A hernia is a condition where fatty tissue or an organ in your body might bulge through a muscle or an abnormal opening in the body. It is caused mainly due to pressure in the muscle area or weakening in the spot. This may occur due to heavy lifting or weakness that was present since birth.

The different types of hernia are inguinal, incisional, hiatal, umbilical and femoral. For inguinal hernias, surgical methods are used. The most common method is laparoscopic repair.

What is laparoscopic hernia surgery?

In this process, you will be given general anaesthesia before the surgeon performs the surgery. Before undergoing the operation, you will have an evaluation of your complete health that will include an analysis of your past medical history and a physical examination. An electrocardiogram or ECG will also be conducted. 

Then a small cut or incision is made in the lower part of your abdomen below the navel. The laparoscope that is a small telescope-like instrument is inserted to view your internal organs. A video camera is attached to the device that projects the internal view of your body on to a screen. This is viewed by the surgeon in the operating room.

During the process, your abdomen is inflated with carbon dioxide, to create some space for the doctor to look inside easily. The inner abdomen lining called peritoneum is cut open to observe the weakness of the abdominal wall or the location of the hernia sac. After locating it, the surgeon will remove the hernia sac from the wall and use a prosthetic mesh to cover the defect. Then the small incisions are closed with surgical tapes or stitches.

Furthermore, if hernias are found on both sides, they can be operated without making a second incision. The mesh can be placed on all the abdominal areas that are weak. This prevents the hernia to occur in the same spot again or spreading to other areas.

However, laparoscopic surgery is not performed for children. It is also not suitable for some cases such as if you are pregnant, or cannot tolerate general anaesthesia or are obese. 

Aftercare

You will be able to go back home on the same day of the surgery after laparoscopic hernia repair. The recovery time lasts for about 1 to 2 weeks. After that period you can return to light activity like walking. However, you must not engage in any kind of strenuous activity like working out or lifting heavy objects.

You might observe soreness after the first 2 days of the surgery. In some cases, bruising is found in your groin area. But if you observe significant swelling in the groin region, contact the doctor immediately.

It is recommended that you maintain a diet that is rich in fibre. This is because if you suffer from constipation, the straining during your bowel movements might put pressure on the area that is repaired.

People prefer laparoscopic hernia repair as they suffer lesser pain and can get back to their normal lives faster than open repair surgeries. It is advised that you take the medications and follow the instruction of your surgeon properly after the procedure. 

 



 Laparoscopic Hernia Repair - What Should You Know?

You will definitely face many complications after a hernia surgery, but certain measures can lead you to a speedy recovery. Your main aim must be to ensure you don t get any infection. Avoid any jerking like sneezing or coughing. Some of the tips for speedy recovery are mentioned below:

Apply ice to reduce pain: If you experience any form of swelling or pain, ice will help reduce it. Apply ice for 10-20 minutes in a day, and you will get your results. However, refrain from applying ice for too long. It might make the condition worse. Also, wrap up the ice in plastic or a piece of cloth and then apply it to the intended portion.
Take regular medication: Patients experience fever and pain after a hernia surgery. To combat these, you can take prescribed medications from your doctor. Medications also aim in improving your immunity so that you do not get infections easily. Hence, the medications are not to be missed.
Keep your wounds clean: The operated area must always be kept clean to prevent any form of infection. You must dress the wound daily and keep the incision points clean and dry. Change the dressing as your doctor has advised you to do. You can apply any antiseptic or any other cream but take your doctor s permission first.
Keep a pillow near you: When you get an urge to sneeze or an urge to a cough, just cover your incision with the pillow and do it.
Maintain a proper diet: A proper diet plays a significant role in the recovery process. Consume fruits to replenish your storehouse of nutrients. Include high-fiber food in your diet so that you don t have to suffer from constipation. You need to avoid constipation as much as you can. If food doesn t work, you can take stool softeners. Constipation will lead to extra pressure on the cuts which can lead to bleeding.
Wear loose clothing: Don t wear tight pants or clothing that will stick to your skin. The waistbands must be loose and not tight.
Avoid lifting weights: Don t lift weights. Lifting weights will cause stress at the cuts and may even lead to rupture so avoid doing strenuous activities.
Go for a small walk: As soon as you feel a bit better go for a little walk. You need to move your muscles otherwise they will become stiff.
Don t smoke: Avoid smoking after the surgery as it will hamper your breathing and circulation process.
Check out for warning signs: Always keep an eye on your wounds. Report to your doctor as soon as you see bleeding or anything abnormal.
Follow the tips mentioned above, and you will see how fast you will recover.

Hernia Surgery - 10 Effective Tips For Speedy Recovery!

