HERNIA REPAIR SURGERY
What is hernia
A hernia is the abnormal exit of tissue or an organ, such as the bowel, through the wall of the cavity in which it normally resides. A hernia generally occurs when an internal organ pushes through a weak spot in your muscle or tissue. Most hernias occur within the abdominal cavity, between the chest and the hips.
Hernias come in a number of types. Most commonly they involve the abdomen, specifically the groin. Groin hernias are most commonly of the inguinal type but may also be femoral.
Types of hernia
An inguinal hernia occurs when tissue, such as part of the intestine, protrudes through a weak spot in the abdominal muscles. The resulting bulge can be painful, especially when you cough, bend over or lift a heavy object. However, many hernias do not cause pain.
An inguinal hernia isn’t necessarily dangerous. It doesn’t improve on its own, however, and can lead to life-threatening complications. Your doctor is likely to recommend surgery to fix an inguinal hernia that’s painful or enlarging. Inguinal hernia repair is a common surgical procedure.
A femoral hernia occurs when tissue pushes through a weak spot in the muscle wall of the groin or inner thigh. Common causes include being overweight and overstraining while coughing, exercising, or passing stool. Symptoms of a femoral hernia include a lump in the groin or inner thigh and groin discomfort.
It may cause stomach pain and vomiting in severe cases. Femoral hernias are uncommon, accounting for fewer than 5 percent of all groin hernias. Typically, surgical repair is necessary because femoral hernias can lead to severe complications.
How to tell you have a hernia?
Feel for a lump or swelling around the pubic bone.
If you find a lump, make note of where it is and lie down.
Did the lump disappear or become smaller? If so, it may be a hernia.
Do you feel discomfort when coughing or lifting heavy objects? It’s almost certainly a hernia.
Your hernia will need to be operated on to be repaired
Because hernias do not heal spontaneously and enlarge over time, it’s important to operate on your hernia as soon as it has been diagnosed. Failing to do so could see your hernia enlarge, which will make its eventual repair more risky and complicated.
Hernia repair can be carried out as either open or laparoscopic surgery, which is also known as keyhole surgery. An open repair is often performed under local anesthetic, which means that you will be awake throughout the entire operation. However, the area being operated on will be numbed to not experience any pain throughout the operation.
Hernia & Complex Abdominal Wall Reconstruction (Hernia Repair Surgery)
Hernia repair surgery or The abdominal wall protects the organs within the peritoneum. Several layers of tissue make up the wall: These layers include muscle, connective tissue and fat, peritoneal membrane, and skin. If a muscle or tissue becomes weak, an organ may protrude and create a lump beneath the skin: This is referred to as a hernia and this can lead to life-taken complications for the body, So for that Doctors or surgeons recommend Hernia Repair Surgery.
Dr. Jaideep Raj Rao is a specialised surgeon and offers comprehensive treatments for hernia repair surgery & Laparoscopic & Robotic Surgery at Arden JR surgery clinic in Singapore.
What is abdominal wall reconstruction?
Reconstructing the abdominal wall is a complex procedure designed to correct defects or weaknesses. These openings may be naturally occurring (which is usual) or may stem from prior hernia surgery, traumatic injury, hernia recurrence, or infection.
Symptoms of abdominal wall hernias
Hernia symptoms can range from a painless lump to an extremely painful, swollen protrusion that cannot be pushed back into the abdomen.
The characteristics of a hernia usually determine the symptoms experienced:
Reducible hernia – Pain may precede lump discovery. Aching may occur with or without tenderness in the area. The lump increases in size upon standing or when pressure on the abdomen intensifies. Unless extremely large, the lump may be reduced or gently pushed back through the opening in the abdominal wall.
Irreducible hernia – Also known as an entrapped or incarcerated hernia. May be the result of a previously reducible hernia that can no longer be returned to the abdominal cavity. It may be chronic and asymptomatic, or quite painful. Nausea and/or vomiting can occur. This type of hernia may lead to strangulation.
