Abdominal wall hernia repair: your options

Posted on 5 July 2022

An abdominal wall hernia can be extremely painful and severely impact your quality of life. The good news is that surgical repair is among the procedures available under Mediclinic’s Private Fixed Fees programme. 

Although hernia can present in different parts of the body, it mainly occurs in the abdominal wall. “The abdominal wall is made of fascia and layers of muscle that keep everything in your abdomen intact – an abdominal wall hernia is when the organs start protruding through the abdominal wall,” explains Dr Dirk Viljoen, a general surgeon at Mediclinic Newcastle. “Usually, it’s the bowel that’s involved, but in theory, any organ could herniate.” 

There are different types of hernias. A congenital hernia is one that you’re born with – often at the site of the umbilical cord or in the groin. Usually, doctors identify it in infancy and it’s generally repaired before adulthood, says Dr Viljoen. However, it is possible that a congenital hernia could persist into adulthood.   

Far more common in adults, though, is acquired hernia – this develops later in life and is especially seen in people with a weakened abdominal wall. According to Dr Viljoen, risk factors include:  

• Age – like all muscles in the body, the abdominal wall can naturally weaken with age, putting the elderly at higher risk 
• Obesity – puts additional pressure on the abdominal wall 
• Lifting heavy objects – people whose jobs involve heavy labour or who lift heavy weights at the gym may have an increased risk of hernia 
• Straining – this is a factor that may be seen in people with, for example, chronic constipation 

• Previous abdominal surgery – surgery to the abdomen often involves cutting through the abdominal wall, which may leave a permanent weak spot, even after the wound has healed. 

“In the early stages, you will experience pain in a specific, localised area,” says Dr Viljoen. “You’ll notice a physical bulge under the skin. It can become very painful and impair your ability to do normal activities – such as exercise, sport and even minor things, like walking.” Left untreated, a hernia can potentially develop into a strangulated hernia, where it cuts off blood supply to the herniated organ. “When that happens, it’s a medical emergency,” warns Dr Viljoen. 

“Surgery is almost always indicated. A hernia won’t go away on its own and will likely grow bigger. There’s no medication you can take or ointment you can use. The only time we wouldn’t advise surgery is if the patient is high risk – for example, very elderly and frail – and the hernia is fairly asymptomatic.”  

Surgery involves locating and removing or reducing the hernia and then placing a synthetic mesh over the site to reinforce the abdominal wall. The good news is that the most common types of hernia repair surgery are all available through the Mediclinic Private Fixed Fees programme. They are: 

Open incisional hernia repair: “This is when the patient has had an abdominal operation before, like a hysterectomy,” explains Dr Viljoen. “We cut over the previous incision, identify and excise the hernial sac, and repair the anatomical defect by placement of a mesh.” 

Open inguinal hernia repair: “This is for a groin hernia. We make a 5-10cm incision in the groin and reduce the content of the hernia. We then repair/strengthen the inguinal floor by placing a mesh.” 

Open umbilical hernia repair: “We cut around the umbilicus and fix the defect in the abdominal wall, in most cases, using a mesh for the repair.” 

Click here to find out more about Mediclinic’s Fixed Fees programme for your hernia repair surgery.