Hernia surgery

Hernias manifest through specific symptoms, signaling the protrusion of organs or tissues through a weakened area in the abdominal wall. Here are five key symptoms associated with hernias:

1. Visible Bulge: One of the most noticeable signs is the presence of a visible bulge or lump under the skin, particularly when standing, coughing, or straining. This bulge represents the protrusion of organs, often the intestine, through the weakened abdominal wall.
2. Pain or Discomfort: Individuals with hernias often experience pain or discomfort at the site of the bulge. The sensation may range from a dull ache to sharp pain, intensifying during activities that strain the abdominal muscles.
3. Feeling of Heaviness: Some people report a general feeling of heaviness or pressure in the abdomen, especially when standing or lifting heavy objects. This sensation is attributed to the herniated tissue placing additional stress on the surrounding muscles.
4. Burning or Gurgling Sensation: Hernias may cause a burning or gurgling sensation at the site of the bulge. This can be a result of stomach acid or intestinal contents passing through the herniated area.
5. Difficulty Swallowing or Indigestion: In the case of hiatal hernias, which occur in the upper part of the stomach, symptoms may include difficulty swallowing, indigestion, or heartburn. This type of hernia can allow stomach acid to move into the esophagus.

Why is Hernia Surgery Needed?

Hernia surgery is frequently performed to prevent and treat complications arising from a hernia. In this section, we discuss five important reasons to perform hernia surgery:  

• Prevent Strangulation: A strangulated hernia deprives the trapped tissue of its blood supply, which poses a grave danger. Therefore, hernia surgery is performed to reposition tissue to avoid this life-threatening condition.  
• Relief of Pain and Discomfort: Frequent pain and discomfort can arise from hernias, especially in activities. Surgery rectifies this pain and improves the quality of life of the patient.  
• Preventing Obstruction: A hernia may obstruct the bowel in some cases, meaning that the intestines would be blocked. Surgery can thus prevent this potentially dangerous complication.  
• Repairing the Weak Area: Hernia surgery repairs the weakened area in the muscle wall that allowed the tissue to bulge out, thus helping prevent recurrence of the hernia.  
• Improvement of Quality of Life: By removing the pain and the worry of serious complications, hernia repair greatly improves the quality of life of those that suffer from hernias.

Types of Hernia Surgery

Types of hernia surgery can differ based on the type of hernia, its location, severity, and the health of the individual. These are some common types of surgeries performed:  

1. Herniorrhaphy (Open Hernia Repair): The traditional surgical method makes a single large incision at the site of the hernia. This procedure pushes back protruding tissue and repairs the weakened muscle wall with stitches, usually reinforced with mesh for additional support. 
2. Laparoscopic Hernia Repair: A minimally invasive surgery involving one or two small incisions in the abdomen for the insertion of a laparoscope and surgical instruments to repair a hernia and reinforce the abdominal wall mesh. Smaller scarring, less pain, and faster return to normal activities are some advantages.  
3. Robotic Hernia Repair: Another minimally invasive method that uses a robotic system under the control of the surgeon for increased precision and flexibility compared to conventional laparoscopic surgery, which is advantageous for complicated hernioplasty.

Conditions Treated with Hernia Surgery

Indications for hernia surgery include protruded organs or tissues through weakened muscle or tissue. This is a specific procedure to tackle some of the conditions related to hernias:

• Inguinal Hernia: Most often in the groin. The abdominal contents push through the groin into the inguinal canal. Surgery fixes the groin wall.
• Femoral Hernia: In the thigh, under the groin with the abdomen protruding. Surgery repairs a femoral canal.
• Umbilical Hernia: About the belly button (umbilicus). Surgery repairs around the umbilicus.
• Hiatal Hernia: The Stomach protrudes through the diaphragm into the chest cavity. Surgery repairs the diaphragmatic opening and stomach position.
• Incisional Hernia: Past surgery sites and protruding abdominal contents. Surgery repairs the incision site.
• Epigastric Hernia: This hernia at the upper part of the abdomen is comprised of fatty tissue protruding and is repaired surgically.
• Spigelian Hernia: This is a rarer type alongside the edge of the rectus abdominis muscle. surgery repairs abdominal wall.

Benefits of Hernia Surgery

Benefits of hernia surgery include a great number and variety saving lives and improving quality of life. Here's the summary:

• Surgery can generally relieve or eliminate chronic pain, allowing for a return to normal daily activities.
• Without surgery, a hernia can strangulate and interfere with better blood circulation, and this is potentially life-threatening.
• Another way is that a hernia obstructs the bowel by cutting through the intestines. So, surgery prevents severe pain due to this condition and may require emergency surgical intervention.
• Hernia surgery has provided the patients with such quality of life that it has reduced pain and thus prevented complications and enabled resuming day-to-day activities with fresh energy.
• The interference in the abdominal wall is repaired, preventing further recurrences. Often, Mesh is used in the repair.
• By correcting the hernia, the risks of other complications are reduced. 
• Laparoscopic and robotic techniques have smaller incisions associated with less pain and quicker recovery than traditional open surgery.
• By using surgical mesh during hernia repairs, the chances of hernia recurrence are significantly diminished.
• They restrict physical activities. Surgery repairs that area, thereby restoring better functioning. 
• By repairing the hernia, the risk of other related health issues is also reduced.