Strangulated hernia – Pain is definite and is followed by tenderness. Some patients experience a fever, nausea and/or vomiting. This condition requires emergency surgery, as the blood supply to the entrapped intestines is compromised and can lead to gangrene.
Causes of abdominal wall hernias
Hernias frequently occur due to a combination of defects in the abdominal wall and pressure that pushes the tissue or organ through the weakened section. Although muscle weakness and small openings can be present at birth, abdominal wall hernias generally occur later in life. Anything that increases the pressure in the abdomen can over time cause a hernia. Potential causes include lifting heavy objects, obesity, persistent sneezing and/or coughing as well as constipation. Smoking, poor nutrition and overexerting oneself may weaken the wall, increasing the likelihood of an abdominal wall hernia. Incisional hernias following surgery are often caused by poor nutrition, wound infections and obesity. These hernias are usually repaired using a surgical mesh implant.
Hernia repair surgery
Intestinal strangulation is always a concern, so in almost all cases hernias should be repaired.
Methods of hernia repair surgery
Hernias are repaired through a variety of techniques depending on the type and location.
Umbilical: at the navel
Ventral: in the abdominal/ventral wall
Hiatal: along upper stomach/diaphragm
Femoral: upper thigh/outer groin
Inguinal: in the inner groin
Incisional: occurs through a scar or incision in the abdomen
Surgical treatment for hernias
Conventional surgery – The Surgeon creates an incision adjacent to the hernia from which to repair the weakened section of the abdominal wall. Surgical mesh may be used.
Advantages of laparoscopic surgeries
There are several advantages of laparoscopic surgery in comparison to the previous old-fashioned surgery methods.
Very small scars.
Stay for fewer days in the hospital
Less tissue cutting.
Less pain while scar heals – lesser use of pain medications.
Get back to normal life sooner.
Quick healing as the scar is small.
As exposure of internal organs gets reduced for external contaminants, hence the risk of infections reduced.
Abdominal wall reconstruction surgery
Abdominal wall reconstruction surgery is used to close large abdominal hernias. This procedure can address recurrent hernias, ventral hernias and parastomal hernias. During the surgery, a variety of techniques are used to modify the abdominal wall and fix the hernia. In addition, several types of mesh are used to reinforce the weakened areas of the wall. The surgeon separates the layers of the abdominal wall, and places mesh behind each layer; thus, strengthening the wall.
Unlike most hernias, which develop in adolescence or adulthood, 20 percent of babies are born with umbilical hernias. An umbilical hernia occurs at the umbilicus (belly button) when a loop of the intestine pushes through the umbilical ring, a small opening in a fetus’ abdominal muscles through which the umbilical cord—which connects a fetus to its mother while in the womb—passes.
Umbilical hernias occur most often in newborns, and 90 percent will naturally close by the time the child reaches 5 years of age. This condition can persist to adulthood and get bigger in size.
A hiatal hernia occurs when the upper part of the stomach pushes through an opening in the diaphragm and into the chest cavity. The diaphragm is the thin muscle wall that separates the chest cavity from the abdomen. The opening in the diaphragm is where the esophagus and stomach join many people with a hiatal hernia never have symptoms. Some people with hiatal hernia have some of the same symptoms as gastroesophageal reflux disease (GERD). GERD occurs when digestive juices move from the stomach back into the esophagus.
The most common cause of a hiatal hernia is an increase in pressure in the abdominal cavit
Everything you need to know about hernia & hernia surgery
Dr. Jaideep Raj Rao is a Senior Consultant Surgeon at Arden JR Surgery, Mount Elizabeth Novena Hospital, Singapore.
His areas of interest are in minimal access and robotic surgery, bariatric and metabolic surgery, gastrointestinal surgery, oncology surgery, and hernia and complex abdominal wall reconstruction (hernia repair surgery).
Dr. Rao is on the editorial review board for the Asian Journal of Endoscopic and Laparoscopic Surgery, International Journal of Abdominal Wall and Hernia Surgery, and Hernia
Dr. Jaideep Raj Rao has taken some time to compile the most relevant information on Hernia, Different Types of Hernia & Hernia Surgery.