1. What is a hernia?

A hernia is a protrusion of some content of the abdominal cavity through a defect in the abdominal wall. It presents as a bulge, many times painful, and its characteristic feature is that the bulge goes down spontaneously or with change in position.

2. What are common types of hernias?

Inguinal hernia, Femoral hernia, Umbilical hernia, Incisional hernia, Epigastric hernia , Hiatal hernia (At SHRC we also perform this procedure which is also known as Fundoplication)

3. Where can the hernia occur?

A hernia can occur in the front of or in the sides of the abdomen. Hernias occurring in the front are the most common. The ones that occur low down in the two groins are called the inguinal hernias. Other hernias can occur in the area of the belly button or above it, and bulges can also occur in the areas of previous operations on the abdomen where the wound has not healed completely. These hernias are called incisional hernias.

4. Why do hernias occur?

The hernias that occur spontaneously occur in areas where there is a tendency for hernias to form.They may not necessarily occur in the young age group. The tendency can persist into adulthood and the hernia manifests much later. The exact reason why a hernia forms is not known but situations where the abdominal pressure increases tend to manifest with overt hernias. Examples of this kind of increased abdominal pressure include straining due to prostatism, straining at stool or having occupations which involve a lot of abdominal strain.

5. What can be done to prevent hernias?

Truth be told, hernias cannot be prevented. If you are born with a tendency to form a hernia, you will form one but once it is formed, you can, to some extent, alleviate pain and discomfort, by avoiding straining.

6. How are hernias treated?

Hernias are essentially a mechanical problem and to correct this, one needs surgery. There is no question of medication to correct a hernia.

7. Why should one undergo surgery?

Hernias tend to have complications. These take the form of what is called irreducibility where a hernia which initially comes out and goes back spontaneously refuses to go back. In other words, the contents which come out through the defect in the abdominal wall muscles get stuck - this is the first step. Later, this can cause an obstruction to the intestine, for example, that comes out and that causes severe pain. When this obstruction goes on to a stage where even the blood supply to the intestine is affected, this is a condition called strangulation. This is an emergency, as strangulation can be a potentially life-threatening problem. Hence, it is strongly recommended that hernias are dealt with before any of these complications occur.

8. What does surgery involve?

Hernia is treated by either the conventional open surgery or laparoscopic surgery called keyhole surgery or minimally invasive surgery. The principle in both kinds of operations are the same. The defect in the abdominal wall musculature is defined and is covered by a synthetic mesh that strengthens the abdominal wall. Laparoscopy is preferred because there is less pain during surgery and recovery is faster. For example, if you have an open operation, while you may go home in a day or two, the pain lasts a week to 10 days and it perhaps takes about 2 weeks before you can get back to work. In laparoscopic surgery, you go back either the same night or the next morning, the pain is much less, you are fully mobile within the next 2-3 days and you can be back at work in 3 days’ time.

9. Are there any complications in hernia surgery?

Complications are very rare in hernia surgery. This surgery is generally a safe operation but to expect no complications also, would be unreasonable. The common complications in hernia surgery include recurrence where in about 2% to 3% of cases, the hernia may come back because the mesh that we put in may get displaced. Other rare complications include bleeding in the site of the operation, infections either of the wound or of the mesh itself and sometimes chronic pain which can last for several weeks in the area of surgery, but it has to be stressed that these are RARE, and by and large, hernia operation is a safe operation.

10. Is there a difference in the operation for different kinds of hernia?

Yes, different hernia are dealt with differently. The common hernias are the hernias in the groin and on the front of the abdomen. In dealing with the groin hernias laparoscopically, we make 3 holes - one above the umbilicus and one on either side, go into the abdomen, define the defect as we mentioned earlier and use a mesh to bridge it, and these meshes are held in place through metal pins. The surgery takes about 25-30 minutes and you are home the same evening or the next morning. In the hernias that occur in the front of the abdomen, called incisional or ventral hernias, the 3 holes that we make are on the left side of the abdomen, and once we go in, we define the defect, release adhesions that may be there, create a space for the mesh (the mesh we use here is usually larger than the ones we use in the groin hernias) and they are held in place not only by metal pins but also by stitches which anchor it to the muscles in the front of the abdomen.

11. Are there times when you would not consider doing laparoscopic surgery?

By and large, most hernias can be dealt with laparoscopically. As laparoscopy is done under general anaesthesia, patients who are unfit to undergo general anaesthesia because of their medical problems cannot be treated laparoscopically. Many times, these hernias are done by the conventional open method either with local anaesthesia or with regional anaesthesia. Sometimes, when there are repeated operations in the abdomen, there may be extensive adhesions and these adhesions prevent proper access to the area of the hernia laparoscopically. In these patients also, we would prefer to do the open method.

About SHRC

SHRC (Shanti Hospital and Research Centre) is an ultra modern multi speciality hospital. Patient care services at SHRC are geared towards faster recovery and shorter hospital stays. The team at SHRC are qualified and experienced. Many of the surgeons and physicians at SHRC have been trained in UK, USA and Canada.

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Shanti Hospital & Research Centre
307, 40th Cross
8th Block, Jayanagar
Bangalore 560 082

Mainline: +91 80 4322 9999
Pharmacy: +91 80 4322 9831