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Hernia
What is Hernia
A hernia is a medical condition that occurs when an internal organ or tissue protrudes through an opening or weakness in the surrounding muscle or tissue that is meant to hold it in place. Hernias can be caused by a variety of factors, including age, obesity, pregnancy, heavy lifting, chronic coughing, and previous surgeries.
Symptoms of hernia :
Hernia can vary depending on the type and severity of the hernia, but here are some common symptoms that you may experience:
A bulge or swelling in the affected area that may be more noticeable when standing, coughing, or straining.
Pain or discomfort in the affected area, which may be mild to severe and may worsen when standing, coughing, or lifting
A feeling of pressure or heaviness in the affected area
Nausea, vomiting, or constipation in cases where the hernia is obstructing the digestive system.
Difficulty swallowing or experiencing heartburn in cases of hiatal hernias.
In some cases, a hernia may not cause any symptoms at all, especially in the early stages.
It’s important to note that some symptoms of a hernia may be similar to other medical conditions, such as muscle strains or digestive problems. If you suspect that you may have a hernia, it’s important to seek medical attention to get an accurate diagnosis and appropriate treatment.
There are several types of hernia that can occur in different parts of the body.
Inguinal Hernia
This is the most common type of hernia and occurs in the groin area when a part of the intestine or other tissue protrudes through the inguinal canal.
Femoral Hernia
This type of hernia also occurs in the groin area but is more common in women. It happens when a part of the intestine or other tissue protrudes through the femoral canal.
Umbilical Hernia
This type of hernia occurs around the belly button, when a part of the intestine or other tissue protrudes through the abdominal muscles.
Incisional Hernia
This type of hernia occurs in a surgical incision or scar tissue from a previous surgery.
Haital Hernia
This type of hernia occurs when a part of the stomach protrudes through the diaphragm and into the chest cavity.
Epigastric Hernia
This type of hernia occurs in the upper abdomen between the belly button and breastbone, when a part of the intestine or other tissue protrudes through a weakness in the abdominal wall.
Spigelian Hernia
This type of hernia occurs in the lower abdomen, through a weak spot in the abdominal muscles.
complications of hernia
If left untreated, hernias can lead to a number of complications, some of which can be serious. Here are some potential complications of hernias:
Strangulation
This occurs when the blood supply to the herniated tissue becomes cut off, which can lead to tissue damage and even tissue death. Strangulation is a medical emergency and requires immediate surgery.
Incarceration
This occurs when the herniated tissue becomes trapped in the weakened area, which can cause pain, discomfort, and pressure. Incarceration may require surgery to alleviate the symptoms and prevent further complications.
Obstruction
This occurs when the herniated tissue blocks or partially blocks the flow of food or waste through the digestive system. Obstruction can cause symptoms such as nausea, vomiting, and constipation. It is medical emergency and requires immediate surgery.
Adhesions
After surgery to repair a hernia, scar tissue can form around the site, which can cause the tissue to stick together. This can cause pain and discomfort and can make future surgeries more difficult.
Recurrence
Even after surgery to repair a hernia, there is a risk that the hernia can reoccur. This risk is higher in people who have multiple hernias or have weakened abdominal muscles.
Chronic pain
Some people may experience chronic pain at the site of the hernia, even after it has been repaired.
It’s important to seek medical attention if you suspect that you may have a hernia, as early diagnosis and treatment can help to prevent complications.
Types of Surgery for Hernias
There are several surgical options for repairing hernias, depending on the type and location of the hernia. Here are some of the most common types of surgery for hernias:
Open hernia repair: This traditional method involves making an incision at the site of the hernia and then pushing the protruding tissue back into place. The weakened area is then reinforced with sutures or a surgical mesh. This type of surgery is usually performed under general anesthesia.
Laparoscopic hernia repair: This minimally invasive method involves making several small incisions and then using a laparoscope (a thin tube with a camera and light) to visualize the hernia and surrounding tissue. The protruding tissue is then pushed back into place, and a surgical mesh is used to reinforce the weakened area. This type of surgery is usually performed under general anesthesia and has a faster recovery time than open hernia repair.