Laparoscopy surgery is a very vital component of the hernia repair. Studies have shown that many patients have a better outcome when they opt for laparoscopic surgery. Candidates eligible for this mode of surgery include those with bilateral inguinal hernias, ventral hernias, and recurrent hernia. People associated with athletics and other outdoor sports prefer to go for a laparoscopic hernia surgery as it ensures a speedy recovery and minimal tissue invasion (due to small incisions).

Laparoscopic hernia repair- inguinal
A laparoscopic surgery requires an incision of 1-2 cm at the belly (at the lower end). Two small punctures are done near the umbilicus. The punctures are done to make room for the cameras so that the surgeon is able to view the abdomen clearly. The smaller incisions allows the operating instrument to enter into the stomach.

The Procedure:
A balloon is placed in between the abdomen and the overlying muscle so that the peritoneum can be separated. When space is successfully made, the camera comes into the action to view the condition of a hernia. A hernia is pulled from its hole into the abdomen. Once the hole is detected, the defect of a hernia is fixed.

Laparoscopic hernia repair- incisional/ventral: Laparoscopic hernia repair is suitable for all types of a hernia such as an umbilical hernia, ventral hernia, recurrent umbilical hernia, epigastric hernia etc. Just like an inguinal hernia, A camera is placed into the abdomen through the muscles. Two small incisions are made for the operating instruments to get through. This is followed by the cutting of the tissue that is placed between a hernia and the intestine. The hole thus gets exposed. Through one of the laparoscopic ports, the hernia mesh gets rolled and is placed into the abdomen. A hernia is then pulled up and the mesh gets secured with 4 sutures. A special device is used to fix the healthy muscle.

Tension free repair: Tension free  repair is often used to symbolize hernia surgery. A hernia is often triggered by the weakened muscles. Few surgeons endeavors to sew the muscle around the area of a hernia. Since the muscles surrounding the hernia are weak in the first place, they pull apart causing a recurrence of a hernia. To avoid this, most surgeons use a mesh to strengthen the cells around the hernia region. This procedure ensures that the muscles aren t sewn but the mesh placed over the hole can prevent the muscle to push through the walls of the abdomen.

The use of mesh: There are some reservations about using the mesh in a hernia surgery. However, this is the safest and most appropriate way to perform a hernia laparoscopic surgery. The use of a mesh also negates the risk of open incisions and recurrence of a hernia.

Types of Hernia - How Laproscopy Can Help Manage?

When an organ residing in a cavity such as the abdomen tries to push through the muscular layer it resides in, it is called as hernia. 

Though said to be genetic, hernias can be caused by things such as improper heavy lifting, incorrect posture, or chronic constipation and as a result of surgical complication or injury. Factors like obesity, pregnancy, smoking, chronic lung disease aggravate the severity of the hernia. It is believed that about 27% of all males and 3% of females can have a hernia during their lifetime.

Types of hernias:

Inguinal hernia: The groin is the most common area, where the abdomen pushes through a weak spot in the lower abdominal wall, causing a protrusion into the inguinal canal. This is more common in men than women.

Hiatal hernia: The abdomen has the diaphragm separating it from the thoracic cavity in the upper border. When it pushes through the diaphragm, a hernia is caused and there is almost always associated food reflux in these cases. Though the most common cause is associated old age, due to muscle weakness, there also are cases of congenital hiatal hernias.

Umbilical hernia: The abdomen finds a weak layer along its length and protrudes through the skin on the stomach. Most commonly seen in babies around the bellybutton, it gradually corrects itself on its own. Quiet rare in adults, seen during pregnancy and in chronic obese people.

Incisional: These are post-surgical, and happen when the organ protrudes through the weakened wall due to surgery. The abdomen is again the most common area and the hernia can happen either onto the external surface or internally, when they are called ventral hernias.

These are the most frequent types, though hernia affects other organs like the spine, brain, appendix, etc.

Treatment
 
This includes a combination of constant monitoring followed by a decision to do surgical treatment. Hiatal hernias and umbilical hernias can be monitored for a while before deciding on surgery. Inguinal hernias may require surgery earlier in the stage. Post-surgery, a mesh is placed to hold back the tissue in its corrected place. The umbilical hernia in children could be self-limiting. If it does not get auto-corrected in the first year of life, that also would qualify for a surgical treatment. Hernias need to be managed under medical supervision.

Hernia - What You Should Know About It?

