Hernia

موضوع: Hernia الإثنين يناير 03, 2011 11:54 am

What is Hernia?

It is the protrusion (bulge) of abdominal viscera through a weakened part of abdominal wall.

* Both men and women can get a hernia.
* One may be born with a hernia (congenital) or develop over a period of time.
*
A hernia does not get better over time, nor will it go away by itself
(except very small congenital naval hernia). It always becomes bigger
with time

What are the common types?

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

What is the incidence in Indian population?

About
10% of the adult male population will suffer from hernia at some period
during life time. The incidence of inguinal hernia's more in males and
incisional/ umblical hernias is more common in females.

How it can be detected or what are its symptoms?

It
is usually easy to recognize a hernia. One may notice a bulge under the
skin or may feel pain and observe swelling popping out when one lifts
heavy ************************s during urination or bowel movements or
during prolonged standing or sitting or coughing.

* The pain may be sharp initially or a dull ache that becomes worse toward the end of the day or after physical activities.

What is strangulation of Hernia ?

Severe,
continuous pain, redness and tenderness are signs that the hernia may
be entrapped or strangulated. These symptoms are cause for concern and
should immediately be reported to a surgeon for emergency surgery.

Once detected, when and how should it be treated?

Once
detected the hernia should be treated as early as possible because it
provides the best results. Natural history of hernia is slow increase
in size over a period of time. Also, early operation will prevent,
complication like obstruction and strangulation. Surgical results of
large hernia are not as good as the results of an early operation.

Can hernia be life threatening ?

It can be life threatening when strangulation of loop of bowel occurs in the hernia.

What is the treatment for hernia ?

Surgery
is only cure for majority of hernia unless and until there are
contraindications to surgery due to poor general health or organ
failure. All other methods like truss etc. are not only useless but
also worsen the situation by causing damage to the muscles due to
constant pressure (hence less blood supply to the muscle).

What are the types of surgery available for curing hernia ?

Laparoscopic surgery (also known as Minimal Access Surgery/ Minimally Invasive Surgery/ Endoscopic surgery)

* Conventional Open Surgery

How is the endoscopic repair for hernia ?

In
this approach, a laparoscope (a tiny telescope) connected to a special
camera is inserted through a canula, (a small hollow tube), allowing
the surgeon to view the hernia and surrounding area on a video screen.
Other canulas are inserted which allow the surgeon to work "inside."
The hernia is repaired from behind the abdominal wall. A piece of
surgical mesh is fixed over the hernia defect and held in place with
small surgical staples. Usually, 2 or 3 few mm incisions are necessary.
This operation is usually performed with general/ regional/ spinal/
local anesthesia.

What are the advantages of Endoscopic Surgery over the conventional surgery?

Endoscopic
surgery cause much less pain and patients are mobile within hours after
surgery. They are also allowed to resume all activities like driving
etc anything 2-3 days and can go back to work within 5-7 days. Another
advantage is that both side can be operated in the same sitting without
any extra pain or stay. The cosmetic results are excellent.

Is it necessary to use the mesh in all the cases ?

Yes.
Now world over there is consensus that the use of mesh is desirable in
majority of the cases to stengthen the wall whether it is done
conventionally or endoscopically. Only the childhood hernias are
repaired without using mesh.

Is Endoscopic surgery Safe ?

Yes.
Done by properly trained surgeon in well equipped centre who is
regularly doing this operation is a safe surgery with excellent
results.
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