Hernia: Types, symptoms and treatment
Yeah! Hi, I’m Dr. Nitin Jha, I’m a senior consultant laparoscopic surgeon at Fortis hospital, Noida and I also have a clinic in sector 61 Noida which goes by the name of Agarwal Clinic and today we’ll be discussing about Hernia.
By Hernia we mean that there is a small gap in the muscle of the abdomen wall and through this gap there is a protrusion of the contents which are inside of the abdomen like small intestine or the, even large intestine or the omentum fat and which tries to come out of this hole and as long as they go out and then they come back it’s okay. But the day it gets stuck, you know if you have a swelling in which the swelling refuses to go in, that means it is like an emergency then you have to immediately go to the hospital and get it operated upon.
Now, what is the cause, the basic cause of any hernia is, the weakness in the muscle wall and it can be even sometimes without any cause. That is called as Idiopathic. Now, there are basically there are three types of common hernia that we all encounter. The one is the Inguinal Hernia which are present in the lower part of the abdomen on the left as well as on the right side. Then you have our Umbilical hernia which is a hernia in the umbilicus itself, so that in the umbilicus instead of being a pit it becomes a elevated out pouching and then you have something called Incisional hernia in which after any surgery in the abdomen you can have a small bulge occurring from that incision side which is called basically insicional hernia. So be it any type of hernia the treatment is always surgical only. In contents, the usually, the intestine, the small ball, the large ball or the omentum fat can be the content of the hernia.
Now, What is the problem? Why to get it operated? As long as, as I told you, as long as it comes out and then goes back in, it is okay. But the day it refuses to go back in, that means it has become a bit complicated hernia. It starts with irreducibility, matlab, it doesn’t go back inside. Then there is something called as obstruction in which the intestine gets stuck in that pouch and it causes obstruction of the intestine. That is obstruction to the flow of the contents of the intestine. In that case the abdomen becomes bloated, the patient is not able to pass gas or motion from below and he or she can have a continuous vomiting from up. So, and obviously if the time goes on like this because of a decrease in blood supply of the intestine, the intestine can sometimes become strangulated. In that case it is an emergency and we have to immediately go to the surgeon and get it operated upon because if we give it more time the intestines can lose its blood supply and then we have to do a proper, major, big surgery. In which we have to cut the caught part of the intestine and rejoin the normal part. So, obviously we should definitely avoid this kind of circumstances which increases the cost also and plus it increases the morbidity, the trouble to the patient also.
Talking about surgery we initially had only open surgery, in which a small cut almost of this size used to be given whether it was inguinal or umbilical or incisional, but it had its own problems. The issue was, with open surgery, was you had to have a big incision on the belly. Then the bigger the incision the more the pain. The bigger the incision the more the chances of infection. But usually now we don’t do it by open surgery. We do it by something called laparoscopic surgery, in which there are almost two or three small, small holes of the size of around 5 millimeter or 1 centimeter and through, without cutting open the abdomen, through these small, small holes only the whole surgery is done. So the advantage is the patient becomes alright much faster. He needs to stay in the hospital for lesser number of time. He can be back to his work probably in three to four days. But as the thing is you know is any good thing is costly. Similarly the laparoscopic surgery is costly because the mess and the things which are required to fix the mess to the abdominal wall are costly. But if you compare between these two methods, laparoscopic surgery is far, far, far better than open surgery.
My specialty is doing the same surgery which is usually done by all other laparoscopic surgeons by three or four small, small cuts, I do it by only one single cut. So, especially with a uncomplicated simple hernia of the anteroapical wall, be it incisional or be it umbilical or super umbilical hernias which is commonly referred as ventral hernia. They are done by single incision only. That means I just put a small cut almost of this size around 1 to 1.5 centimeters size in the left part of the abdomen and through this same incision we conduct the whole surgery. So, the patient has not three small cuts but only one small cut. That’s the advantage of single incision laparoscopic surgery. So, you can consult me at my clinic in
So, you can consult me at my clinic in sector 61 Noida, Agarwal Clinic C122 and, otherwise you can also meet me in Fortis hospital Noida. Plus you can take an appointment via Lybrate and we’ll be glad to discuss your problems, thank you.