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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 lower torso (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. |
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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 are rare. |
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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 is
weak or weakened. |
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WHAT ARE ITS
SYMPTOMS? HOW CAN IT BE DETECTED?
Hernias may 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. |
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WHEN TO SEELK
MEDICAL CARE?
All newly
discovered 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 strangulated.
If
you find a new, painful tender, and irreducible
lump, its 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. |
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WHEN SHOULD
HERNIA BE TREATED?
In general,
all hernias should be repaired unless severe pre
existing 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. The ensures best results.
Moreover early operation will prevent complications
like obstructions and strangulation. Surgical result
of large hernias are not as good as the result of an
early operation when hernia is small. |
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WHAT IS
STRANGULATION OF HERNIA?
Strangulation of hernia is a surgical emergency. The
hernia becomes very painful, does not reduce and the
overlying skin become red. The patient will require
hospitalization and immediate surgery. |
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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/Endoscopic surgery).
- Conventional (open) surgery. |
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HOW IS
LAPAROSCOPIC/ENDOSCOPIC REPAIR FOR HERNIA PERFORMED?
Three (5-10) mm sized incisions are made and
cannulas (a small hollow tube) 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. |
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WHAT ARE THE
ADVANTAGES OF LAPRASCOPIC/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. |
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HOW SAFE IS
THE ENDOSCOPIC SURGERY?
If done
by a properly trained surgeon in a well equipped
centre it is a safe surgery with excellent results. |
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WHAT HAPPENS
AFTER ADMISSION FOR SURGERY?
Patients are admitted to the hospital on the day of
surgery or a day prior to surgery. On admission
patients are examined and investigations reviewed by
one of the members of the surgery team. A member of
the anesthesia team conducts the parenthetic
check-up. |
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