller scars, and faster healing. Options include:
  • TEP (Totally Extraperitoneal)
  • TAPP (Transabdominal Preperitoneal)
  • IPOM (Intraperitoneal Onlay Mesh)

Choice of technique is guided by the patient’s hernia type and overall condition.