Hernia Surgery

 

Inguinal hernia surgery is among the commonest performed surgeries in the world. Most are performed in the traditional “Open” approach. Some hernias qualify to be operated by the Key hole approach with a telescope which is called a laparoscope. Once the diagnosis of a hernia is reached, the appropriate surgical intervention can be recommended by the surgeon.

 

What is a Hernia?

  • A hernia is a gap or a space or a defect in the strong tissue that holds muscles in place. It occurs when the inside layers of the abdominal muscle have weakened, resulting in a bulge or tear. The inner lining of the abdomen (peritoneum) pushes through the weakened area of the abdominal wall to form a small balloon like sac.
  • This can allow a loop of intestine or abdominal tissue to push into the sac. The hernia can cause discomfort, severe pain, or other potentially serious problems that could require emergency surgery.
  • Both men and women can get a hernia.
  • People may be born with a hernia (congenital) or develop one over time.
  • A hernia does not get better over time, nor will it go away by itself.
  • There are no exercises or physical therapy regimen that can make a hernia go away.

 

How to detect a hernia? How do I know if I have a hernia?

 

The commonest sites for development of a hernia are the groin (inguinal hernia), the umbilius (umbilical or para umbilical hernia) and Incisional hernias which occur at sites of previous abdominal surgery or operations.

Hernias are recognised relatively easily. They may be noticed as a bulge or reducible lump under the skin.

You may feel pain or discomfort when you lift heavy objects, cough, strain during urination or bowel movements, or during prolonged standing or sitting.

In many cases a hernia is detected during routine physical examination by a doctor.

The nature of the pain in many cases is a dull dragging pain which could worsen on standing or sitting for long periods.

An increase in the intensity of pain with the swelling not becoming reducible is a sign of one of the dreaded complications of hernia. The symptoms indicate underlying incarcerated/ischemic or gangrenous bowel (dead bowel) and this situation calls for emergency surgery.

 

Causes of hernia

 

The wall of the abdomen has natural areas of potential weakness. Hernias can develop at these areas due to heavy strain on the abdominal wall, aging, injury, an old incision or a weakness present from birth.

Anyone can develop a hernia at any age. In adults, a natural weakness or strain from heavy lifting, persistent coughing, difficulty with bowel movements (constipation) or urination can cause the abdominal wall to weaken or separate.

 

What are the advantages of Key-hole or Laparoscopic hernia surgery?

 

Laparoscopic Hernia Repair is a minimally invasive technique to fix tears in the abdominal wall (muscle) using small incisions, telescopes (which are connected to an imaging system) and a synthetic mesh. Laparoscopic repair offers a shorter return to work and normal activity for most patients.

 

How is the Surgery Performed?

There are few options available for a patient who has a hernia.

  • Use of a truss (hernia belt) is rarely prescribed as it is usually ineffective. It may alleviate some discomfort, but will not prevent the possibility of bowel incarceration or strangulation. Over long periods the truss tends to weaken the muscles over the abdominal wall further and are therefore not recommended.
  • Most hernias require a surgical procedure.
  • Surgical Repairs are done in one of two fashions:
    1. The open approach is done from the outside through a three to four-inch incision in the groin or the area of the hernia. The incision will extend through the skin, subcutaneous fat, and allow the surgeon to get to the level of the defect. The surgeon may choose to use a small piece of surgical mesh to repair the defect or hole.
    2. The laparoscopic (key-hole surgery) hernia repair is done with the use of a laparoscope (a tiny telescope) connected to a special camera is inserted through a cannula, a small hollow tube, allowing the surgeon to view the hernia and surrounding tissue on a video screen.
    3. Other cannulas are inserted which allow your surgeon to work “inside.” Three separate quarter inch incisions are usually necessary. The hernia is repaired from behind the abdominal wall. A small piece of surgical mesh is placed over the hernia defect, and it may be fixed in place using staples, adhesive sealant, or sutures. This operation is usually performed with general anaesthesia.

 

Get in touch with SIGMA Gastrocare to have a conversation with our experts about treatment of Hernias.

The surgeons at SIGMA are experts in both laparoscopic and open hernia repair.