What is Hernia Surgery ?
The condition of hernia arises when the contents (abdominal fatty tissue or portions of the intestine) of a body cavity bulge out of the area where they are generally contained.
The thin membrane encloses all the contents that outline the inside of the cavity. The condition of hernia may not produce any symptoms but may result in severe pain. The blood supply is cut off when the contents bulge out through the opening that creates severe pressure on the blood vessels. This calls for surgical or medical emergency as blood supplies the oxygen to the tissues.
Types of Hernia
Femoral Hernia : The femoral nerve, vein and artery pass through the path of femoral canal and leaves the abdominal cavity to come into the thigh. A bulge is caused by a femoral hernia beneath the inguinal crease around the mid-thigh area. This condition is usually seen in women where the femoral hernias are not able to be strangulated (have their blood supply cut off) or pushed back into place (irreducible). It is not that all the hernias are strangulated or irreducible. All irreducible hernias need to be thoroughly examined by the doctor.
Incisional Hernia : In the case of abdominal surgery, a flaw is caused in the abdominal wall. This procedure may lead to the development of hernia. This happens after 2-10% of every abdominal surgical procedure. Incisional hernia may come back again even after going through surgical repair.
Epigastric Hernia : The epigastric hernia hardly ever contains intestine and are made up of fatty tissue. Epigastric hernia occurs in between the lower part of the rib cage in the mid line of the abdomen and the navel. This type of hernia is usually painless and they cannot be pushed back into the abdomen.
Inguinal (groin) Hernia : This type of hernia is mostly seen in men (25 times more often) as compared to women. Inguinal hernia makes up around 75 percent of all the abdominal-wall hernias. Direct and indirect are the two kinds of inguinal hernia. Both indirect and direct takes place in the groin area where the skin of the thigh joins the inguinal crease (the torso). Both of them emerge as a bulge in the groin area.
Direct Inguinal Hernia : This hernia develops within the location of the indirect hernia, in the abdominal wall area which is naturally thinner. This type of hernia usually develops in the elderly and middle aged people when the abdominal wall weakens.
Indirect Inguinal Hernia : The pathway is followed by an indirect hernia that is created by the testicles at the time of fetal development, sliding from the abdomen into the scrotum. Generally this pathway gets closed before birth and can happen in later stages of life.
Obturator Hernia : This is a rare type of hernia is frequently seen in women. Obturator hernia stands out from the pelvic cavity through an opening in the obturator foramen (pelvic bone). This type of hernia may not show any bowel obstruction but can result into vomiting and nausea. This is hard to diagnose as there is no bulging.
Spigelian Hernia : Spigelian hernia develops at the border line of the rectus abdominus muscle throughout the spigelian fascia. This is also a rare type of hernia.
Umbilical Hernia : Umbilical hernia is one of the common hernias that can be noticed at the time of birth due to protrusion at the umbilicus (belly button). This happens when the opening of the abdominal wall does not close properly. Umbilical small hernia generally closes by the age of two. On the other hand, umbilical large hernias need surgery at the age of 2-4 years. This kind of hernia may also develop in later stages of life as the spot can stay at a weaker place in the abdominal wall. This hernia may also happen in those women who have given birth or are pregnant.
Who Should consider Hernia Surgery ?
The surgery is meant for those who have the following conditions –
- If the hernia is growing larger.
- If the hernia is restricting your daily activities or causing any discomfort.
- If you are worried about the bowel getting trapped.
Symptoms of Hernia
Symptoms of Strangulated hernia include –
- This hernia is a surgical or medical emergency.
- Strangulated hernia is an irreducible hernia where entrapped intestine has its blood supply cut off.
- A person may feel ill or may have fever.
- Sometimes there are symptoms of vomiting and nausea (bowel obstruction).
- Pain is always there in this type of hernia that is followed rapidly by tenderness.
Symptoms of Reducible hernia include –
- Reducible hernia may be pushed back into the abdomen unless very large.
- It could appear as a new lump in the other abdominal area or groin area.
- Pain can be noticed first before discovering of the lump.
- This hernia may ache but is not tender when touched.
Symptoms of Irreducible hernia include –
- This type of hernia is also known as incarcerated hernia.
- It may show signs of bowel obstruction like vomiting and nausea.
- It could also be a painful enlargement of earlier reducible hernia which cannot return to the abdominal cavity when pushed or on its own.
- This may also result in strangulation.
- It could also be chronic without a feeling of pain.
Causes of Hernia
Hernias can be present at the time of birth and can also develop in the later stages of life. When the abdominal cavity’s pressure increases, it may result in the formation of hernia. It include –
- Coughing
- Chronic lung disease
- Obesity
- Fluid in the abdominal cavity
- Heavy lifting
- A family history of hernias that increase the chances of developing a hernia
- Straining during urination or a bowel movement
Hernia Repair
The surgical procedure for fixing a hernia is termed as hernia repair. Herniorrhaphy is the other name for this procedure. There are 2 kinds of hernia repair –
- Laparoscopic Hernia Repair : This minimally invasive procedure involves some holes in the skin. Through these holes, long-handled surgical instruments and a laparoscope are inserted. The entire procedure is performed under general anesthesia and also involves a proper evaluation of the patient’s health that include physical exam and history, EKG and lab work. There is no feeling of pain during the surgery. With the help of carbon dioxide gas, the abdomen is inflated that enables the doctor to view internal structures. In order to expose the weakness in the abdominal wall, the inner lining of the abdomen (peritoneum) is cut. Also to secure the weak area, a patch is attached below the peritoneum. The inner lining of the abdomen is then sutured.
- Traditional (open) Hernia Repair : During open hernia surgery, an opening in the skin is created by making a cut. Then hernia is fixed through this opening which is many inches long.
Benefits of Laparoscopic Hernia Repair Surgery
- Quick recovery time and the patient can return to its daily activities earlier.
- 3 small incisions are made instead of 1 large incision.
- Less postoperative pain.
- A quick return to work.
Cost of Hernia Surgery in India
India is recognized all over the world for its surgical and medical expertise especially in the case of hernia problems. Cost-effective hernia surgery in India is yet another factor that attracts a large number of patients from across the world.