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

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

Gastroesophageal reflux disease, or gerd, as it is commonly known is a digestive disorder that is caused primarily due to intestinal distress. Gerd is caused in the muscle that lies between the oesophagus and the stomach, when the acid is produced in the stomach, it starts to flow backwards. For patients suffering from gerd, the acids flow back into the oesophagus instead of the stomach, causing symptoms like severe heartburn, chest pain and nausea, amongst others. So what does one do to deal with gerd? here's a brief list!

Obesity: being overweight and obese are two of the most important factors that contribute to discomfort in gerd patients. Working towards a healthier weight is a sure shot way of dealing with this ailment.

Alcohol and smoking: the muscle ring that can be found between the stomach and the oesophagus relaxes with the intake of alcohol or with smoking, which prevents it from closing to stop the stomach's juices from reaching the oesophagus. So, giving up both substances would be a good idea if you are a gerd patient.

Go gluten free: adopting a gluten free diet can help you cut out ingredients including grains and dairy products that contain more protein than what your digestive tracts can handle.

Other dietary measures: in order to handle gerd effectively, you will need to remove or reduce chocolate, fatty food, spicy food, and even oily and fried food from your diet. You may need the help of food with extra fibre, like fruit so that it can pass through the digestive tract faster.

Smaller and well timed meals: eating meals regularly and dividing them into smaller meals that can be digested quickly and more efficiently is one of the best ways of dealing with gerd to prevent the onset of backward flowing of stomach acids.

Exercise: ensuring that you do not take a nap or lie down right after a meal and putting in a small amount of exercise everyday will also help in doing away with the uncomfortable and painful symptoms of this disease.

Making lifestyle changes is one of the best ways to deal with gerd. Yet, it would be best to see a doctor regarding severe cases where the symptoms do not abate and medication may be required.

How To Deal With GERD

Thyroid disorders are conditions that affect the thyroid gland, which is a butterfly-shaped gland in front of the neck. There are specific kinds of thyroid disorders that include:

Hypothyroidism
Hyperthyroidism
Goiter
Thyroid Nodules
Thyroid Cancer
Epidemiology, Incidence, and Prevalence
It has been estimated that about 42 million people in India suffer from thyroid diseases.

Hypothyroidism

Hypothyroidism occurs when the thyroid gland produces an insufficient amount of thyroid hormone. It can develop from problems within the thyroid gland, pituitary gland, or hypothalamus. 

Symptoms of hypothyroidism can include:

Fatigue
Poor concentration or feeling mentally "foggy"
Dry skin
Constipation
Feeling cold
Fluid retention
Muscle and joint aches
Depression
Prolonged or excessive menstrual bleeding in women
Common Causes of Hypothyroidism

Hashimoto's thyroiditis (an autoimmune condition that causes inflammation of the thyroid gland)
Thyroid hormone resistance
Other types involving inflammation of the thyroid, such as acute thyroiditis and postpartum thyroiditis
Hyperthyroidism

Hyperthyroidism refers to the excessive production of thyroid hormone, a less common condition than hypothyroidism. Symptoms of hyperthyroidism are usually related to increased metabolism. In mild cases, there may not be apparent symptoms.

Signs and symptoms of hyperthyroidism can include:

Tremors
Nervousness
Fast heart rate
Fatigue
Intolerance for heat
Increase in bowel movements
Increased sweating 
Concentration problems
Unintentional weight loss
Common causes of hyperthyroidism

Graves' disease
Toxic multinodular goiter
Thyroid nodules that overexpress thyroid hormone (known as "hot" nodules) 
Abnormal secretion of TSH
Thyroiditis (inflammation of the thyroid gland)
Excessive iodine intake
Goiter: A goiter is an enlargement of the thyroid gland, regardless of cause. A goiter may be associated with hypothyroidism, hyperthyroidism, or a normal thyroid function. 

Thyroid Nodules: Nodules are lumps or abnormal masses in the thyroid. Nodules can be caused by benign cysts, benign tumors, or less commonly, by cancers of the thyroid. If nodules are excessively large, they may cause symptoms related to compression of nearby structures. 

Thyroid Cancer: Thyroid cancer is more common among adult women than men or youth. About 2/3rd of cases occur in people under age 55. There are different kinds of thyroid cancers depending upon the specific cell type within the thyroid that has become cancerous. Most cases of thyroid cancer have a good prognosis and high survival rates, especially when diagnosed in its early stages.

Investigations

Blood tests are done to measure levels of thyroid hormones. Blood tests are also done to identify antibodies against thyroid tissue, such as titers of antithyroglobulin, antithyroperoxidase, or TSH receptor-stimulating antibodies.

Treatment

Thyroid disorders can be treated with medications or, in some cases, surgery. The treatment will depend on the particular disease of the thyroid.Medications can be given to replace the missing thyroid hormone in hypothyroidism. Synthetic thyroid hormone is given in pill form by mouth. When hyperthyroidism is present, medications can be used to decrease the production of thyroid hormone or prevent its release from the gland. 

