Hernia: What, Why, How.

A hernia is a “defect” or weakness in the abdominal wall. There are several locations and types of hernias, the common areas being the groin (inguinal or femoral), belly button (umbilical), above or below the belly button (ventral), and the site of a previous operation (incisional).A hernia develops due to the combination of a muscle weakness in the abdominal wall and a persistent pressure due to this weakness, over a period of time. In men it is present in the groin area (inguinal), in women they occur higher up in the belly region often near the navel (femoral).

Some of the causes of hernia include:

Ø  A congenital defect at birth

Ø  Abdominal muscles can weaken over time

Ø  Poor nutrition

Ø  Chronic Constipation

Ø  Straining during urination

Ø  Constant coughing or sneezing

Ø  An abdominal injury or surgery

Ø  Improper lifting of heavy weights

Ø  Being overweight/obesity

There are different types of hernia:

1. Inguinal Hernia – It is more common in men than in women.

2. Femoral Hernia – It is most common in women, especially those who are pregnant or obese.

3. Incisional Hernia – This type is most common in elderly or overweight people who are inactive after abdominal surgery.

4. Umbilical Hernia – This is one of the most common hernias. Common in new-borns, it also commonly afflicts obese women or those who have had many children.

Others include:  Hiatal Hernia, Epigastric Hernia, Spigelian Hernia and Muscle Hernia

Symptoms of hernia include:

•           Hernia in the abdomen or groin can produce a noticeable lump or bulge that can be pushed back in, or that can disappear when lying down.

•           Laughing, crying, coughing, and straining during a bowel movement or physical activity may make the lump reappear?

•           Visible Swelling or bulge in the groin or scrotum

•           Increased pain at the site of the bulge

•           Pain while lifting or dull aching sensation

•           A sense of feeling full or signs of bowel obstruction over time

Treatment of hernia:

Hernias treatment typically does not resolve on their own and surgery may be the only way to repair them. If an adult has an umbilical hernia, surgery is usually recommended because the condition will not likely improve on its own and the risk of complications is higher.

Hernia treatment is Surgical includes:

Repair of a hernia in the groin (an inguinal hernia) is the most frequently performed operation in general surgery.

1) Herniorrhaphy: (tissue repair) Open surgery technique which involves a surgeon making a long incision directly over the hernia then using surgical tools to open the cut enough to access it. The t issues or a displaced organ are then returned to their original location, and the hernia sac is removed. The surgeon stitches the sides of the muscle opening or whole through which the hernia protruded. Once the wound has been sterilized, it is stitched shut.

2) Hernioplasty:  in this type of open surgery, instead of stitching the muscle opening shut, the surgeon covers it with a flat, sterile mesh, usually made of flexible plastics, such as polypropylene, or animal tissue. The surgeon makes small cuts around the hole in the shape of the mesh and then stitches the patch into the healthy, intact surrounding tissues.

The mesh acts as a supportive, strengthening mechanism as they regrow and gives the extra support.

3) Laparoscopic surgery: (minimal access)   involves, tiny incisions are made to allow for the insertion of surgical tools (key whole surgery) to complete the procedure. There are two types of minimal invasive surgeries used transabdominal preperitoneal (TAPP) repair and totally extraperitoneal (TEP) repair.

 Return to usual activities was faster for laparoscopic repair, by about seven days, and there was less persisting pain and numbness than with open surgery. The hernia defect or hole is covered with mesh from within the abdomen and staples commonly fired through it into the muscle tissue in order to fix it as a patch.

Complications of an untreated inguinal or femoral hernia may include:

Obstruction (incarceration) – Part of the intestine becomes stuck in the inguinal canal, causing nausea, vomiting, stomach pain, and a painful lump in the groin.

Strangulation – Part of the intestine is trapped in a way that cuts off its blood supply. In such cases, emergency surgery (within hours of occurring) is called for to prevent tissue death.

Post-operative care:

After surgery, you will be given instructions. These include what diet to follow, how to care for the incision site, and how to take care to avoid physical strain. Hernias may recur regardless of the repair operations; sometimes this can be due to inherent tissue weakness or protracted healing.

Minimal Access Surgery in Wockhardt Hospital:

At Wockhardt hospital our General surgery is responsible for the preoperative, operative, and postoperative management of patients with a broad spectrum of diseases, including those which may require non-operative, elective, or emergency surgical treatment. Our team of surgeons are successfully competent in diagnosis as well as in treating and managing all surgical operative interventions. Our skilled surgeons are trained in various specialties and have specialised expertise in various disciplines in surgery. Backing this team of highly skilled surgeons are trained nurses and technicians and state-of-the-art operation theatres equipped with the latest technology.

Services of digestive care include state of the art technology and instruments to perform Minimal Access (Laparoscopic) surgery, highly skilled team of anaesthetists, critical care high dependency units with highly skilled intensivists.

The field of Minimal Access Surgery or Laparoscopic Surgery has revolutionised surgical management is part of the spectrum of services. Our experienced team of surgeons specialize in performing high end procedures based on international standards.

These procedures are performed through tiny incisions instead of one large opening. Because the incisions are small, patients tend to have quicker recovery times and less discomfort than with conventional surgery — all with the same benefits.

 The Institute with its multi-disciplinary approach has well-coordinated protocols to treat patients under this speciality

At Wockhardt Hospitals we have well equipped state-of-the-art facility having latest endoscopic, monitoring, and infection control equipment .Our consultant team includes experience d gastroenterologist, gastroenterology surgeons endoscopes technicians, pulmonologist and qualified endoscopic nurses. Wockhardt is committed to deliver expert gastroenterology care in a timely, safe, and patient friendly manner.