Robotic hernia repair: This is similar to laparoscopic hernia repair, but instead of the surgeon manually manipulating the instruments, a robotic system is used to control them. This type of surgery is also minimally invasive and offers the benefits of laparoscopic surgery, including faster recovery times and less scarring.
The choice of surgical technique depends on the type and size of the hernia, as well as the individual patient’s health and preferences. In some cases, a watchful waiting approach may be taken for small, asymptomatic hernias that do not require immediate surgery. It’s important to discuss the options and risks with a qualified healthcare professional.
Differences between TEP and TAPP
TEP (totally extraperitoneal) and TAPP (transabdominal preperitoneal) are two different surgical techniques used to repair inguinal hernias, which are hernias that occur in the groin area.
Approach: TEP is a minimally invasive technique that involves making small incisions in the abdominal wall and then creating a space between the abdominal wall and the peritoneum (the lining of the abdominal cavity) to access the hernia. TAPP, on the other hand, involves making an incision in the abdomen and then lifting the peritoneum to access the hernia from the inside.
Peritoneal access: In TEP, the peritoneal cavity is not entered, whereas in TAPP, the peritoneum is opened to access the hernia.
Mesh placement: In TEP, the mesh is placed on the outside of the peritoneum, between the abdominal wall and the peritoneum. In TAPP, the mesh is placed inside the peritoneum, covering the hernia from the inside.
Recovery: Both TEP and TAPP are considered minimally invasive and are associated with shorter recovery times compared to open surgery. However, TEP may offer a slightly faster recovery time, as it does not involve entry into the peritoneal cavity.
Both TEP and TAPP have similar outcomes in terms of effectiveness and recurrence rates, and the choice of technique depends on the individual patient’s anatomy, medical history, and the surgeon’s preference and experience. It’s important to discuss the options and risks with a qualified healthcare professional.
IPOM stands for “intraperitoneal onlay mesh,” which is a surgical technique used to repair certain types of hernias. It involves placing a mesh inside the peritoneal cavity (the abdominal cavity that contains the internal organs) to reinforce the weakened area and prevent the hernia from recurring.
In IPOM, the surgeon makes several small incisions in the abdomen and then inserts a laparoscope (a thin tube with a camera and light) to visualize the hernia and surrounding tissue. The hernia sac is reduced back into the abdominal cavity, and a mesh is placed on top of the weakened area. The mesh is then secured in place with sutures or surgical staples.
IPOM has several advantages over traditional open surgery, including a faster recovery time, reduced pain and scarring, and lower rates of hernia recurrence. However, like any surgical procedure, IPOM carries some risks, including infection, bleeding, and injury to nearby organs. It’s important to discuss the options and risks with a qualified healthcare professional.
FAQs around Hernia
Is hernia mesh used for all types of hernia repair?
No, hernia mesh is not used for all types of hernia repair surgery. In many cases, the perforation in the abdominal wall can be closed without any support or reinforcement. Thus hernia mesh is not needed every time.
What type of anesthesia is used during hernia repair surgery?
Hernia surgery can be performed under general, spinal, or local anesthesia. The anesthetist will ask you some questions to determine if you are allergic to some components of general anesthesia. If so, then either spinal or local anesthesia will be used.
When can I return to work or school after surgery?
You can return to work or school within 2 weeks at maximum. If you’ve had open surgery, the recovery may take longer, due to which the doctor may ask you to wait for at least 2 weeks before rejoining work or school.
What foods should you avoid after hernia surgery?
Some foods can increase the risk of constipation after hernia surgery. Thus, you should avoid such food items, including- White bread
Biscuits and crackers
Chunky meats, such as steaks and dry meals
Carbonated beverages and alcohol
Sweets and sugary foods
When will I need to take follow-ups after Hernia Surgery?
You will most likely need to take follow up with the doctor after 7-10 days of surgery. During this follow-up, the doctor will monitor the healing process and remove the stitches (if any). Only then will the doctor decide if further follow-ups are needed.
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