HERNIA
What is a Hernia?
A Hernia is a protrusion/bulge through the layers of the abdominal
muscles due to weakening.
It is similar to an inner tube pushing through a damaged tyre.
The inner lining of the abdomen (peritoneum) pushes through the
weakened area of the body wall to form a small balloon like sac.
This can allow a loop of bowel or other tissue to push into the sac.
Symptoms
A hernia may be asymptomatic or may cause aching or pain particularly
when you lift heavy objects, cough or strain during urination or bowel
movements or during prolonged standing or sitting.
The common areas where hernias occur are the groin, at the umbilicus and
at the site of previous operation scars.
When the contents of a hernia do not reduce, it can cause serious
problems such as obstruction/strangulation that may require emergency
surgery.
A hernia does not get better over time. Nor will it go away by
itself.
Treatment Options
Open Approach
The traditional open approach is done from the outside through an
incision at the site of the hernia.
The tissue is cut in layers until the hernia sac is approached and this is
dealt with by excising it.
This is followed by repair of the layers of muscles by suture and/or using a
synthetic mesh to cover the defect.
Laparoscopic Approach
In the Laparoscopic approach, through a camera system inserted
through a small incision, usually around the umbilicus and the weakness
in the abdominal is approached from behind the abdominal wall.
Using this technique the hernia is pulled back inside and the weakness is
covered by a large piece of synthetic mesh, which is then held in place using
small titanium tackers.
This is similar to putting a patch on the inside of a tyre.
By using a large piece of mesh to cover all the potential hernia sites in the
groin the chances of recurrence or development of a new hernia in this region is
reduced to a minimum.
Not everyone is a candidate for laparoscopic hernia repair and your Surgeon
will decide the feasibility of this after a thorough examination and taking into
consideration the history of previous surgery in the region.
Advantages of Laparoscopic Hernia
-
Smaller incision means
usually less pain associated post operatively
-
May allow earlier for
return to work or normal activities
-
Less chance of recurrent herniation
As with any operation complications can occur. The main problems are
bleeding and infection. There is some slight risk of injury to the
bladder, the intestine blood vessels, nerves or the sperm tube. Sometime
patients may develop difficulty in urinating that may require a catheter
to be put in for a short while.
Occasionally the procedure may have to be converted to an open
operation due to technical problems such as dense scar tissue or
bleeding during the operation. The decision to convert to an open
procedure is strictly based on patient safety.
After Surgery
After the operation you will be recovered in the recovery room until
you are awake to go back to your bed in the ward.
Usually you will be able to go home the following day after surgery
with pain relief and/or anti-inflammatory tablets.
You may have some difficulty with urination and opening your bowels
for the first few days.
Some mild pain and soreness may be present for about a week or so and
it will be necessary to take things easy during this time.
If you develop high fever, chills, vomiting or discharge from your
wounds you should contact the surgery.
With Laparoscopic repair you will probably be able to get back to
your normal duties within a much shorter period of time and be able to
do walking up the stairs and driving and sedentary work almost
straightaway.
Your should make an appointment to see your Doctor within two
weeks after discharge.
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