Visit: http://www.anilsharmalaparoscopy.com/hernia.php
CONTACT US: +91 9811690841
A Hernia occurs when the contents of a body cavity protrude out of the cavity, in which they are normally contained, through a weak spot in a surrounding muscle or connective tissue. Hernias by themselves may or may not produce symptoms as they are asymptomatic and can cause slight to severe pain. A hernia does not get better with time, nor will it go away by itself (except, very small congenital navel hernia)
Inguinal hernias are the most common types of male hernias, that are located in the lower abdomen and thigh going towards the scrotum, as bulge in the groin. They are more common in men than women. Inguinal hernias usually occur when fatty tissue or part of a bowel, bulge out through a part of the lower abdominal wall known as inguinal canal.
Femoral Hernias occur in the groin region, just below the groin crease. They occur due to weakness in the lower groin region usually as a result of pregnancy and child birth. They are therefore more common in women than men. They are more prone to complications and hence should be repaired once they are diagnosed. Femoral hernias are quite uncommon.
An umbilical hernia occurs when part of the intestine protrudes through the umbilical opening in the abdominal muscles. These hernias may occur in infants at or just after birth and may resolve by 3 or 4 years of age. However, the area of weakness can persist throughout life and can occur in men, women and children at any time. In adults, umbilical hernias will not resolve and may progressively worsen over time. They are sometime caused by abdominal pressure due to being overweight, excessive coughing and pregnancy.
Ventral Hernia is a hernia that surfaces on any part of the front surface of the abdominal wall without previous surgery, it results in a bulge in the ventral surface that develops a balloon-like sac.
Hernia that occurs through a previously made incision in the abdominal wall i.e., the scar left from previous surgical operation.
Strangulation of Hernia is a surgical emergency in which the intestines get strangulated in the hernia. It occurs when the blood supply to the herniated bowel is cut off or greatly reduced, causing the bowel tissue to die or rupture. The hernia becomes very painful, does not reduce and the overlying skin becomes red. The patient in this case requires immediate hospitalization and surgery. In case of delay, the intestine may also need to be removed.
Surgery is the only way to cure hernia. A hernia will not go away on its own but will increase in size if left untreated. There is no medical treatment for it. However, the patient should be seen by a surgeon for assessment and deciding the management.
Once detected, for best results, the hernia should be treated as early as possible. Also, early operation will prevent complications like obstruction and strangulation. When compared with large hernias the surgical results with smaller hernias are more satisfying as compared to large hernias.
Laparoscopic surgery has the following advantages over open hernia surgery:
Yes. Now all over the world, there is a consensus that the use of mesh is desirable in majority of patients to strengthen the wall whether surgery is done conventionally or endoscopically. Only the childhood hernias are repaired without using mesh.
Patients are admitted in the hospital on the day of surgery or a day prior to surgery. On admission, patients are examined and investigations are reviewed by one of the team members. A member of the Anaesthesia team conducts the pre-anaesthetic check-up. Pre-operative investigations are performed if needed. Patients need to be fasting overnight before the surgery. Next morning, he/she will be shifted to the operation theatre half an hour prior to surgery. After surgery, they are shifted to the recovery room for 2-4 hours under the care and supervision of our Anaesthesia team for observation and then shifted back to the room.
Patient is given sips of water orally on returning to the room and progresses to drinking all kinds of liquid on the same evening as surgery. They may sit up, visit the toilet and move around for a few hours after the surgery and are encouraged to do so early. Patients are given a normal breakfast next morning and discharged from hospital after a visit by one of the team members. On discharge, a discharge summary with the advised medication is handed over to patient.
Yes, day care surgery is being performed on young and fit patients. The patient is called to the operation theatre in the morning in a fasting state of more than 8 hours. After the operation, patient is observed of 4-6 hours post operatively in the day care facility before getting discharged. In case the need arises, there is a provision for overnight admission as well.
After the operation the patient will be kept in the recovery room, for few hours. The anaesthetist decides about shifting the patient to the room. The decision depends on many technical factors.
The patient may suffer some discomfort when coming out of the effect of sedation. It gradually reduces to a tolerable level within a few minutes without any pain killer. However, if necessary the patient may ask for pain killer, injections or tablets. The patient should try to avoid these drugs because the produce drowsiness and patient may sleep for a longer period which is not desirable.
The patient is allowed to have sips of water immediately after the operation and liquids on the day of operation. In case of vomiting the liquid intake may be stopped and resumed after 30 minutes. The liquids may include water/cold drinks/tea/coffee/ milk/ juices or some clear soups.
The patient is allowed to have normal meals of choice from the next morning for breakfast/lunch/dinner.
The patient should have small frequent meals for few days after operation following which, patient can resume their normal diet gradually. This is vital because the patient may feel bloated and distended if the quantity of food is large at a time.
The patient should try to move the limbs and can sit up after operation and should also go to the toilet on their own. There are no restrictions whatsoever for the physical movement. In fact, majority of the patients will feel much better after they have started movements. The pain also reduces once patient starts sitting up, moving and walking. There is no restriction on the patient’s physical activity. They are allowed to walk as soon as they recover from their sleep. There is no restriction on climbing of stairs, lifting weight, etc. They may even drive two wheelers or car as soon as they feel fit. This infact is one of the major advantages of the laparoscopic procedure.
The patient will be discharged on the same day or next day of operation unless there is some associated medical/social problems. They are advised to visit again for follow up after 2-5 days when the dressings are removed. They should avoid wetting the dressings unless they are water proof. After the removal of dressing, they can have normal bath with soap and water.
In very few cases, there may be some discharge from the wound in the post-operative period. This should not bother the patient. They can wipe the discharge and apply band-aid so as to avoid staining the clothes. If it is more, the patient should report to the surgeon during the next visit.
A hernia occurs when an organ in the muscle or tissue that holds it in place pushes through an opening. For example, in the abdominal wall, the intestines can split through a weakened region. Hernias usually occur between your chest and between hip and abdomen, but may also occur in the upper thigh and groin areas.
As Surgery is the only way that hernia can be treated, it should not be left unattended as it will only grow in size if untreated. Once it is detected, it should immediately be treated as early as possible. Early detection and removal of Hernia will prevent complications like obstruction and strangulation.
During my practice so far I have conducted numerous Laparoscopic Hernia Repairs on patients of all ages. As the President of Asia Pacific Hernia Society, I conceptualized and created Hernia Essentials, a comprehensive Hernia training Course, primarily based on International guidelines on management of hernia.
To enjoy good health, to bring true happiness to one's family, to bring peace to all, one must first discipline and control one's own mind. If a man can control his mind he can find the way to Enlightenment.
