Hernia refers to the condition when an organ or fatty tissue inside the body begins to protrude from its location. Hernias are mostly detected in the groin, belly, or the stomach region. They occur because of muscle weakness in the said region where it is detected but they can be treated with surgery. In most cases, a surgery is prescribed and laparoscopic hernia repair is a very popular surgical procedure that has proven to be successful in most of the cases. This is why a growing number of patients decide to go for it.

Laparoscopic hernia repair: procedure: In this surgical procedure, a laparoscope (an instrument with a high-resolution camera and high-intensity light) is passed inside the abdomen through small incisions that varies between 0.5 and 1.5 inches in length. When the laparoscope moves inside the abdomen, it sheds light on the hernia and sends the images to the monitor connected to it. The surgeon views the hernia on the monitor and then the abdominal cavity is made to swell with carbon dioxide so that the surgeon can find enough space to operate the hernia. Once this is done, the surgeons operate the hernia with tiny surgical instruments. Once the hernia is removed, space or the hole is covered with a mesh from inside the abdomen.

Advantages of laparoscopic hernia repair: The laparoscopic procedure is popular because it is comfortable for the patient in many ways. They have to endure lesser post-operative pain as compared to open surgery, which means the recovery is quicker. They require lesser drugs for healing and the patient can get back to work in fewer days. It is an advanced form of surgery and thus, gives better results.

Disadvantages of laparoscopic hernia repair: While the non-invasive laparoscopic surgery has several advantages, it also comes with some drawbacks. It is lengthier in comparison to open surgery and also costs more. It cannot be performed by all the surgeons and only those who are skilled in this type of surgery can do justice to the different cases of a hernia. 

Recovery after laparoscopic hernia repair: The patient takes one to two weeks after the surgery to return to light activity and daily routine. Nevertheless, heavy exercise and strenuous activity should be avoided until four weeks after the surgery. The full recovery time differs from patient to patient depending on their age, gender, and health condition but one month is the average time for full recovery.

555 Manish Technique for inguinal hernia repair:

Totally extra-peritoneal (TEP) repair of inguinal hernia is now a standard surgical technique. A 12 mm incision in infra-umbilical region for Hasson trocar is must for TEP repair of inguinal hernia. This is the only technique known to laparoscopic surgeons. We have innovated a "555 Technique" for completing Mini TEP repair of inguinal hernia by using all three 5 mm ports.

555 Technique" is a feasible option without compromising the principles of TEP repair for inguinal hernia. Innovation of simple "Manish Retractor" is the key in completing Mini TEP repair. This technique is simple, less invasive, less morbid, and cost effective as it avoids dependence over costly Hasson trocar with better cosmetic results.

Laparoscopic Hernia Repair - What Should You Know

The liver has a significant role to play in metabolism and digestion. The failure of a liver can lead to significant health issues. There are some causes for liver failure, which cannot be treated with medications. In these people, a transplant, which is replacing the diseased or injured liver with another liver, is the only definitive treatment option.

Some conditions which can require a liver transplant are:

Severe cirrhosis with a life expectancy of less than a year
Severe liver failure
Non-alcoholic steatohepatitis (NASH)
Liver cancer
Chronic hepatitis C
Biliary atresia in children
Types of transplant:

Living donor transplant: In some patients, partial liver can be removed from a close family member and transplanted into the affected individual. The liver is known for its regeneration ability, and over time, will grow in the recipient.
Cadaveric transplant: Immediately after death, a liver can be removed and transplanted.
While the concept of a transplant sounds quite convincing and appealing for those with a severe liver disease, it is also important to note that not all would qualify for a liver transplant. The conditions which would disqualify a recipient are discussed below:

Significant heart disease: Those with severe coronary artery disease, valvular disease, cardiomyopathy, aortic stenosis, and cardiomyopathy are not candidates for a liver transplant.
Severe lung disease: Those with poor lung perfusion do not qualify for a liver transplant.
Advanced age: Greater the age, lesser the survival rates. So, people aged more than 70 are usually not considered for a transplant.
Obesity: A person with a BMI of more than 35 is often not a good candidate for a transplant. The overall health should be managed in these people.
Malnutrition: On the other extreme, severely malnourished individuals are also not considered for a transplant.
HIV infection: A person who is HIV-infected does not qualify for a liver transplant.
Substance abuse: Anyone who is actively abusing alcohol and/or substances is definitely removed from the list for a transplant.
Metastasis: If a patient is looking for a liver transplant due to hepatic cancer, it is essential that the cancer is contained. If it has spread to various parts, then containing it would be difficult, and a transplant may not succeed.
Multisystem organ failure: Other than heart and lungs, even people with poor renal function are not ideal candidates for a liver transplant.
A detailed liver recipient evaluation assessing the severity of liver disease, chances of survival, and overall health are done before a person is listed for liver transplant. This evaluation ensures a better success rate with the transplant.

