More than 90% of our cases are performed laparoscopically or with a minimal access technique
Hernia Surgery overview:
Our success rate for hernia repair matches that among the best of the centres around the world. The surgeries performed by our experts are exceptionally safe, secure, and reliable. Although there are inherent risks in any surgery, we make every effort to minimize the risks involved.
What is an abdominal wall Hernia?
The Abdominal wall covers the front and the back of the abdomen, it runs from the rib cage to the groin and protects the internal organs like intestine and liver. Normally it is a strong structure made up of many layers of tissues. However, sometimes an area of weakness develops as a result of operation or otherwise and the internal contents start protruding through. This condition is known as Hernia.. The Hernias are of many types depending on their location or cause.
What are Groin Hernias?
The groin is the line between the lower abdomen and the thigh. A hernia which develops along this line is called Inguinal, or Femoral Hernia.
Types of hernias:
Inguinal hernias they are located in the groin either in or above the scrotum. When they bulge through directly they are named Direct Hernia or when through the inguinal canal called Indirect Hernia. Femoral hernias are located in the upper thigh, sometimes it is difficult to distinguish them from inguinal hernias, and however, the treatment remains the same.
Ventral Hernias appear in the abdominal wall mostly around the belly button (Umbilical Hernia) or in the upper part called Epigastric hernia. Man times they arise from the scar of a earlier operation, they are labeled as Incisional Hernais.
How do you get a Hernia?
Hernias are usually divided into two main categories:
A hernia can be Congenital or acquired
The congenital hernias are present at birth or develop shortly after, they come out through the still open passage known as inguinal canal..These hernias are noticed as a bulge by the mother when the baby cries.
Acquired hernias develop when your abdominal wall becomes weak or lax either due to ageing, earlier operation, and dietary imbalance, lack of exercise, heavy weight lifting, or poor life style like smoking. Hernia is a complex disease, in majority of cases no cause can be attributed (Idiopathic Hernia)
What are the symptoms of a Hernia?
A soft swelling in your groin or abdomen, or pain is the most common sign of a hernia the type of hernia you have will determine where the bulge appears. Some hernias can only be seen when you stand up and may disappear completely when you lie down. Others may only be visible when you strain your muscles by coughing, sneezing, laughing, bending, or lifting. Usually, the bulge is soft enough that you can gently push, or knead it back into your abdomen (reducible), and it is often not there when you wake up in the morning. Most hernias are not painful. However, sometimes the area around your hernia may be tender and you may feel some sharp twinges or a pulling sensation. As your hernia gets bigger, your pain and discomfort may increase. If not repaired in time, a hernia may eventually prevent you from enjoying normal activities due to increased discomfort, such as exercising, working, household chores, or sex.
In early stage the bulge may appear only while standing, straining or coughing. The pain may sometime be the only symptom, and the bulge can only be detected by careful exami nation. Initially you are able to push or knead it back. Gradually it may remain all through the day and cannot be pushed back (irreducible Hernia). Constant pain means you should get it treated at the earliest.
Health Risks
when you are unable to push it back and it has become painful that means an organ, such as your intestine, have become trapped. An incarcerated hernia is a medical emergency.-Contact your doctor immediately if you have this situation.
If left untreated, an incarcerated hernia is tightly trapped and blood will no longer flow into the tissues. With lack of blood supply, the trapped tissues may die. A strangulated hernia and will cause severe pain, nausea, vomiting, and rarely even death. A strangulated hernia requires immediate surgical attention at the nearest emergency hospital. A hernia at this stage means that you will lose the option of choosing the ideal type of surgical treatment. If you have a hernia, contact your doctor right away if:
- The hernia is painful,
- The hernia can‘t be pushed back, and
- you feel sick to your stomach or vomit, the hernia is painful or you cannot pass gas or have a bowel movement
A Laparoscopic Inguinal Hernia operation showing the placement of the Mesh
Hernia is best diagnosed clinically after a careful examination by the surgeon, on occasions however it may be difficult to diagnose. When small they can appear and then disappear. When this happens, don’t assume that the hernia is cured; rather the hernia defect, or hernia sac, simply goes back through the same weak area. This weakness still requires surgery. Ultrasound, CT scan, or MRI are rarely needed, their role is in diagnosing obscure hernias or for planning the treatment of a complex ventral hernia. As mentioned earlier the most reliable way is by a physical exam by a surgeon experienced in hernia repair.
Hernias do not get better by waiting. If you have a hernia problem surgery is the only known effective treatment. The hernia belts are more harmful than useful they should be avoided. You will need an operation to repair the weak spot in your abdominal wall ultimately. Hernia that is not repaired in time can get bigger, and may lead to more serious complications. This is particularly true for femoral hernias, which have a much higher risk of developing complications, surgery is recommended for all femoral hernias as soon as possible and also for groin hernia if one is medically fit.
The type of hernia repair performed by your surgeon will depend on the size and location of the hernia, anesthesia risk, and strength of the surrounding tissue as well as experience of the surgeon in open and laparoscopic repair.
Hernias can be repaired in one of the following two ways:
- The “anatomical” repair is done using your Natural Tissue without the surgical mesh to repair the hernia defect. The operation involves cutting open the hernia site in contrast to the laparoscopic procedures where it is done through tiny punctures.
- In the open repair after exposing the defect a mesh made of artificial fiber is placed in most of the cases. At SMARTSurgery Cliniqs, we use the best available meshes.
Hernia repair using mesh can be done by using either the “open anterior” surgical technique or using a Laparoscopic posterior approach. - Laparoscopic repairs are always performed under General Anesthesia. In this approach, three tiny punctures are made in the abdominal wall, one to allow a surgical scope to be inserted, along with two additional narrow tubes to allow placement of the surgical instruments. The hernia is then repaired by anchoring with glue, or special tacks a mesh patch over the defect from behind (“posterior repair”).
Open vs Laparoscopic Technique
Laparoscopic techniques require the use of general anesthesia.
In expert hands the laparoscopic surgery is less painful, and is associated with a faster recovery with practically no scars. This technique certainly requires more expertise. It is the preferred option in advanced centres.
Choosing the right surgeon
It is critical for you to choose your surgeon wisely. The experience and skill of the hernia surgeon especially with Laparoscopic surgery is vital to the good outcome.
- Watchful waiting or early surgery? Discuss frankly..
- It is good know about the experience and complication rates of your hernia surgeon.
A good faculty, a team approach, diligent work up, and a well planned surgery are the essential ingredients for a successful outcome. At SMART Surgery cliniqs our experienced team of surgeons, nurses, and support staff is committed to offer you excellent and comprehensive care.
