Dr Pradeep K Dewan, Best Laparoscopic Surgeon, Bariatric Surgeon Delhi

Hernia Treatments

HERNIA

What is Hernia?

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

A Hernia does not get better over time, nor ell it go away by itself (except very small congenital navel hernia). It always becomes bigger with time.

What are the common types?

The common types of hernias are present in the groin (inguinal), belly button (umbilical) and the site of 1a previous operation (incisional). There are many more types but are rare.

What are its symptoms? How can it be detected?

Hernia is easy to recognize. It appears as a bulge under the skin. This bulge may appear on standing or straining and disappear on lying down. It may or may not be painful. Discomfort may worsen at the end of the day and also while coughing and sneezing.

What is the treatment for hernia?

Surgery is the only cure for majority of hernias. There is no medical treatment for hernia.

When should hernia be treated?

Once detected the hernia should be treated as early as possible because it provide the best results. Also, early operation will prevent complications like obstruction and strangulation. Surgical results of large hernias are not as good as the results 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 hospitalization and immediate surgery.

What are the types of surgery available for treating hernias?

The types of surgery available for treating hernias are:

Laparoscopic surgery (also known as Minimal Access Surgery/ Minimal Invasive Surgery/ Endoscopic Surgery).
Conventional Open Surgery.

Type of Hernia

How is the laparoscopic /Endoscopic repair for hernia performed?

There 3.5-10 mm sized incision are made and cannulas placed in them. A laparoscope (a long narrow telescope) connected to a special camera is inserted through a cannula (a small hollow tube), 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.

Both sides 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 patients to strengthen the wall whether surgery is done conventionally or endoscopically. Only the childhood hernias are repaired without using mesh.

Is Endoscopic Surgery safe?

Yes. Done by a properly 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 hospital on the day of surgery. After surgery, they are shifted to the recovery room for 2-4 hours under the care and supervision of our anaesthesia team, for observation and then shifted back to the room. It takes about 4-8 hours before the patient comes back to his or her home.

Patients are given sips of water orally on return to the room and progresses to drinking all liquids on the same evening of surgery. They may sit up, visit the toilet and move around few hours after surgery and are encouraged to do so early.

They will be given a normal breakfast next morning and discharged from hospital after a visit by one of the MAS ream members. On discharge, a discharge summary with medication advised is handed over to the patient.

Can the surgery be performed as day care procedure?

Yes, day care surgery is being performed on young and fit patients. The patient is called to the operation theater in the morning with fasting more than eight hours. After the operation patients observed for 4-6 hours post operatively in the day care facility before discharge. In case the need arises, facilities are available also for overnight admission.