Common Surgical Complications That One Should Be Prepared For?

Hernia or what in Ayurveda is known as Antra Vriddhi, is a condition that takes place when an internal organ in your abdomen gets displaced and protrudes outward, giving rise to swelling in the abdominal region. 
Even though you can develop a hernia anywhere in your body, it mostly occurs in the abdominal region and can affect both men and women at any age.

The causes of hernia are: 
Even though hernia can be a hereditary condition, certain factors can contribute in causing it. These are:
1.   Persistent coughing
2.   Putting excess pressure while passing faeces
3.   Straining your abdominal muscles by exercising or lifting objects that are heavy
4.   Obesity
5.   Buildup of fluid in your abdominal cavity

Symptoms
Some of the symptoms that indicate you have hernia include a visible, hard protrusion, development of soft lumps and pain. However, some people may not experience any symptoms at all. Hernia can be of many types, depending on the part of the body affected and even varying on the basis of your gender. In worst cases, you may require surgery but Ayurveda can cure your hernia completely without the need of you going through a surgical process.

How does Ayurveda help?
Ayurveda helps in curing your hernia by focussing on your diet. If you follow these rules, you can cure yourself of hernia completely.

1.   Reduce the amount of food you eat in a day and take small meals frequently instead of the standard three meals.
2.   While eating, make sure you eat your food slowly.
3.   Drink lots of water and other fluids, but do not consume aerated drinks
4.   It is advised not to take water with your meals, but only to drink a glass of water an hour after and half an hour before each meal. By doing this, you reduce your chances of getting heartburn and aid in the proper functioning of the digestive system.
5.   Eating any form of raw food, such as uncooked meat and vegetables is strictly forbidden along with processed foods such as bread, cakes, cookies etc. However, when eating cooked food, make sure it's lightly cooked and not overcooked.
6.   Having a glass of juice freshly squeezed from vegetables or fruits is recommended, especially carrot juice as it is enriched with calcium and vitamin A that help in the healing process.
7.   Make sure that whole grains, nuts, seeds, vegetables and fruits are a part of your diet.
8.   Lastly, go for a walk after each meal and do not sleep after eating, especially if you've had a heavy meal.

Hernia : Ayurveda Treatment for Hernia Problem

What do we mean by a hiatal hernia?

The hiatus is an opening in the diaphragm (the muscular wall) which separates the chest cavity from the abdomen. Normally, the esophagus (food pipe) goes through the hiatus and attaches to the stomach. In a hiatal hernia, the stomach bulges up into the chest through that opening.

What does statistical data say about a hiatal hernia?

Statistically, approximately 60% of individuals who are above age 50 or older have a hiatal hernia.

In which age group is hiatal hernia very common?

The incidence of hiatal hernias increases with age. It is commonly seen in the older age people specifically in people who are above 50. 

What are the causes of hiatal hernia?

The most common risk factors are as follows: 

Obesity Congenital deformities, such as scoliosis
Certain types of surgery
Major trauma
Conditions which causes an increase in abdominal pressure within the abdomen, such as heavy lifting, or bending over, frequent or violent coughing, violent sneezing, violent vomiting, and straining during bowel movements
What are the types of a hiatal hernia?

There are four types of a hiatal hernia and they are as follows:

Sliding hiatal hernia: This is the most common variant of a hiatal hernia. It occurs when your stomach and esophagus slide into and out of your chest through the hiatus. It is usually asymptomatic.
Fixed hiatal hernia: It is also known as a paraesophageal hernia. In a fixed hernia, part of the stomach pushes through diaphragm and stays there.
Type III hiatal hernia: In this type, as a hernia goes on increasing, the phrenoesophageal ligament stretches and displaces the gastroesophageal junction above the diaphragm
Type IV hiatal hernia: Type IV hiatal hernia includes a large defect in the phrenoesophageal ligament causing other organs, such as colon, spleen, pancreas and small intestine to enter the hernia sac.
What are the sign and symptoms of hiatal hernia?

Common symptoms include:

Heartburn
Chest pain or epigastric pain, coughing
Difficulty in swallowing
Belching, eructation, and hiccups
How to diagnose the condition?

To diagnose this condition following tests or procedures are included:

X-ray of the chest and abdomen Barium follow-through examination of gastrointestinal tract (GI) to visualize GI tract.
Upper endoscopy for examining the esophagus and stomach from inside Esophageal manometry for measuring the rhythmic muscular contractions of esophagus while swallowing, and also, measuring the force exerted by the muscles of esophagus.
What is the treatment available for it?

It includes medications and surgery which are as follows:

Antacids to neutralize stomach acid and to reduce acid production
Medications that heal the esophagus 
Surgery of opening of diaphragm to make it smaller and for reconstruction of an esophageal sphincter

Hiatal Hernia - How Is it Diagnosed?

