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Hernia
 

WHAT IS HERNIA?
A hernia occurs when the contents of a body cavity bulge out of the area where they are normally contained. These contents, usually portions of intestine or abdominal fatty tissue, are often enclosed in the thin membrane that naturally lines the inside of the cavity. Although the term hernia can be used for bulges in other areas, it most often is used to describe hernias of the lowertorso (abdominal wall hernias}. hernias by themselves usually are harmless, but nearly all have a potential risk of having their blood supply cut off (becoming strangulated). If the hernia sac contents have their blood supply cut off at the hernia opening in the abdominal wall, it becomes a medical and surgical emergency.

WHAT ARE THE COMMON TYPES?

The common types of hernias are present in the groin (inguinal), belly button (umbilical) and the site of a previous operation (incisional). There are many more types but those are rare.


WHY DOES A HERNIA OCCUR?

Most of the time, hernias develop when pressure in the
compartment of the residing organ is increased, and the boundary i s weak or weakened.
By far most hernias develop in the abdomen, when a weakness in the abdominal wall evolves into a localized hole, or "defect", through which fatty tissue, or abdominal organs covered with peritoneum, may protrude. Another common hernia involves the intervertebral disc, and causes back pain or sciatica. Any condition that increases the pressure of the abdominal cavity may contribute to the formation or worsening of a hernia. For example: obesity , heavy lifting, coughing, straining during a bowel movement or urination and ch ronic lung d i seaie



WHAT ARE ITS SYMPTOMS? HOW CAN IT BE DETECTED?

hernias may be present either with pain at the site, a visible or palpable lump or in some cases by more vague symptoms resulting from pressure on an organ which has become "stuck" in the hernia, sometimes leading to organ dysfunction. Fatty tissue usually enters a hernia first, but it may be followed by or accompanied by an organ,


WHEN TO SEEK MEDICAL CARE?

All newly diStovered hernias or symptoms that suggest you
might have a hernia should prompt a visit to the doctor. hernias, even those that ache, if they are not tender and easy to reduce (push back into the abdomen), are not surgical emergencies, but all have the potential to become serious. Referral to a surgeon should generally be made so that you can have surgery by choice (called elective surgery) and avoid the risk of emergency surgery should your hernia become irreducible or strangulated.
If you find a new, painful, tender, and irreducible lump, it's
possible you may have an irreducible hernia, and you should have it checked in an emergency setting. If you already have a hernia and it suddenly becomes painful, tender, and irreducible, you should also go to the emergency department. Strangulation (cut off blood supply) of intestine within the hernia sac can lead to gangrenous (dead) bowel in as little as 6 hours. Not all irreducible hernias are strangulated, but all cases of strangulation are irreducible hernias.


WHEN SHOULD HERNIA BE TREATED?

In general, all hernias should be repaired unless severe pre­existing medical conditions make surgery unsafe. Once hernia is detected, it should be treated as early as possible. Surgery is the only cure for majority of hernias. This ensures best results. Moreover, early operation will  prevent complications like obstructions and strangulation. Surgical results of large hernias are not as good as the result of an early operation
when hernia is small.


WHAT IS STRANGULATION OF HERNIA?

Strangulation of hernia is a surgical emergency. The hernia becomes very painful, does not reduce and the overlying skin becomes red. The patient will require hospitalisation and Immediate surgery,


WHAT ARE THE TYPES OF SURGERY AVAILABLE FOR TREATING HERNIAS?
The types of surgery available for treating hernia are:
Laparoscopic surgery (also known as Minimal Access Surgery/Minimal Invasive Surgery yEndoscopic Surgery)
Conventional (open) Surgery

HOW IS LAPAROSCOPIC/ENDOSCOPIC REPAIR FOR HERNIA PERFORMED?

Three (5-10) mm siied incisions are made and cannulas (a small hollow tube) are placed in them, A laparoscope (a long narrow telescope) connected to a special camera is inserted through a cannula, allowing the surgeon to view the hernia and surrounding area on a video screen. Other cannulas are inserted which allow the surgeon to work "inside." A piece of surgical mesh is fixed over the hernia defect and held in place with small surgical staples.


WHAT ARE THE ADVANTAGES OF LAPAROSCOPIC/ENDOSCOPIC SURGERY OVER CONVENTIONAL SURGERY?
Endoscopic surgery causes much less pain and patients are mobile within hours after surgery. They are also allowed to resume all activities much earlier and can go back to work within 5-7 days. Another advantage is that both sides can be operated in the same sitting without any extra pain or stay. The cosmetic results are excellent. Contrary to common belief a mesh can also be placed in laparoscopic procedures

HOW SAFE ISTHE ENDOSCOPIC SURGERY?
If done by a well trained surgeon in a well equipped centre it is a safe surgery with excellent results

WHAT HAPPENS AFTER ADMISSION FOR SURGERY?

Patients are admitted to the hospital on thedayofsurgeryora day prior to surgery, On admission patients are examined and investigations reviewed by one of the members of the surgica! team. A member of the anaesthesia team conducts the pre anaesthetic check-upSL
Pre-operative investigations are performed rf needed. Patients need to be fasting overnight for the surgery.
Next morning, the patient is shifted to the operating theatre half an hour prior to surgery. After surgery, he/she is shifted to the recovery room for 2-4 hrs under the care of our anaesthesia team. It takes about 4-3 hours before the patient comes back to his or her room.
The patient is given a normal meal for a dinner and discharged from hospital after a visit by one of the surgery team members*. On discharge, a discharge summary with medication advised is handed over to the patient.


 


 
 
   
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