Risk & Complication

Even though hernia surgery is meant to be safe and effective, there are always risks and complications whenever surgery is involved. The list of risks and complications goes as follows:

Risk Factors:

• Infection: There might be a possibility of infection at the incision site or in the abdomen.
• Bleeding: Excessive bleeding during or after surgery may take place.
• Allergic to Anesthesia: Allergic reaction to anesthesia ranges from mild to very severe.
• Blood Clots: A patient might develop DVT (Deep Vein Thrombosis) or PE (Pulmonary Embolism) depending upon his or her risk factors.

Risk factors include obesity, smoking, diabetes, chronic cough, previous surgery, old age, and any connective tissue disorder.

Complications:

• Recurrence: A hernia may recur, depending upon certain types or surgical techniques.
• Nerve Damage: Chronic pain or numbness will occur whenever there is nerve injury in the surgical area. 
• Complications Associated With Mesh: Complications due to mesh can include infection, migration, shrinkage, pain, discomfort, and the formation of scar tissue. 
• Seroma or Hematoma: There can either be a seroma (fluid accumulation) or a hematoma (blood accumulation) at the surgical site. 
• Bowel Obstruction: Although this is to be avoided surgically, in very rare circumstances, it can result in a bowel obstruction due to the formation of scar tissue. 
• Scrotal Swelling (in inguinal hernia repair): Repairing an inguinal hernia can cause the scrotum to swell or bruise.
• Chronic Pain: Some patients report chronic pain after hernia surgery, even after a successful repair. 
• Damage to Adjacent Structures: Very rarely, however, damage to the surrounding organs may occur during the procedure.

Hernia treatment typically involves surgical intervention to repair the weakened abdominal wall and alleviate symptoms. Here is an overview of the treatment procedure in five key points:

1. Medical Evaluation: Upon suspecting a hernia, a healthcare provider conducts a thorough examination, which may include imaging tests like ultrasound or CT scans to confirm the diagnosis, assess the size and type of hernia, and plan the appropriate treatment.

2. Watchful Waiting or Lifestyle Changes: In some cases, particularly with smaller hernias that are not causing significant symptoms, a watchful waiting approach may be recommended. However, lifestyle modifications such as weight management and avoiding activities that exacerbate the hernia may be advised.

3. Anesthesia: The anesthetic can be arranged depending on the type of surgery and some other factor such as the patient's health. Anesthesia could be general, regional, or local with sedation. 

4. Accessing the Hernia:

• Hernia Surgery (Herniorrhaphy): The most common and effective treatment is surgical repair of the hernia. This can be done through traditional open surgery or minimally invasive techniques like laparoscopic hernia repair. During surgery, the protruding tissue is pushed back into place, and the weakened area is reinforced with stitches or a mesh patch to prevent recurrence.

• Open Hernia Repair: In open surgery, a larger incision is made directly over the hernia site. This approach may be preferred for certain complex hernias or when laparoscopic repair is not suitable.

• Laparoscopic Hernia Repair: A less invasive option, laparoscopic surgery involves smaller incisions and the use of a camera (laparoscope) for visualization. This approach often results in quicker recovery, reduced postoperative pain, and a shorter hospital stay compared to open surgery.

5. Hernia Repair: The surgeon identifies the herniated tissue in the abdomen and returns it to its original position. Thereafter the abdominal wall is reconstructed and strengthened by applying surgical mesh for support and closure of the wounds with sutures. 

6. Closure of the Incisions: Depending on the situation, incisions are closed with sutures or staples or with the application of surgical glue followed by the application of dressing. 

Post-Operative Care:

Post-operative care is of utmost importance for the smooth recovery of a patient after the operation on a hernia. Here are the complete details about what to expect and how to help with the proper healing:  

• Follow the instructions on pain medicine strictly. Apply ice for relief. 
• Maintain hygiene for the wound. Keep it clean and observe for signs of infection.
• Limit activities and lifting for a few weeks, and gradually exercise more. 
• Ensure bowel movements with extra fiber in the diet and drinking water.
• Start with soft foods; stage back to a regular diet. 
• Stay hydrated and attend follow-up appointments. 
• Avoid tight clothing, rest well, and stop smoking. 
• Let your doctor know if you have any adverse symptoms such as an infection, bleeding, an increase in pain, fever, nausea, recurrence of the hernia, or difficulty urinating.