A Hernia may be defined as the protrusion of an organ into an adjacent connective tissue or muscle. The protrusion usually occurs through a tear or a weakened area in the muscle (Fascia). Hernia can be an Inguinal Hernia, Umbilical Hernia, Hiatal Hernia or Femoral Hernia. It can also originate from an incision (Incisional Hernia).

The Inguinal Hernia is commonly observed in males. Here, the intestine squeezes through a tear in the abdominal wall into the groin (Inguinal canal). At times, the small intestine bulges through the abdominal wall (weak spot) near the belly button, which results in Umbilical Hernia. In Hiatal Hernia, the upper part of the stomach passes into the chest through the diaphragm, and of all the hernia types, the Inguinal Hernia is the most common.

Severe strain and muscle tear or weakness can result in Hernia. Obesity, chronic constipation, chronic coughing and sneezing, ageing, damage caused by injury, medical conditions like Cystic Fibrosis, contribute to increased incidences of Hernia. In case of Hernia, the affected area tends to protrude or bulge out. If left untreated; Hernia can prove to be detrimental. One needs to consult a physician for proper diagnosis and treatment. Physical examination can help in the diagnosis of Inguinal Hernia. An ultrasound is needed to diagnose Umbilical Hernia. A Barium X -ray or endoscopy can be of great help in the diagnosis of Hiatal Hernia.

The severity of the Hernia depends upon its size. In case the Hernia is rapidly increasing in size, a surgery is needed for the repair. The surgery performed can be open or laparoscopic. In open surgery, Hernia is identified through an incision. Once located, the Hernia is removed from the adjacent tissues. In laparoscopic repair, small incisions are made in the affected region. Through these incisions, specialized instruments are inserted. It is through these instruments that the surgeon visualizes and performs the surgery.

In such repairs, a mesh, held in place by sutures is used as a scaffold. This facilitates the growth of new tissues in the affected person. This technique significantly lowers the chance of a recurrence. Certain factors must be well addressed, before performing a Hernia operation:

* Hernia operations, laparoscopic in particular, should be performed by experienced surgeons. Inexperienced surgeons will do you more harm than good.
* Laparoscopic Hernia operation should be avoided in case a patient has adhesions from previous surgery.
* Extreme care should be taken while performing a Hernia operation in infants and children.
* In some cases, Hernia surgery might affect or injure the vas deferens in men. This in turn can affect fertility in men.

What To Know About Hernia Operation

Umbilical hernia refers to a condition where your intestine protrudes through the opening of the belly button. This condition generally affects infants, but some people may suffer from it in adulthood as well. Umbilical hernias are common but do not cause any health issues in most cases. However, in some instances, the disorder leads to problematic symptoms.

Symptoms of umbilical hernia:

If you or your child suffers from the symptoms mentioned below, you should seek treatment.

  Pain
  Nausea/vomiting
  Discolouration and swelling at the region of the hernia

If one or more of these symptoms appear, seeking treatment at the earliest is necessary to avoid further complications.

Complications from umbilical hernia:

Even though complications from the disorder are rare in infants, they are not unheard of. The most common complication occurs when the portion of the intestine protruding from the belly button is trapped. In such a case, blood supply to this region is cut. This can lead to tissue death or gangrene. The infection slowly spreads to the rest of the digestive system, causing a life-threatening situation.

Adults who have umbilical hernia are more likely to suffer from complications of the condition.

Treatment for umbilical hernias:

Treatment differs based on the age of the patient. In most infants, the umbilical hernia does not produce any symptoms. In fact, such hernias typically disappear on their own after a year or two. A doctor may also be able to push the hernia in during a routine check-up. However, you should not try to do this yourself.

When is surgery needed for an umbilical hernia?

An infant requires surgery for the hernia if he/she experiences the following traits-

  Pain
  The hernia has a diameter larger than half an inch
  The hernia is large and does not decrease in size in the first two years of the child s life
  Does not disappear even when the child reaches the age of four
  The external portion of the intestine sticks out and gets trapped.

However, in the case of umbilical hernias affecting adults, a doctor will always recommend surgery to avoid possible complications arising from the disorder.

How is the surgery performed?
For both infants and adults with an umbilical hernia, the surgical procedure remains the same. The surgeon makes a small incision at the base of the belly button. The doctor uses this opening to return the external part of the intestine inside the abdominal cavity. Once this is complete, the doctor stitches the incision.

In adults, a supportive mesh is also used to ensure that the intestine does not protrude once more through the belly button.

Laparoscopic hernia repair is suitable for all types of a hernia such as an umbilical hernia. 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 healthy muscle.

Umbilical Hernia - Everything You Should Know About It!

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