1. What is a hernia?
    A hernia is a defect in the muscular structure of the wall of the abdomen. This can cause the passage of abdominal content (fat, bowel) through the defect. This will bulge out like a lump.
  2. What is an incarcerated hernia?
    In a normal situation this lump can go in and out through the defect. Incarceration is if this bulge is trapped out of the abdominal cavity and can not go back to its normal position.
  3. Is this risky?
    The most common location for hernias is the groin (inguinal and femoral hernias). However, hernias can develop in other sites such as the navel region (umbilical hernia), any part of the abdominal wall and on the site of previous surgery (incisional hernia).
  4. Where are hernias located?
    The average stay after keyhole surgery is 2 to 4 days although a few fit young patients may be able to go home the day after operation.
  5. What are the symptoms and signs of a hernia?
    Most people start noticing swelling and discomfort, this may increase with movement and lifting and at some stage this may become painful.
  6. How is a hernia repaired?
    The treatment involves reducing the hernia back to the abdominal cavity, closing the muscular defect and fixing a mesh over the area to reinforce it and reduce the tension on the muscle. Using a mesh has been shown to reduce the risk of hernia recurrence.
  7. Is this done under general anaesthetic?
    Hernia repair can be done under local anaesthetic, but this is reserved for patients with high general anaesthetic risks. In fit patients general anaesthetic is preferred and carries very minimal risks.
  8. Is there any other treatment?
    In some cases a belt-like device (truss) can be used to push back the hernia into the abdomen. However this solution is not a practical solution and should be reserved for patients unfit for surgery.
  9. How long is the hospital stay?
    Most patients can go home in the same day. For incisional hernias it is sometimes necessary to leave some drains in the abdominal wall to drain fluids hence patients are kept in hospital for 1-2 days.
  10. When can I go back to work?
    Normally after 2 weeks if it is an office job. During the first 2 weeks patients should avoid any lifting and for 6 weeks only light lifting and physical activities are advised. Heavy lifting and physical exercises involving the abdominal muscles should be avoided for 2-3 months; this is to avoid tension on the muscles and hernia recurrence.



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Prof. Mohammad Abu Hilal is the Director of the Department of General Surgery and Head of the Hepatobiliopancreatic, Robotic and Minimally Invasive Surgery Unit at Fondazione Poliambulanza.

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