In the case of a hernia, a gap forms in the abdominal wall, which allows tissue of the abdominal cavity to protrude. Depending on the size of the hernia and its contents, hernias usually cause a visible protrusion (in particular, when standing and exerting pressure in the abdomen), which can cause pain when the tissue protrudes. If a loop of intestine penetrates the abdominal wall gap, in rare cases, it can become trapped and compromise the blood supply to the intestinal section or result in an intestinal obstruction. In this case, emergency surgery is indicated. For anatomical reasons, the navel and the groin are weak points of the abdominal wall, which is why hernias are more likely to occur here. In the embryonic period, there is a connection to the outside via the umbilical cord, which then closes after birth. If this gap fails to close, it is referred to as a congenital umbilical hernia. However, an umbilical hernia often also occurs in adulthood (acquired umbilical hernia) due to the weakening of the abdominal wall, following e.g., pregnancy, considerable weight gain or increased stress.
Inguinal hernias occur more often in men (but not only) due to the fact that the inguinal region also forms a weak point during the embryonic period as a result of the passage of the testicles (from the inside of the abdomen into the scrotum). The lifting of heavy loads, practising sports or the state of pregnancy increase the pressure in the abdominal cavity and can lead to bulges in the area of these weak points. The incisional hernia is another common type of hernia. If surgery was performed in the abdominal cavity, scars always remain in the abdominal wall. The scar tissue never presents the same elasticity and strength as the original connective tissue or the muscles. Therefore, hernias can also develop in these areas. The more extensive the surgical scar, the higher the risk of a future scar rupture. The diagnosis can often be performed based solely on the clinical examination. In certain cases, imaging is required (ultrasound or computer tomography).
Once an abdominal wall hernia has occurred, it cannot be reduced by way of medication, physiotherapy, or sports. The only treatment option is surgery, although this is not an absolutely necessity and of equal urgency in all cases. Various surgical techniques are available, which I will discuss with you depending on the findings and previous operations. We distinguish between minimally invasive and open hernia surgery, with or without mesh reinforcement. Unilateral inguinal hernias are usually performed on a minimally invasive outpatient basis, while bilateral hernias, umbilical or incisional hernias require a short hospital stay.