Laparoscopic Epigastric Hernia Surgery in Bangalore, Procedure, Benefits

Overview

You may have heard of hernias quite often but ever wondered what exactly it is. A hernia is a medical condition in which a weakened abdominal wall allows the contents of your abdomen to protrude or bulge out. 

A hernia is not just of one type. Yes, there are several types of hernias, the majority of which occur in the abdomen. One such type of abdominal hernia, called epigastric hernia, is going to be discussed in this article. 

An epigastric hernia occurs when the abdominal contents push through the midline of the epigastrium. This is the area between your sternum (breastbone) and the belly button. An epigastric hernia mainly presents no or minimal symptoms. However, it does not go away on its own, and can only be treated through surgery.

Let’s find out more about epigastric hernia, one of the most popular surgical techniques used to treat laparoscopic epigastric hernia repair. 

What Is An Epigastric Hernia ?

An epigastric hernia is a medical condition in which abdominal contents push through a weak spot in the abdominal wall to form a bulge. An epigastric hernia is called so because it develops in the epigastrium, which is the region below the breastbone and above the navel.  Epigastric hernias are commonly seen in adults as well as in children. An individual may have more than one epigastric hernia at the same time. 

Like other hernias, the exact cause of an epigastric hernia is not known. However, it is believed to be caused by a weakness in the abdominal wall muscles or due to incomplete closure of abdominal tissue during development. Factors such as obesity, pregnancy, persistent coughing, heavy lifting, and involvement in strenuous labor or sports activities may increase the risk of epigastric hernias.

Epigastric hernias are frequently small and asymptomatic and may seem to appear and disappear, in which case they are referred to as reducible hernias. When the hernia shows symptoms, it seems like an abdominal lump that can be seen and felt and may be accompanied by pain and tenderness. Actions such as crying, straining, or defecating can create abdominal pressure and may produce or exacerbate these symptoms.

In symptomatic cases, leaving an epigastric hernia untreated can lead to complications such as strangulation and bowel obstruction. Therefore if you notice any signs or symptoms of an epigastric hernia, it is important to consult a doctor for an expert opinion. Let’s take a detailed look at the treatment modalities. 

How Is An Epigastric Hernia Treated?

Surgery is the only long-term treatment method for an epigastric hernia. Epigastric hernia repair surgery can be performed via the conventional open technique or laparoscopically.

• Open Epigastric Hernia Repair: It is the traditional method for treating a gastric hernia. It is usually done under general anesthesia or local anesthesia with sedation. Your doctor makes one large incision on the skin in the belly region, above the hernia.  The surgeon inserts surgical instruments through the incision. The hernia mass is pushed back into place and the abdominal wall is closed with stitches. To reinforce the closure and lower the probability of the hernia returning,  the surgeon may place a surgical mesh in the abdominal wall.
• Laparoscopic Epigastric Hernia Repair: Laparoscopic surgery has the shortest recovery period, is the least painful, and is minimally invasive. The surgeon makes a few small incisions in the region to access and repair the hernia. Here, a thin scope (laparoscope) with a tiny camera is used to get an internal view of the hernia and the surrounding structures. 

Let’s learn more about laparoscopic epigastric hernia repair.

What is Laparoscopic Epigastric Hernia Surgery?

Laparoscopic epigastric hernia repair is a minimally invasive surgical technique that is used to treat epigastric hernias using a laparoscope. A laparoscope is a thin, long, flexible tube with a camera and light source at one end, which is inserted into a patient’s body to transmit live images of the internal structures onto a monitor.  This helps a surgeon visualize the inside of a patient’s body and focus on the site to be operated on. 

In a laparoscopic epigastric hernia repair, the surgeon makes a few small incisions (keyhole-sized) on either side of the hernia and inserts a laparoscope through one of the incisions. After accessing the epigastric hernia and viewing its details on a monitor, surgical tools are inserted through the other incisions. The herniated tissue is pushed back into place with the tools. The holes in the abdominal wall are closed with sutures and a piece of mesh may be used to close and strengthen the abdominal wall. Finally, the laparoscope and surgical tools are removed and the incisions are closed.

How Does Laparoscopic Epigastric Hernia Surgery Work?

What Happens Before the Surgery? 

