Understanding

What are Rare Hernias?

While inguinal, umbilical, and incisional hernias account for the vast majority of abdominal wall hernias, several rarer types occur in specific anatomical sites and present unique diagnostic and surgical challenges.

Because these hernias are uncommon, they are frequently misdiagnosed or overlooked. Dr. Kumar has particular expertise in recognising and repairing these rare presentations, including epigastric, supraumbilical, lumbar, spigelian, and diaphragmatic hernias.

Why Rare Hernias Need a Specialist

Frequently Missed

Rare hernias are often misdiagnosed as musculoskeletal pain or other conditions.

Anatomically Specific

Each rare type occurs at a different site requiring a tailored surgical approach.

Higher Complication Risk

Delayed diagnosis increases the risk of incarceration, strangulation, or organ damage.

Tailored Repair

A general hernia repair technique may not be appropriate — specialist expertise is essential.

Five Rare Types

The Five Rare Hernia Types

A concise guide to the rare hernia types Dr. Kumar diagnoses and repairs.

1

Epigastric Hernia

Develops in the upper midline between the belly button and the breastbone, where tissue pushes through the linea alba. Three times more common in men.

• Often small, contains preperitoneal fat
• Can be congenital or acquired
• Open or laparoscopic mesh repair

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2

Supraumbilical Hernia

Occurs just above the umbilicus in the upper midline — sometimes classified as a variant of the epigastric hernia but typically closer to the navel.

• Close to but distinct from umbilical hernia
• Often present from birth
• Small incision mesh repair typical

See related: Epigastric Hernia

3

Lumbar Hernia

A rare posterior abdominal wall hernia through the lumbar triangle (Grynfeltt or Petit). Can be congenital, acquired, or post-traumatic.

• Bulge in the flank or lower back
• May follow trauma or surgery
• Open mesh repair most common

See related: Incisional Hernia

4

Spigelian Hernia

A rare lateral ventral hernia through the spigelian fascia — the line where the rectus muscle meets the lateral abdominal muscles. High incarceration risk.

• Located lateral to the rectus, below the navel
• High risk of strangulation (up to 30%)
• Laparoscopic repair preferred

See related: Ventral Hernia

5

Diaphragmatic Hernia

A defect in the diaphragm allowing abdominal organs (stomach, bowel) to enter the chest cavity. Can be congenital, traumatic, or acquired.

• Symptoms: breathlessness, chest pain, reflux
• CT chest and abdomen for diagnosis
• Laparoscopic or thoracic repair

See related: Hiatal Hernia

Recognition

Common Symptoms

While each rare hernia has its own features, several symptoms are shared across the group.

Localised Bulge

A small, often intermittent lump at the hernia site, sometimes only visible on standing or straining.

Site-Specific Pain

Aching or burning pain at the anatomical site, often worsening with exertion, lifting, or coughing.

Reduced with Rest

Symptoms typically ease when lying down or resting, returning with activity — a classic hernia sign.

Tender on Touch

Direct tenderness or a palpable defect on examination, sometimes the only clue in small rare hernias.

Often Asymptomatic

Many rare hernias are discovered incidentally on CT or MRI performed for unrelated reasons.

Emergency Signs

Severe pain, vomiting, breathlessness, or non-reducible bulge requires immediate medical attention.

When to Seek Care

When to Consult a Specialist

Book a Consultation If You Have

A bulge in the upper abdomen, flank, or unusual site

Persistent pain at an unusual site not explained by other causes

Imaging (CT/MRI) showing a hernia at an uncommon location

Symptoms not improving with conservative management

Our Approach

Detailed clinical examination and history

Targeted CT or MRI for accurate diagnosis

Tailored surgical plan based on type and defect

Daycare laparoscopic repair when feasible

Rare Hernia Specialist

Unexplained Pain or an Unusual Bulge?

Book an appointment with Dr. Kumar for an accurate diagnosis and a tailored surgical plan for any uncommon hernia presentation.

Book Appointment

Surgical Approaches

How Dr. Kumar Repairs Rare Hernias

Dr. Kumar specializes in advanced minimally invasive techniques. Laparoscopic and Robotic approaches are preferred for faster recovery, less pain, and tiny scars. Open repair is reserved for select cases.

★ Preferred Approach

Advanced Laparoscopic Rare Hernia Repair

Minimally Invasive · Keyhole Surgery

For most rare hernias (Spigelian, lumbar, supraumbilical, obturator), Dr. Kumar's preferred approach is laparoscopic — typically TEP or TAPP. Keyhole access allows inspection of the entire abdominal wall, detecting occult defects that single-incision open surgery would miss, with wide mesh overlap for a durable repair.

✓ Inspects entire abdominal wall
✓ Detects occult defects
✓ TEP / TAPP techniques
✓ Wide mesh overlap

★ Preferred Approach

Advanced Robotic Rare Hernia Repair

Latest Technology · 3D Vision

State-of-the-art advanced robotic platform for unmatched precision, 3D visualization, and wristed instruments — ideal for complex or large rare hernias that benefit from component separation, TAR, or full Abdominal Wall Reconstruction (AWR).

✓ Superior 3D HD vision
✓ Wristed instrument precision
✓ Robotic AWR / TAR
✓ Best for large rare defects

When Needed

Open Rare Hernia Repair

Time-tested open technique (mesh repair) reserved for select cases — large, infected, contaminated, or emergency hernias, and patients unsuitable for keyhole surgery.

Dr. Kumar's Specialty Focus

AWR / TAR

Abdominal wall reconstruction with TAR/component separation

Complex Hernia

Large, multi-recurrent, contaminated defects

Recurrent Hernia

After previous repair — different anatomical plane