Thyroid Disorder - What All Should You Know 

Gallstones are solid deposits/stones of digestive fluids that form in the gall bladder. The size of these stones varies from person to person. While some people may develop only one stone in the bladder, others may develop multiple gallstones simultaneously.

Signs you must watch out for-

Abdominal pain
Pain in the back or between the shoulder blades
Vomiting and nausea
Heartburn
Bloating and indigestion
Change in bowel movement
Dark urine
Fever and chills
Rapid heartbeat
Yellowish skin and pale eyes (Jaundice)
These are the most common symptoms that a person with gallstones encounters. One should consult the doctor right away upon experiencing these symptoms. If ignored for long, these signs can aggravate and lead to further complications.

Complications that may arise from gallstones-
There are quite a few complications of gallstones, including the following-

Cholecystitis- when gallstones become stuck at the neck of the gallbladder, it causes inflammation.
Obstruction in the pancreatic duct- a gallstone blocking the pancreatic duct can cause pancreatitis followed by intense abdominal pain.
Blockage in the bile duct- if the gallstones create a blockage in your bile duct, the outcome may be an infection or jaundice.
Gallbladder cancer- people, who have a history of gallstones, are more likely to develop gallbladder cancer.
Treatment of Gallstones-
Gallstones can certainly be treated, if diagnosed early in time. To confirm the diagnosis, your doctor may perform a CT scan, X-ray, Ultrasound or an ERCP. Once the condition is diagnosed, your doctor will recommend a surgery to remove the stones in the gallbladder (known as Cholecystectomy). The preferred choice of surgery includes the following-

Laparoscopic removal- In most of the cases, the doctor adopts this minimally invasive approach to remove gallstones. First, he makes a small incision in the abdomen. He will then insert a tube-like instrument with an attached camera into the gallbladder to have a clear sight of the gallstones, and surgically remove them from the gallbladder.
Open surgery- This is performed under general anesthesia. During this procedure, a single, long incision of roughly 3-6 inches is made on the upper side of your right abdomen. The tissues and muscles are pulled back to divulge the gallbladder. The gallstones are then removed, and the incision stitched up. Open surgery is performed when laparoscopic surgery is not suitable for the patient.
Gallstones cannot be managed with just diet and medications. A surgery is usually needed to remove the stones and cure the patient. For Laparoscopic surgery, the rate of success is nearly over 95%. Identify the symptoms before it aggravates, and consult a doctor for treatment.

Gall Stones - Is Surgery The Only Treatment?

Rarely do people ascribe Erectile Dysfunction to Hemorrhoids. Yet the correlation between the two is not far-fetched. Research has suggested that men who have suffered from Hemorrhoids in the last year are at an increased risk of developing Erectile Dysfunction. These two conditions are apparently incongruous. For someone suffering from Erectile Dysfunction, there is a lack of blood flow to the penis. For someone suffering from Hemorrhoids, there is swelling of veins inside the rectum. 

Younger people are more at risk unlike most diseases like High blood pressure, Alzheimer s diseases etc which are progressively more likely to occur in older men, this problem is more likely in younger than in older men. The study found that about 24.9% men under 40 years, who had been diagnosed with hemorrhoids in the last year, had suffered from Erectile Dysfunction. So the correlation is more prevalent in younger men than older men. According to the findings of the study, men aged 30 or less are more likely to experience Erectile Dysfunction after being diagnosed with Hemorrhoids in the last year. Moreover, men between the ages of 30-39 are twice more likely to suffer from Erectile Dysfunction if diagnosed with Hemorrhoids in the last year.

The correlation between age and likelihood of occurrence of Erectile Dysfunction due to Hemorrhoids is quite clear from these findings. The Apparent reason according to researchers in the study, localized swelling of varicose veins in the deep anus region may be responsible for some local irritation which can give rise to Erectile Dysfunction. Manage the Pain First Young men, who are suffering from Erectile Dysfunction, ostensibly arising out of the presence or history of Hemorrhoids in the past year, need to first manage the pain due to Hemorrhoids. Pain arising out of Hemorrhoids can be very difficult to put up with. A decrease in hemorrhoids pain can reduce the discomfort to some extent. Bleeding during bowel movement, intense pain during and after sitting, a feeling of itchiness or irritation near the anus etc are all indicators of hemorrhoids. If one has to habitually push hard during a bowel movement, he/she is more likely to suffer from Hemorrhoids, since the varicose veins can swell up during such hard pushing. 

The solution to alleviate pain, one can use various topical solutions containing Witch Hazel and Aloe Vera. These are anti-inflammatory herbs. Most of the anti-hemorrhoid creams contain either of these two. Apart from using topical solutions, one needs to change his dietary habits. One should abstain from foods that upset the stomach and adopt foods that soften the stool. This can help one avoid straining while moving bowels and spare the varicose veins from being inflamed. One can also benefit by practicing anal breathing which exercises the PC muscles and the anal sphincter. This could benefit both Hemorrhoids and Erectile Dysfunction.

Hemorrhoids - How It Increase Risk Of Erectile Dysfunction?

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