Hernia

What is a hernia?

A hernia is a protrusion of bodily contents beyond its normal confines. Hernias are classified according to location in the body. 

The most common is a groin or inguinal hernia, where part of the intestines or fat slips out through a defect in the muscle of the groin. Defects in the umbilicus are also common (umbilical / paraumbilical hernia). Incisional hernia (a.k.a. ventral hernia) may occur in a previous surgical scar that did not heal properly. 

Some hernias are seen externally, such as a hiatal hernia that occurs through a loose hiatus in the diaphragm. This leads to part of the stomach slipping up into the chest and patients present with symptoms of gastro-esophageal reflux (GERD).

Do hernias need to be treated?

Generally, yes. If left untreated, they grow in size and may lead to serious complications.

How are hernias diagnosed?

  • Physical examination 
  • Ultrasound scan
  • CT scan

What are the complications of a hernia?

Possible complications include: 

  • Incarceration of hernia contents – contents such as intestines or intestinal fat get stuck in the hernia sac. Surgery is required.
  • Intestinal obstruction – the stuck intestines cause obstruction in the intestinal system leading to vomiting and pain. Urgent surgery is required.
  • Gangrene of the intestines – blood supply to the intestines is cut off and the bowels undergo necrosis. Emergency surgery is required.

How are hernias repaired?

A special mesh is used to repair the defect. With the mesh, recurrence rates are lower. In our practice, we place the mesh using one of the following methods:

  • Standard 3-incision laparoscopic surgery. One incision in the umbilicus is 1.0cm and the others 0.5cm. The procedure is known as laparoscopic hernia repair.
  • SILS/Single Incision Laparoscopic Surgery. A single 2cm incision in the umbilicus to repair the defect.
  • Robotic Surgery where the state-of-the-art daVinci surgical system is used. With this method, the surgeon operates in a 3-D environment with 10x magnification using computer-aided instruments that eliminates tremors
  • Open surgery. This is the last resort.

Why choose Centre for Screening and Surgery?

The Centre for Screening and Surgery (CSS) specialises in the screening and detection of cancer in its early stages. In the case of colon and other gastrointestinal cancers, we use high-definition gastroscopy and colonoscopy to diagnose cancers or remove polyps, in addition to blood tests for tumour markers. When surgery is needed, we specialise in the minimally invasive approach, including robotic surgery, leading to less pain, a shorter recovery, and better cosmetic results. 

CSS is led by Dr Kum Cheng Kiong, a pioneer in Asia for Minimally Invasive Surgery (Laparoscopic Surgery or Keyhole Surgery) with more than 30 years of experience and has received advanced training in colorectal surgery in Cleveland clinic, USA. He is the former President of the Singapore chapter of the Endoscopic and Laparoscopic Surgeons of Asia (ELSA) and the founding member of the Endoscopic and Laparoscopic Surgeons of Asia.

FAQ

Generally, yes. If left untreated, they grow in size and may lead to serious complications.

No, hernias do not always cause pain. Depending on the type of hernia you have, your symptoms and pain level can vary. Often, hernias do not cause many noticeable symptoms at first. Some people may experience a pulling sensation or sensitivity in the area around the hernia.

A majority of hernias are inguinal hernias, which men are especially prone to. One reason for this is that while male babies are in the womb, the testicles are formed in the abdomen and pass through the groin canal into the scrotum. This canal usually closes after birth. If the canal does not fully close, the weakness may ultimately result in an inguinal hernia many years alter.

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