Umbilical Hernia is a common condition in infants in which the intestine protrudes or pokes out through the abdominal muscles in the navel area, where generally the Umbilical cord is located. Umbilical Hernia is generally harmless if not sore and is evident when the bellybutton protrudes. During childhood, Umbilical Hernia closes on its own, but sometimes when it does not, it might require a surgical correction during adulthood. This condition is commonly seen in premature babies and can be diagnosed through physical examination alone.

Symptoms

Umbilical Hernia causes swelling or bulging near the navel and is generally visible under normal circumstances. However, in some cases, the protrusion occurs only when the baby strains, coughs or cries. Though this condition is painless, it can cause discomfort during adulthood. To avoid complications, it is advisable to seek professional help even if the condition initially seems harmless. There might be symptoms of pain, swelling, discoloration, and tenderness in the navel, accompanied by vomiting sometimes.

Causes

When the fetus is still unborn and in womb, the umbilical cord passes abdominal muscles of the baby through a small opening, which generally closes post birth. But in case muscles fail to completely join the midline of abdominal wall, this condition appears post birth, and sometimes later in life.

During adulthood, when there is too much pressure on the abdomen, it leads to this condition. This pressure might build up due to a number of causes like multiple pregnancies, obesity, previous abdominal surgery, ascites (fluid in the abdominal cavity), and long-term dialysis for kidney function.

Complications

Complications might be caused when the protruding part of the intestine gets incarcerated or trapped and fails to push itself back into the abdominal cavity, reducing the blood supply. This leads to tissue damage and umbilical pain. If the blood supply totally fails, tissue death leads to gangrene, causing infection, and posing a life-threatening situation. In such cases, surgery might have to be performed in an emergency.

Treatment

Most of the times, abdominal tissue pushes itself back but sometimes, it has to be done by an experienced medical professional. When this cannot happen, surgery has to be performed to correct the situation. The surgery can be open or laparoscopic.

A small incision is made at the base of the bellybutton during surgery, which is a small and quick procedure. The hernia is corrected and sutures close the incision. For adults, sometimes mesh is used for strengthening the abdomen during open surgery.

Take Away

Umbilical Hernia is a condition in which the intestine or abdominal tissue protrudes through the abdominal muscles in the navel area, where generally the Umbilical cord is located. It is a harmless condition but sometimes painful. Generally, it corrects itself but when it fails to do so, corrective surgery is required which can be open or laparoscopic.

 Umbilical Hernia - How To Manage It?

Anti-reflux surgery (Fundoplication) is a procedure for treating gastroesophageal reflux disease (GERD) incorporated in hiatus hernia operation. GERD occurs when stomach contents reflux and enter the lower end of the esophagus (LES) due to a relaxed or weakened sphincter or a hiatus hernia. GERD is very much treatable and can cause serious complications if left untreated. 

GERD symptoms
The main symptom of GERD is heartburn or indigestion, along with other symptoms, such as 

Acidic sour taste in the mouth
Burning pain in the throat
Difficulty in eating
Bloating and belching
Stomach pains
Regurgitating food
Nausea
Vomiting blood
Dark tarry stools
Laparoscopic Anti-Reflux Surgery
Laparoscopic surgery reinforces the lower oesophageal sphincter s ability to prevent gastroesophageal reflux from occurring. The surgery involves wrapping the top part of the stomach around the lower end of the esophagus and suturing it in place. Since the esophagus passes through the hiatus, suturing is done to narrow the hiatus as it helps in the prevention and treatment of concurrent hiatal hernia.

Laparoscopic Surgery Procedure
A laparoscope, a long, narrow telescope with a light source and a video camera at the end, is inserted through a tiny incision into the abdomen. Images from the camera are projected onto a large high definition monitor for the surgeon to view enlarged images as it helps the surgeon perform surgery with precision.

The patient is placed under general anesthesia
The surgeon makes a small incision in the upper abdomen and inserts the laparoscope into the abdomen.
The surgeon introduces carbon dioxide into the abdominal cavity near the belly button to expand the viewing area of the abdomen giving the surgeon a clear view and room to work.
Additional small incisions are made for a variety of surgical instruments to be used during the procedure.
After the identification of critical structure, the hole in the diaphragm, through which the esophagus passes, is then tightened with sutures.
The surgeon wraps the upper part of the stomach around the lower esophagus guided by the images on the laparoscope, then creates a valve which is precisely sutured in its place.
The laparoscope and other instruments are removed and the gas is released.
The tiny incisions are closed and covered with waterproof dressings to avoid any kind of infections.
The patient is usually discharged within 1-2 days of the surgery.
Post-surgery, hospitalization is required just for one day - no bed rest is required after that. The patient can quickly return to all normal activities and immediate relief from symptoms also happen. 

Laparoscopic Surgery - How It Can Help With Anti-Reflux and Hernia?

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