These are abnormal protrusion of abdominal contents through a defect in the abdominal wall. These include the common groin hernias (inguinal or femoral); hernias can also follow previous abdominal surgery (incisional hernias) or can be around where stomas are sited (parastomal hernias).

Symptoms are usually those of a swelling which goes back when the individual is lying down. Occasionally, the swelling needs to be pushed back. When the swelling can’t be pushed back, this may mean that it is obstructed (associated with vomiting, pain and constipation) and sometimes the health of the bowel is under threat (the swelling is very painful to touch).

The mainstay of treatment for groin hernias is surgery. This could be keyhole (laparoscopic) or open. A mesh is usually inserted to reinforce the repair.  For other types of hernias (incisional or parastomal), if the defect is large as to make complications unlikely, there is a choice of leaving it alone, managing with corsets to keep the hernia in or surgery. Large hernias may be repaired using new composite and biological meshes and using reconstructive techniques such as open or endoscopic component separation. Traditionally mesh has been placed in the 'on-lay position however there is a mechanical advantage to placing the mesh under the defect rather than on top of it and this can often be achieved with keyhole (laparoscopic) surgery, reducing the need for large incisions and decreasing the likelihood of post-op infections (see picture below). The Midland Gut Clinic Surgeons are experienced in all these procedures and will help you to decide upon the correct option for you.