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What exactly is a hernia?

A hernia occurs when an organ or fatty tissue pushes through a weak point or opening in the muscle or tissue that holds it in place. The groin area and abdominal wall are the most common areas of the body for a hernia. A portion of intra-abdominal viscera or fat protrudes through a weak spot in its muscle wall in the abdomen. When this happens, it creates a bulge under the abdominal skin either in the groin or abdominal areas.

Types of Hernia:
Many types of hernias exist. A few of the most common types are:

  • Incisional Hernia
  • Femoral Hernia
  • Umbilical Hernia
  • Inguinal Hernia
  • Hiatal Hernia
  • Ventral Hernia

When do you need surgery:

Most hernias are just lumps and are not painful. However, some hernias get bigger as time goes on, become symptomatic causing pain and nausea and they usually do not get better by themselves. The content of a hernia may become trapped which can lead to obstruction and strangulation which is an emergency. When this happens, it often requires emergency surgery.

Surgery is needed if :

  • Your activities become limited or you have pain.
  • Your hernia becomes larger and or you develop pain, nausea, and vomiting.
  • Your doctor and you worry about the content to be trapped.

The Surgical procedure for Hernia:

  • Hernia repair surgery is often an outpatient procedure. 
  • It does not require overnight stay in the hospital.  It may be done as an open surgery (traditional) or laparoscopic surgery. 
  • You can be given local anesthesia in some cases so you can stay awake throughout the surgery with the pain blocked by the anesthetic. 
  • If you need general anesthesia, you will be kept unconscious throughout the procedure. 
  • It might take you anywhere from days to weeks to get back to your normal activities. This is true, whether it’s open surgery or laparoscopic repair.

Open hernia surgery-

With open repair, there is a small incision made close to the hernia. The surgeon then looks to find out what has protruded through the muscle wall and then moves it back into the right space. The muscle weakness is fixed with either a piece of mesh sewn in or permanent sutures are made, whichever the surgeon prefers. Then, the incision is closed with absorbable material.

Robotic or Laparoscopic Repair:

This type of repair usually requires general anesthesia for the patient. Then, the surgeon creates several small incisions to various places on your abdomen. Then, a non-toxic gas is used to inflate the areas so that the surgeon can better see your organs. 

Then, the surgeon inserts a laparoscope into one incision followed by other instruments in the other incisions. The laparoscope has a tiny camera that lets the surgeon see inside your abdomen on a screen in the operating room. He uses that image to guide his use of the instruments. As he watches the screen, he can use small surgical instruments to repair the muscle weakness with or without a mesh.

When a patient has surgery with a laparoscope, it often means less pain and less scarring when the surgery is over, and patients can often get back to their normal activities more quickly.

However, the laparoscopic repair of a hernia makes it more likely for a hernia to recur. When the surgeon is highly skilled in the procedure, that risk is reduced.

Using a laparoscope lets the surgeon work without having to use any scar tissue that came from an earlier repair of a hernia, so it may be the better choice for those who have hernias that reoccur after an open surgery has been done as well as for patients who have a bilateral type of hernia.

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