Imagine our abdominal wall to be a bag. The bag (abdominal wall) contains and safeguards vital organs of the abdomen like Liver, intestines, fat etc inside it. The bag (abdominal wall) is made up of several layers – outermost is skin, then fat followed by several layers of muscles and finally peritoneum.
If because of any reason, the muscles in the wall become weak / develop a hole / defect then the intestines or other abdominal contents protrude out of that muscular defect and appear as a bulge underneath the skin. This abnormal bulge of abdominal contents through the muscular defect is known as “hernia”.
Hernia is named according to its site – namely Epigastric, Umbilical, inguinal, incisional etc.
Causes: Congenital, after surgery, pregnancy, obesity, muscle weakness, excessive straining of abdomen like suddenly lifting heavy weights or long term straining because of constipation, cough, urinary obstruction.
With time, the hernia defect can keep getting bigger. The intestines that bulge through the defect may get stuck and stop going back in the abdominal cavity. The intestines can develop obstruction and if the blood supply of the intestines stops then eventually the intestines can die and this condition, if not treated timely, can even lead to death.
Hernia is a mechanical defect and requires surgical repair. Repair is nowadays done by closing the defect with sutures and then reinforcement using a mesh. A mesh is a synthetic piece of membrane that is stitched over the defect to provide extra strength to the repair so that the hernia does not recur. These days the hernia surgery is done by laparoscopic techniques. This causes very little pain, quick return to activity and provides good cosmesis. Patients can return to normal activities, gym and exercises very soon after surgery