A spigelian hernia is a hole through a weakness in the abdominal wall. At the start of trouble you may notice a lump or bulge appearing to the side and below your tummy button. It occurs along the lower edge of the “six-pack” in body builders. The bulge consists most usually of fatty tissue but may contain bowel (gut). You may experience discomfort at first but it may become more painful when lifting heavy objects or coughing.

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Who commonly presents with it?

These hernias are caused by a weakness in the muscles of the abdominal wall. Other factors, which contribute to the development of epigastric hernias are obesity, coughing, heavy work, sports etc.

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How does it present?

Common sign of a spigelian hernia is a lump or bulge either below or to the side of the belly button. The lump may feel soft to the touch. Another symptom is constant or intermittent abdominal pain

Pain intensity can vary. The weakness in the muscle wall could enlarge and rarely may contain loops of bowel. In these circumstances if you are unable to push the hernia back, a blockage of the bowel may occur, which causes vomiting and abdominal pain. If you experience this you should contact your doctor immediately as you may require an emergency operation.

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What can be done?

Many patients wish to have a hernia repaired because they are increasing in size, becoming more unsightly and uncomfortable. You will be asked to attend the pre-admission assessment clinic prior to admission to ensure you are fit for surgery, allowing time for the necessary pre- operative tests, which may include blood tests, cardiogram (ECG) and a chest x- ray.

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How long will your recovery take?

Recovery is very quick, with most patients being discharged the same or next day following surgery. Complete recovery is based on individual needs and fitness of the patient. Patients are encouraged to start mobilising gently immediately after surgery and refrain from lifting heavy objects for at least one week. A return to full activities is expected within 2-4 weeks.

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What are the main risks of surgery?

Your surgeon will advise on any specific complications and risks. For all types of surgery there is always a risk of wound infection and a 1-2% risk of recurrence of the hernia.

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