When an organ or fatty tissue is squeezed through a hole (weak spot) in the connective tissue or a surrounding muscle then it causes a hernia. Usually, hernia happens at the abdominal wall and sometimes it can be seen as an external bulge.

There are various types of hernia which include:

  Inguinal Hernia (happens in the inner groin).
  Incisional Hernia (develops through a scar or an incision in the abdomen).
  Umbilical Hernia (develops at the belly button).
  Femoral Hernia (develops in the outer groin or upper thigh area).
  Ventral Hernia (develops in the general ventral or abdominal wall).
  Hiatal Hernia (develops inside the abdomen, beside the upper diaphragm or stomach).

The most common cause of hernia is the combination of pressure and opening of connective tissue or weakness of the muscle. Anything that escalates the abdominal pressure can lead to a hernia, including lifting heavy weights, constipation, persistent sneezing or coughing, obesity, and diarrhea. Overexertion, poor nutrition, and smoking can also weaken the muscles and can increase the possibility of a hernia.

Mesh Surgery 
Surgical mesh is used to supply extra support to the damaged or weakened tissue. It is a medical device, usually made out of either animal tissue (from skin or intestine) or synthetic material. Surgical mesh of synthetic material can be made in non-knitted sheet forms or in the knitted mesh. The synthetic material used for making a surgical mesh can be absorbable, non-absorbable material, or a combination of both.

Surgical mesh made out of animal tissue is disinfected and processed in a way that makes it suitable for implantation. These are absorbable and mostly made from the tissues of pig or cow.
Absorbable mesh degrades and loses its strength over time. It is not made to supply
long-term support to the restored site.

On the other hand, non absorbable mesh remains in the body for a long duration and is accounted for as a permanent implant. It provides permanent strength for restoring hernia.

In Hernioplasty or the mesh surgery for a hernia, the muscle opening is not stitched shut, instead it is covered with a sterile, flat mesh which is mostly made of synthetic or animal tissue. Small cuts are made around the hole in the shape of the mesh and the patch is stitched into the healthy surrounding tissues. The weak or damaged tissues around the hernia use the mesh, as support to regrow.

Recovery
Usually it takes up to 4 to 6 weeks to recover completely from mesh surgery. However, one can get back to his/her normal routine within 2 weeks post the surgery. There are certain precautions that one should undertake to avoid any complications. One should avoid heavy weight lifting, heavy exercises, stretching, and running. These precautions include diet modifications too. One should avoid consuming heavy fatty food and meat.

Takeaway
A hernia can be caused by a number of reasons and mesh surgery is a medical procedure helps to treat this problem. One should not avoid the treatment of hernia as the early treatment reduces the complications.

Mesh Surgery For Hernia - All You Must Know!

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?

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?

Hernias are quite common and occur more in men than in women. When left untreated, the condition gets very painful, and sometimes become life-threatening. Hence, ignoring a painful hernia is a bad idea, and seeking medical assistance is necessary. To know more about the condition and the treatment available, read on.

What is a hernia?
A hernia refers to an abnormal exit of an organ or tissues. When a fatty tissue or an organ squeezes or penetrates through a weak spot of the surrounding connective tissues or muscles, the condition hernia appears. Though there are various types of a hernia, it is an inguinal hernia and the ventral hernia that are two of the most common types.

Inguinal hernia
When the bladder or the intestine protrudes into the groin's inguinal canal or extends through the abdominal wall, it is referred to as an inguinal hernia. Around 96% of the groin hernias that occur are usually inguinal hernia. It is due to the weakness in the groin area of men that men commonly suffer from this kind of a hernia.

Ventral hernia
A ventral hernia is a type of a hernia that develops in the abdominal wall's front. Usually, it occurs at the weak areas of the abdomen such as the location of a previous surgery. Varying in sizes, it may be small to complex and large, these hernias may appear weeks or months or sometimes years after surgery. The various types of a ventral hernia are an epigastric hernia, umbilical hernia, incisional hernia, Spigelian hernia and parastomal hernia.

Complications, if left untreated...

If left untreated, your hernia may grow and become more painful. A portion of your intestine could become trapped in the abdominal wall. This can obstruct your bowel and cause severe pain, nausea, or constipation. An untreated hernia can also put too much pressure on nearby tissues. This can cause swelling and pain in the surrounding area. If the trapped section of your intestines doesn t get enough blood flow, strangulation occurs. This can cause the intestinal tissue to become infected or die. A strangulated hernia is life-threatening and requires immediate medical care.

Treatment Options--

Open surgery
Open surgery for treating hernia is the most traditional and old surgical practice. To perform this common type of hernia surgery, local anesthesia is required, while an incision of around 4 to 5 cm is made in a hernia affected area. Even the most complex and large hernias can be easily treated through such surgeries. Open hernia surgery usually takes 30 to 45 minutes.

Laparoscopic surgery
Compared to the open surgery, laparoscopic surgery requires more time, around an hour or so and is one of the modern surgical processes. Though long-standing or chronic or large hernias cannot be removed through laparoscopy as easily as in open surgery, still, when it comes to smaller incision and quicker recovery time, it is definitely the laparoscopic hernia surgery that is chosen by many. But the costs for laparoscopic surgery is a bit higher than that of the open surgery.

Remember, both women and men can get a hernia at any age. People can even be born with a congenital hernia or develop a hernia over time. A hernia neither goes away all by itself, nor it gets healed over time. Getting operated, in the majority of cases, is usually considered to be the best option to get rid of this condition.

Hernia (Inguinal Or Ventral) And The Surgical Treatment Options Available!

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

Dependent on each patient, hernias need to be managed under medical supervision.

Hernia - What Should You Know?

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?

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