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Hernia Surgery - Multi Specialty Hospital | Bangalore Orthopaedic and Surgical Hospital | BOSH | Bangalore

A hernia occurs when an internal part of the body pushes through a weakness in the muscle or surrounding tissue wall. A hernia usually develops between the chest and hips. In many cases, it causes no or very few symptoms, although one may notice a swelling or lump in tummy (abdomen) or groin. The lump can often be pushed back in or disappears when you lie down. Coughing or straining may make the lump appear.

Types of hernia :

Some of the more common types of hernia are described below.

  • medicalInguinal hernias: Inguinal hernias occur when fatty tissue or a part of bowel pokes through into groin at the top of inner thigh. This is the most common type of hernia and it mainly affects men. It's often associated with ageing and repeated strain on the abdomen.
  • medicalFemoral hernias also occur when fatty tissue or a part of bowel pokes through into groin at the top of inner thigh. They're much less common than inguinal hernias and tend to affect more women than men. Like inguinal hernias, femoral hernias are also associated with ageing and repeated strain on the abdomen.
  • medicalUmbilical hernias: Umbilical hernias occur when fatty tissue or a part of bowel pokes through abdomen near belly button (navel). This type of hernia can occur in babies if the opening in the abdomen through which the umbilical cord passes doesn't seal properly after birth. Adults can also be affected, possibly as a result of repeated strain on the abdomen.
  • medicalHiatus hernias: Hiatus hernias occur when part of the stomach pushes up into chest by squeezing through an opening in the diaphragm (the thin sheet of muscle that separates the chest from the abdomen). This type of hernia may not have any noticeable symptoms, although it can cause heartburn in some people. It's not exactly clear what causes hiatus hernias, but it may be the result of the diaphragm becoming weak with age or pressure on the abdomen.

Other types of hernia

Other types of hernia that can affect the abdomen include

  • medicalincisional hernias – where tissue pokes through a surgical wound in abdomen that hasn't fully healed.
  • medicalEpigastric hernias – where fatty tissue pokes through abdomen, between navel and the lower part of breastbone (sternum)
  • medicalSpigelian hernias – where part of bowel pokes through abdomen at the side of abdominal muscle, below navel
  • medicalDiaphragmatic hernias – where organs in abdomen move into chest through an opening in the diaphragm; this can also affect babies if their diaphragm doesn't develop properly in the womb
  • medicalMuscle hernias – where part of a muscle pokes through abdomen; they also occur in leg muscles as the result of a sports injury.

One should seek medical advice immediately if suffering from hernia and develop any of the following symptoms:

  • medicalSudden, severe pain
  • medicalVomiting
  • medicalDifficulty passing stools (constipation) or wind
  • medicalThe hernia becomes firm or tender, or can't be pushed back in

These symptoms could mean that either:

  • medicalThe blood supply to a section of organ or tissue trapped in the hernia has become cut off (strangulation)
  • medicalA piece of bowel has entered the hernia and become blocked (obstruction)

A strangulated hernia and obstructed bowel are medical emergencies and need to be treated as soon as possible.

Assessing a hernia: An ultrasound scan is used to confirm the diagnosis or assess the extent of the problem. This is a painless scan where high-frequency sound waves are used to create an image of part of the inside of the body. Once a diagnosis has been confirmed, the doctor will determine whether surgery to repair the hernia is necessary.

A number of factors will be considered when deciding whether surgery is appropriate, including:

  • medicalThe type of hernia – some types of hernia are more likely to become strangulated, or cause a bowel obstruction, than others
  • medicalThe content of your hernia – if the hernia contains a part of your bowel, muscle or other tissue, there may be a risk of strangulation or obstruction
  • medicalSymptoms and the impact on one’s daily life – surgery may be recommended if the symptoms are severe or getting worse, or if the hernia is affecting the ability to carry out your normal activities
  • medicalGeneral health – surgery may be too much of a risk if general health is poor

Although most hernias won't get better without surgery, they won't necessarily get worse. In some cases, the risks of surgery outweigh the potential benefits.

Procedure: There are two main ways surgery for hernias can be carried out:

  • medicalOpen surgery – where one cut is made to allow the surgeon to push the lump back into the abdomen
  • medicalKeyhole (laparoscopic) surgery – this is a less invasive, but more difficult, technique where several smaller cuts are made, allowing the surgeon to use various special instruments to repair the hernia

Recovery: Most people are able to go home the same day or the day after surgery and make a full recovery within a few weeks. After the operation, the groin will feel sore and uncomfortable. Patient will be given painkillers to help relieve this discomfort. If still in pain after going home, it is recommended to continue taking painkillers as advised by the doctor. Applying gentle pressure to the wound using hand, or a small pillow can make coughing, sneezing and moving between sitting and standing more comfortable.