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!

Hemorrhoids can be very painful and are impossible to ignore. They can be defined as internal or external swollen veins. In some cases, making a few lifestyle changes such as eating fiber-rich foods and drinking plenty of water may be enough to relieve the problem. In other cases, surgery may be required. Surgery for hemorrhoids depends on the severity of the case. There are many different types of surgeries that may be performed.

Banding
Banding or rubber band ligation is a surgical process used to treat internal hemorrhoids. This involves placing a tight band around the hemorrhoid base to cut off its blood supply. This procedure does not involve the use of anesthesia.

Sclerotherapy
This is also used to treat internal hemorrhoids. It involves injecting a particular chemical into the hemorrhoid that makes the hemorrhoid shrink and keeps it from bleeding. This procedure does not involve the use of anesthesia.

Coagulation therapy
Coagulation therapy is also referred to as infrared photocoagulation. The procedure involves the use of infrared light and extreme heat and cold. The aim here is to help the hemorrhoid shrink and retract. It may be performed with an anoscopy. An anoscopy is a procedure that allows the doctor to look inside the rectum with the help of a scope. This procedure does not involve the use of anesthesia.

Hemorrhoidal artery ligation
Hemorrhoidal artery ligation (HAL) or transanal hemorrhoidal dearterialization (THD) is often used to remove hemorrhoids. It involves using an ultrasound to locate the swollen blood vessels and then closing these off. This procedure does not involve the use of anesthesia.

Hemorrhoidectomy
Large external hemorrhoids can be treated with a hemorrhoidectomy. Internal hemorrhoids that have prolapsed and are not responding to other forms of treatment can also be treated with this procedure. The procedure is performed while the patient is under general anesthesia or local anesthesia. The hemorrhoids are then cut off surgically. Hospitalization may be required for a few days after this procedure.

Hemorrhoidopexy
This procedure is also known as stapling and may be performed while the patient is under local or general anesthesia. It is typically used to treat prolapsed hemorrhoids. During the procedure, the doctor staples the prolapsed hemorrhoid to the walls of the rectum and cuts of the blood supply to the affected vein. By doing this, the tissue is allowed to shrink and be reabsorbed into the body. As compared to a hemorrhoidectomy, stapling is less painful and has a quicker recovery time. 

Surgical Treatment Of Hemorrhoids!

Gallstones are bits of solid material that may be formed in the gallbladder. The gallbladder is a little organ located under the liver. You won't not know you have them until they've block your bile duct, causing pain that will need immediate medical intervention, and even hospitalisation in some cases.They may comprise of cholesterol, salt, or bilirubin, which consists of red platelets. Gallstones vary in size. They can be as little as a grain of sand or as even the size of an apricot in many cases.

Women are more likely to develop gallstones than men. Read on to know more:

Causes: There are a number of causes for this condition, especially in women. These causes are as follows:



Intake of anti-conception medication pills, hormone trade treatment for menopause side effects, or pregnancy
Fasting
Malfunctioning of the gall bladder
High cholesterol levels
Gallstones may be created when there is excessive amount of cholesterol in the bile discharged by the liver. This bile normally separates the cholesterol and helps in the normal functioning of the liver and other digestive organs of the body.
Bilirubin: Bilirubin is a substance created when your liver wrecks old red platelets. A few conditions, like cirrhosis of the liver and certain blood issues causes the liver to create more bilirubin than it ought to. This can lead to complicated conditions like gallstones.
Bile: Your gallbladder needs to exhaust bile to be sound. In the event that it discharges its bile content, the bile turns out to be excessively thick which causes stones to shape.
Weight: Being overweight or underweight can also cause a malfunction which can lead to the appearance of such stones. The diet also has a bearing in such cases.
Symptoms:

Fever
A yellowish tint in your skin or eyes, which can demonstrate jaundice
Sickness or retching
Clay coloured stools
Pain in the right upper quadrant of your stomach area
Nausea
Vomiting
Other digestive issues
Treatment:

Numerous individuals with gallstones may be asked to go through surgery to remove the gallbladder. These include the following:

Laparoscopic cholecystectomy: The specialist passes instruments, a light, and a camera through a few little cuts in the midsection.
Open cholecystectomy: The specialist makes bigger cuts in the belly to expel the gallbladder. You may have to spend a couple days in the hospital after the operation.
Without getting operated: If you have a mild condition and your specialist feels you shouldn't have an operation, he may recommend medicines like chenodiol, ursodiol, or both. These medications work by dissolving cholesterol stones. One may experience mild loose motions as a side effect.

Symptoms, Causes and Treatment of Gallstones in Women

Fissure in Ano, also known as Anal Fissure, is basically a small longitudinal cut in skin that lines the opening of the anus. Fissures cause bleeding and severe pain in the bowel movements. These are very common in the general public, but often confused with other pain. A fissure can happen at any point in your lifetime and can have equal general distribution.

