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Hernia Surgery

Hernia Surgery
In simple language hernia is a defect in the abdominal wall, through which the abdominal contents like intestine, omentum (intra- abdominal fat) or other organ protrude or bulge out forming a swelling. Usually the swelling increases on straining, coughing, walking and causes discomfort.

What are the different types of hernia?
There are many different types of hernia depending upon the site of hernia and cause of hernia. The common ones are the inguinal and femoral hernia presenting as swelling in the groins, umbilical hernia presenting as swelling at the navel (belly button) and incisional hernia occurring at the site of previous surgery. The umbilical and incisional hernias are clubbed together as ventral hernias and have similar surgical treatment.

Hiatus hernia is an altogether different type of hernia where part of the stomach protrudes from abdomen to the chest through the diaphragm (a wall between the abdomen and chest). It is a totally different problem and has very different treatment plans and is discussed with the problem of heartburn on another page.

Is Surgery a must?
Yes, it is mandatory. For treatment of hernia, surgery is the only remedy. Surgery was, is and probably will always be the only treatment for hernia. Delay in operation can result in enlargement of hernia or may cause complication like obstruction or strangulation, resulting in gangrene of a part of the intestine, which requires emergency surgery. During such complication, apart from hernia repair this surgery may requires removal of gangrenous bowel increasing the risk of surgery and also risk of mesh infection. Dr. Chirag Thakkar is one of best laparoscopic Hernia Surgeons of Ahmedabad.

Is Laparoscopic hernia repair better?
For incisional/ventral hernia laparoscopic repair has great advantages. It can prevent large incisions and extensive dissection just below the skin that is required in open repair. In open repair tubes need to be placed in the abdominal wall to remove the blood and serum, which may be kept for a week or more. With open repair there is a significant rate of wound infection and mesh infection. These complications are minimized to a great extent in laparoscopic repair. Overall time to recovery and pain after surgery is also significantly decreased with laparoscopic method.

For inguinal hernia, laparoscopic hernia repair has some benefit in regards to post- operative recovery and pain. The rate of chronic pain problem after surgery is less with laparoscopic hernia repair than open repair. Also there are some hernias that are better operated by open method, while for hernia on both sides it is better to be operated laparoscopically as both sides can be repaired through the same incisions/holes. In case of patients having recurrent hernia after open surgery, laparoscopic repair is advantageous and preferable.

Can I get my hernia treated without staying overnight at the hospital?
Surgery under Local anaesthesia (Day care surgery): Walk out of Operation Theatre after Surgery (Ambulatory surgery)

Hernia surgery can be done under local anaesthesia (patient is conscious and awake and only the site of surgery is anaesthetised). As no general anaesthesia is given, patient can walk as well as eat and drink immediately after surgery. The anaesthesia related complications are also avoided. This method is especially important for elderly patients with other cardiac and chest problems in whom the risk of anaesthesia is very high. Patient can be discharged on the same day of surgery after this type of surgery. Life style of the patient is not altered much. Patients can resume office work in 2-3 days. Dr. Chirag Thakkar has a very wide experience in performing Hernia Surgeries under local anaesthesia.

After surgery care and precautions:
Patients are mostly discharged on the same day of surgery after they urinate. Rest is required for 2-3 days after which office work can be resumed. You have no physical restrictions. You can exercise but start slowly. We request that you walk at least 1 to 3 miles per day, every day. This routine post-operative exercise will shorten your recovery period and post-operative pain. Normal diet is resumed on the same day of surgery. For laparoscopic surgery and surgery done under general anaesthesia we prefer to keep patient in hospital for one day. Walking and climbing a couple of stairs can be done as per patient comfort. We take subcuticular stitches and so no stich removal is required and patient can take daily bath after surgery. After these laparoscopic procedures, old blood will accumulate in the lower portion of your abdomen and by gravity, this may create a discoloration of your genitals and groin after some time. This is normal. You may experience some pain and burning sensation on the skin of your legs and testicles. This is called a temporary neuropathy. Exercise and walk. These symptoms will subside promptly. If not, notify your physician. Most discomfort will be experienced by patients when getting up and sitting down. This is normal.

Precautions:
  • Avoid strenuous work and lifting weight over 5kg for the first three months after surgery
  • Avoid catching cough and cold and if present take treatment for the same immediately
  • Avoid bending forward too frequently
  • Do not continue to suffer from constipation, but treat it at the earliest
  • Do not gain weight for at least 6 months post-operatively
  • Avoid yoga and other exercises as per the advice of your surgeon and perform only such exercises as permitted

The cost of surgery varies according to the type of hernia, type of surgery (whether open or laparoscopic), class of accommodation, duration of hospital stay and type of mesh to be used. Hence for every case of hernia it is necessary to first have a consultation with the surgeon. Dr. Chirag Thakkar is a leading Hernia Surgeon of Gujarat.