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What causes a spigelian hernia?

It is difficult to ascertain the exact cause of these hernia, however it becomes noticeable on straining, sports and exercise.

What are the expected symptoms?

In majority, spigelian hernia presents as a lump protruding through just at the level and few centimetres away from the umbilicus. It may be associated with bowel disturbance or pain mainly on standing or any activity increases intra- abdominal pressure. It might be hard to find on clinical examination. Often a CT scan may be required to diagnose spigelian hernia.

What are the alarming symptoms?

• Increasing in size

• Worsening pain

• If the hernia turns hard and associated with nausea or vomiting, could indicate obstructed hernia

What is a strangulated hernia?

Strangulated hernia is a surgical emergency, if neglected can lead to very serious complications. Strangulation occurs when blood supply to hernia contents, usually bowel, is impaired leading to ischemia (death of the bowel) or gangrene of the bowel.

What is the treatment of Spigelian hernia?

Spigelian hernia is better repaired by surgery.

What are the different types of surgery available?

At nu-life surgery, we prefer to repair this hernia with a laparoscopic approach. This approach allows the surgeon to evaluate the hernia from inside the abdominal cavity helping in carrying out a sound repair. Hernia can be repaired by open approach in patients who are suitable for laparoscopic method. Both the approaches have advantages and disadvantages. You will be able to discuss with your surgeon at the time of consultation.

What happens during surgery?

Spigelian hernia repair is usually carried out under general anaesthesia. Incisions made will vary according to the type of surgery. Aim of the operation will be to identify the hernia defect and push it back in to the abdomen then a mesh repair will be carried out to reinforce the abdominal wall. The wound is usually closed with absorbable sutures.

What is the after care?

You will be encouraged to be mobile as much as possible. We advise our patients to refrain from lifting heavy weights for four-six weeks and avoid driving till they are able to put an emergency stop. Our patients will be able to go home on the same day depending on the timing of the surgery.

Do I need to take time off from work following surgery?

It depends on the type of work involved, however generally you will need two weeks off from work.

What are the risks from surgery?

Minor side effects and complications common but serious side effects are very rare. There are risks of wound infection, bruising, bleeding from the wound rarely chronic pain and recurrence of hernia (2%)

Spigelian Hernia

Spigelian hernia is a very rare type of hernia which occurs in both men and women alike. It often develops later on in life when the abdominal muscles are not as strong as they were in one’s youth. A spigelian hernia protrudes through a weakness between the muscle fibres of the abdominal wall. This protrusion may contain a section of the intestines but in other cases it takes the form of an empty sac. This often forms on the right hand side of the abdomen.

A spigelian hernia develops between the muscles of the abdominal wall rather than pushing through layers of fat which may cause it to be mistaken for another type of abdominal complaint.

Symptoms of spigelian hernia:

• Poor bowel function or constipation

• Dull ache

• Recurring pain especially on bending or stretching


Some answers to questions we are often asked…

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