What is Hernia? How Do We Fix Hernias?
A hernia is a bulge of tissue that pushes itself out through a weak spot. It is most commonly found in and around the abdomen. Hernias may have mild symptoms like pain, discomfort or absolutely no symptoms. Nevertheless, hernias can inflict serious complications depending on their location, size and onset of symptoms.
A hernia can be treated via a surgical hernia repair. However, if the hernia is small, harmless and does not bother the patient, it can be managed using compression garments and avoiding activities like lifting heavy objects and weight training.
Common Types of hernia:
- Epigastric hernia:
This variety of hernia occurs when tissue bulges in the upper region of the abdominal wall, above the naval.
- Umbilical hernia:
An umbilical hernia presents itself through or near the belly button where the umbilical cord was once attached.
- Femoral hernia:
This type of hernia occurs when tissue bulges near the groin or inner thigh. It is generally located close to the femoral artery/vein and is typically treated using surgery.
- Inguinal hernia:
An inguinal hernia occurs when tissue pushes through the lower abdominal wall, typically into the inguinal canal. This variety of hernia is generally more common in men than women.
- Hiatal hernia:
This type of hernia occurs when the stomach breaches through the diaphragm. It can be dangerous if it alters the position of the stomach. A hiatal hernia does not present itself with a visible bulge, however, patients diagnosed with it tend to have had acid reflux as a symptom.
- Incisional hernia:
An incisional hernia occurs when a patient’s incisions have not healed completely post-surgery. It occurs typically in the abdominal wall where due to pressure the tissue bulges through the weak spot.
- Expectations – during the consultancy, the patient is prompted to express their desired expectations with the surgeon and discuss its possibilities. Showing pictures of desired results is more helpful in reaching a consensus.
- Medical history – the physician will ask the patient about their past-medical history as well as family history to ensure that they are eligible to undergo the surgery. Patients with ailments, diseases, infections or blood disorders are advised not to undergo this procedure as they are at higher risk.
- Communication – the surgeon will clarify all the do’s, don’ts and other clarifications in detail for both pre-surgery and post-surgery.
- Photography – a professional will take before and after pictures in different angles to record the change made due to the procedure. The patient may also be provided with a photoshopped picture before the surgery to have realistic expectations.
- Stay – the patient may be required to stay a night or two for monitoring.
- Smoking – the patient is strictly advised to avoid smoking a week before the procedure as it can affect the surgery and healing process.
- Medications – after reviewing the patient’s medical history, the physician may ask the patient to stop consumption of certain medicines. They include – aspirin, immunosuppressants, anti-inflammatory medicine, herbal capsules, blood thinners and other anti-coagulants.
- Care – the patient will be asked to arrange for driven transport as they cannot drive post-surgery. It is also advisable to have someone at home to help a few days during recovery.
Hernia Repair Surgery Procedure
- General surgery:
This approach to hernia repair involves the surgeon making an incision near the hernial site. The surgeon then proceeds to push the bulge back into place and placing a mesh. The mesh is then sutured into position. Once the surgeon is satisfied with the results, the incision is closed using sutures. This surgical procedure is performed under general anaesthesia. The surgeon may also make use of drainage tubes to drain any body fluid formed near the surgical site.
- Laparoscopic surgery:
This method of surgery is performed under general anaesthesia. The surgeon begins by making small incisions close to the hernial site. The abdomen is then inflated using a stable and harmless gas, this allows the surgeon to view the site internally through the laparoscopic camera (probe). The surgeon then proceeds to push the bulge back into place and placing a mesh which is then sutured into position. Once the surgeon is satisfied with the results, the abdomen is deflated and the incisions are closed using sutures.
Laparoscopic surgery is less invasive and has a shorter downtime when compared to its other surgical counterpart.
Risks & recovery
- Downtime – the patient can resume normal activities in 7 to 14 days, depending on the technique used.
- Activities – there should be minimal movement for the first few days into recovery. Swimming, gymming or any strenuous exercise should be avoided until prompted by the surgeon.
- Lifting – the patient is advised not to lift any heavy objects or perform any weight training until prompted, as it can lead to a recurrence.
- Scarring – depending on the technique used, there may be visible scarring. This can be reduced using laser resurfacing.
- Sensation – there may be partial loss of sensation after complete healing. This can cause temporary or permanent numbness around the treated area.
- General risks – surgical procedures may cause redness, bruising, bleeding, scarring, loss of sensation and infection.
- Rest – the patient is advised to take complete rest to promote fast healing.
- Ice & compression – the wound should be compressed with an ice pack to reduce swelling.
- Elevation – the patient is advised to sleep in an upright and elevated position. This reduces swelling and avoids any tugging or pulling.
- Garments – the patient may be advised to wear compression garments until the incision has completely healed.
- Smoking – the patient is strictly advised to avoid smoking for up to two weeks post-treatment. Smoking can interfere with blood flow and can cause problems with healing.
- Alcohol – the patient is advised to avoid alcohol consumption for a few days as it can counteract with medications prescribed for aftercare.
- Medicines – the surgeon may prescribe painkillers, immunosuppressants and antibiotics. They can be a combination of tablets as well as topical treatments. These medicines need to be consumed/applied promptly, as prescribed by the physician.
- Makeup – makeup can be used to conceal any prolonged bruising and scars post-recovery.
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