Types of Fissure in Ano:

  Acute Fissure: Fissure in Ano less than 6 weeks of duration is known as Acute Fissure.

  Chronic Fissure: Anal Fissure with more than 6 weeks of duration is known as Chronic Fissure. 

Causes of Fissures in Ano:

  Anal fissures are basically caused by stretching of the anal muscles beyond its capability.

  In adults, it is caused by the passing of large stools, constipation or by prolonged diarrhea.   In older adults it is caused by the less flow of blood to that area.

  It is also caused by sexually transmitted infections (syphilis, chlamydia, herpes) and it results in fissures.

  Anal sex can also be the cause of fissures.

Symptoms of Fissures in Ano:

  Tear in the skin around the anus

  Small lump of skin, or skin tag next to the tear

  Pain during bowel movement

  Stools with blood or pus

  Itching and burning in the anal area 

Preventions During Fissures in Ano:

  One should drink enough water.

  One should have high fibre diet so that one does not suffer from constipation.

  Be careful and hygienic after anal defecation.

  In case of suspected fissure or any kind of pain, use a lubricating ointment.

  Sit in lukewarm water

Treatment for Fissures in Ano

Surgical treatments are not recommended, but there are some other measures that can be taken and are listed as follows:

  Some prescribed medication to lower the severity of pain.

  Nitroglycerin ointment may help heal the fissure.

  Having a rich fiber diet as a lifestyle change.

  Drink enough water as that helps in softening the stool.

  Sometimes Stool softeners may be required to soften the bowel movement.

When Anal Fissure does not heal with all of the above listed things, then a surgery may be required:

  Lower most part of the internal anal sphincter is divided laterally. With this acute fissure heals of its own. In chronic cases one may require to undergo fissurectomy.

  The surgery decreases the anal pain and spasm, allowing the fissure to heal.

  If a sentinel pile is present, it is removed to heal the fissure. 

It is important to note that any kind of treatment requires 6-10 weeks to recover. However, the pain may disappear just after 2-4 days after the surgery. One must consult a doctor before going for any treatment. This surgery can also be performed with LASER,where there is less trauma and early recovery is posssible.

Fissure In Ano

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

An anal fissure or fissure-in-ano is a small, cut in the skin in anal passage which results because of trauma to skin by passing hard stool in this region. Sometimes pain is so severe that patient tends to avoid passing stool in an attempt to stay away from pain.

Symptoms of Anal Fissure: 

  Pain in anal region while passing stool; it may be burning/pricking/Itching in nature.

  Bleeding may or may not be there.

  If untreated for long time; a skin tag known as Sentinel tag or Sentinel Piles develops from the lower end of fissure.

Causes 

The causes related to the emergence of an anal fissure include:

  Passing hard stool which causes frictional injury to inner lining of anal passage.

  Repeated bowel movement or diarrhea

  Trauma to anal canal like by enema nozzle 

Why non surgical treatment is better than Surgery:

Usually surgery (Lateral sphincterotomy) is advised in a view to relieve spasm in anal region so that Fissure starts healing but there are certain complications like stool incontinence etc. associated with this procedure which makes non surgical approach better than surgical intervention. Some of the reasons which make non surgical approach better than surgery for anal fissure are as follows: 

  Acute anal fissure can be conveniently treated by Graded Kshar Karma Treatment. In this treatment a specialized Ayurvedic medicine is applied in fissure region which debrides the fissure and promotes healing. In this way fissure heals completely. So, no need for any surgery at this stage and thus no complication like bleeding, pain, stool incontinence, etc.

  When Fissure is not treated at this stage; a skin tag known as sentinel piles develops from the lower end of fissure. This condition also can be managed by Graded Ksharsutra TM Treatment. In this treatment, Graded Ksharsutra TM - a specialized medicated thread is ligated at the root of sentinel piles and sentinel tag gets detached in 3-5 days. No hospitalization or bed rest is required in this treatment. So, at this stage also fissure can be managed without surgery.

  Delayed healing and Recurrence of Anal fissure are other complications seen after Anal Fissure surgery. Such complications are not seen in Graded Kshar Karma and Ksharsutra Treatment.

  In some case stool incontinence (inability to hold stool; which is far worse than Anal fissure itself) is also seen after Anal Fissure surgery. However, there is no harm to stool control in Graded Kshar Karma and Ksharsutra Treatment.

  No hospitalization or bed rest is required in Graded Kshar Karma and Ksharsutra treatment. Hospitalization and bed rest for a considerable time period is necessary in surgery.

  Graded Kshar Karma and Ksharsutra are more economical than surgery. With this discussion; it is for sure that non surgical treatment for Anal Fissure is far better than Surgery.

Anal Fissure - Non Surgical Treatment Is Better Than Surgery!

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