• Before going ahead with the laparoscopic epigastric hernia surgery, discuss the procedure with your doctor, including its benefits and risks. Convey your expectations from the procedure and any doubts or questions you may have. 
• Your doctor will discuss your medical history, which includes your symptoms, other present ailments, and current medications or supplements if you are taking any.
• The doctor will conduct a physical examination of the bulge and may suggest diagnostic tests like blood analysis, chest X-ray, and an ECG (electrocardiogram) based on your age and condition.
• You might be asked to stop certain medications, such as blood thinners, for a brief period before and after the procedure in order to avoid complications such as excessive bleeding during the surgery.
• Make sure you inform your doctor about any allergies, such as allergies to latex or any medications.
• If you are a smoker, you will be asked to quit smoking for a certain period before and after the surgery, as it can delay healing. 
• If you are overweight, your doctor may ask you to lose some weight before the surgery to reduce your risk of complications. 
• You may be asked to shower the night before or on the morning of the surgery.
• You may also be given an enema in order to empty your stomach contents before the procedure. 
• Make sure you arrange for a friend or a family member to drive you home on the day of surgery and help during your recovery.
• Your doctor will ask you to fast for at least 8 hours before the surgery.

What Happens During the Surgery? 

• Laparoscopic epigastric hernia repair surgery is an outpatient procedure where you will be sent back home on the same day. 
• Before starting with the procedure, you will be asked to lie back on the operating table, and general anesthesia will be administered.. This will put you to sleep and make the procedure painless.
• Your abdomen and belly button will be cleaned with an antiseptic solution.
• Your doctor will make 2-4 small incisions of a small keyhole size on either side of the hernia. A laparoscope will be inserted through one of the incisions. 
• To provide the surgeon with a clear view, the abdominal cavity may be inflated with carbon dioxide gas. 
• With the help of the images transmitted by the laparoscope on a monitor, the doctor will access and analyze the hernia.
• Specialized surgical tools are inserted through the other incisions. The surgeon uses these tools to isolate the portion of the abdomen that is pushing through the muscle (called the hernia sac). The surgeon returns or pushes back the hernia sac or the protruding tissues to its proper place with the help of surgical instruments and also repairs the weakened portion of the muscle wall with sutures.
• A synthetic mesh may also be placed in the muscle wall to improve strength and prevent the recurrence of the hernia. 
• Finally, the laparoscope and surgical tools are removed from the body. The incisions are closed with the help of sutures and a sterile dressing.

What Happens After the  Surgery? 

• After the surgery, you will be sent to the recovery room, and your vitals such as blood pressure, breathing rate, and heart rate will be closely monitored while you wake up from anesthesia.
• You will be asked to return home once you are stable, which is mostly on the same day.  In cases with a requirement for further monitoring, you will be asked to stay back in the hospital for 1 to 2 additional days.
• Before you go home, the doctor will prescribe medication such as painkillers, provide post-surgery care instructions, and finalize a follow-up appointment schedule. 
• You can expect some soreness during the first 24 to 72 hours and tenderness in the abdomen for at least a week after the surgery. During this time, avoid any activity that increases pressure on the abdomen. 
• Once you are home, get adequate rest and avoid any strenuous activities, such as heavy lifting, for the initial 3 to 4 weeks. 
• Ensure not to wet the surgical site until it heals well, and keep the area clean and dry till the doctor wants you to. Your dressing will be removed when the wound would heal sufficiently, which usually takes 5 to 10 days. At this time, the doctor will clear you for taking a bath or shower.
• Have a healthy, fiber-rich diet and drink plenty of fluids in order to prevent constipation.  Straining to pass a bowel movement can increase pressure on the surgical site.
• Follow all the post-surgical instructions given by your surgeon and attend the follow-up visits as instructed in order to achieve a fast and smooth recovery. 
• A complete recovery and return to normal activities can take around 6 to 8 weeks.

What are the Benefits Associated With Laparoscopic Epigastric Hernia Repair Surgery?

Laparoscopic epigastric hernia repair has the following benefits when compared to traditional surgery:

• Reduced pain and discomfort.
• Faster recovery and return to routine life.
• Smaller incisions that ensure more cosmetically pleasing results.
• Lower recurrence rates compared to an open surgery.
• Possibility of checking for and repairing a second hernia on the opposite side at the time of the surgery.

Are There Any Risks Associated With Laparoscopic Epigastric Hernia Repair Surgery?

Any surgery, no matter how small, comes with the possibility of complications. Laparoscopic epigastric hernia repair comes with the risk of the following complications:

• A general reaction to anesthesia, like nausea and vomiting
• Recurrence of hernia
• Bleeding
• Inflammation and pain at the surgical site
• Wound infection 
• Development of blood clots in the legs (deep vein thrombosis)
• Migration of the clot to the lungs or heart (embolism) 
• Injury to nearby organs, blood vessels, nerves, 
• Inability to pass urine after the surgery
• Blood or serum collection under the wound

Why Choose Medfin?

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