Which is the Best Surgery for Hernia?

Any unusual bulge or lump that is seen around your abdominal area, groins, pelvic area, lower chest, or belly button (umbilicus), which typically disappears on lying down, is known as Hernia. These are usually small, painless swellings that are asymptomatic and grow in size over a period of time. 

Hernias are believed to be caused due to a protrusion of any organ or tissue through a damaged or weakened muscle, disrupting the natural barrier. These most often go unnoticed and do not require treatment. Such hernias can be easily managed at home through lifestyle changes and medications. However, when hernias grow in size and press against the surrounding structures, they cause symptoms like abdominal pain, fever, nausea, vomiting or constipation.

Hernias can sometimes cause complications like strangulation ( a part of the hernia is trapped and deprived of the blood flow) which leads to throbbing pain and another related discomfort. This requires immediate medical treatment through surgical intervention.

Read on to know which surgical approach is best to treat hernias which yields good results with minimal postoperative complications.

When is Surgery Required?

In most cases, if the hernia is small without any significant symptoms then surgery may not be needed immediately. But you should remember that hernias eventually grow in size over a period of time and may cause pain and discomfort, so if not now, surgery will definitely be required in future. Surgery for hernias is required when it grows rapidly in size causing several complications that include:

• Obstruction

• • • This is a condition where a part of the hernia gets trapped. 
    • The symptoms include:
      • Severe abdominal pain
      • Nausea and vomiting
      • Constipation 

• Strangulation

• • If the hernia is not treated surgically, it may cause a life-threatening condition known as strangulation. 
  • This is because the blood flow to the trapped part of the intestine or tissue is cut off.
  • This leads to the following symptoms:
    • Fever, vomiting and nausea
    • Sharp, shooting abdominal pain
    • A lump may grow rapidly and harden over time
    • Constipation, and unable to pass gas
    • Heartburn and acidity
    • Acid reflux
    • Chest pain and shortness of breath

It is best to consult your general physician (GP) if you notice any symptoms for further evaluation and treatment plan.

Hernia Surgery Procedure

Your GP will conduct a thorough physical examination and record a detailed medical history to diagnose hernia. If need be, your GP may advise tests to confirm hernia through X-rays, CT (Computed Tomography) and MRI (Magnetic Resonance Imaging).

Your GP would then refer you to a surgeon who decides which surgery is best for you, depending on the size of herina and type of your hernia, and the severity of your symptoms. 

There are two main surgical approaches for hernia repair namely open mesh surgery and laparoscopic surgery. Open surgery has become an outdated surgical approach for most types of hernia (except for umbilical and femoral hernias) owing to a larger incision (cut) involved, more prominent scarring, and prolonged recovery time.

Currently, laparoscopic surgery is the best choice for surgically treating most types of hernias. This is a minimally invasive (involves less bleeding and trauma) procedure with high success rate and minimal postoperative complications.

How is Laparoscopic Surgery for Hernia Performed?

Laparoscopic surgery is a minimally invasive, outpatient procedure that does not require hospitalization. The steps involved are:

• You will be made to lie down on the operating table and only the area to be operated is exposed. 
• You will be given a general anesthesia (numbing solution which makes you unconscious), and a breathing tube to help you breathe throughout the surgical procedure.
• Your pulse, heart rate and blood pressure (BP) are continuously monitored during the whole procedure.
•  The surgical area will be cleansed with an antiseptic solution to remove any debris or contaminants from the surface that pose a risk of infection.
• Your surgeon will make 2 to 3, half inch or smaller incisions (cuts) around the site of the hernia.
• A laparoscope is inserted through one incision to visualize the hernia defect on a projection monitor. A laparoscope is a long tube-like medical device that consists of a tiny camera at the end and a light source. The images are taken by the laparoscope and projected on the monitor that helps or guides the surgeon’s movements.
• Surgical instruments are inserted through other small incisions.
• The hernia sac is removed from the defect and a prosthetic (artificial) mesh is placed over it to cover the defect.
• The incisions are closed with sutures (stitches) that usually dissolve on their own.
• A waterproof surgical plaster or dressing is placed over the sutured wound.
• You are likely to be kept under observation for 1 to 2 hours before you are allowed to go home, once the anesthesia wears off.
• Ask someone to drive you back home.
• You may experience mild pain and discomfort for the initial 24 to 48 hours which can be managed by pain medications.
• Recovery post laparoscopic surgery takes around 3 to 4 weeks.
• Proper rest, sleep and a healthy diet (high fiber diet) is important for good healing.
• Mild swelling and bruising is normal and can be managed with anti-inflammatory drugs. 
• Avoid hot water baths and swimming for around 4 weeks.
• Avoid any strenuous exercise or activity for at least 4 to 6 weeks.
• Avoid lifting heavy objects as this may lead to wound separation, delayed healing and recurrence.
• Contact your surgeon if you experience
  • High grade fever (> 104 degrees)
  • Chills 
  • Severe throbbing pain at the surgical site
  • Inability to urinate
  • Extreme nausea 
  • Redness or pus draining from the incision

Why is Laparoscopic Surgery the Best Choice to Treat Hernias?

Laparoscopic surgery is the most preferred surgical approach due to the following advantages:

• It causes less bleeding and trauma to the surrounding structures
• It is an outpatient procedure hence you can go home the same day
• Requires small incisions hence there is less scarring
• It is a quick procedure with a high success rate of around 85 to 95%
• Recovery is faster, which takes around 3 to 4 weeks
• There are minimal postoperative complications that can be easily managed.

Takeaway

Hernias cannot be left untreated, since they cause life-threatening complications followed by symptoms that affect your quality of life. It is important to be aware of various symptoms that indicate the presence of hernia, since this helps in early diagnosis and treatment.

If you experience any symptoms related to a hernia, consult our healthcare professionals at Medfin for further evaluation and treatment. We are well equipped in disease diagnosis and treatment planning with the state-of-the-art technology used at our center.

Disclaimer: 

The content on this site is the copyright of Medfin and is intended for informational and educational purposes only. This should not be considered as a substitute for medical and surgical expertise. Results from any treatments or surgeries are subjective to an individual patient and the type of procedure/ surgery performed. Please seek professional help regarding any medical concerns. Medfin will not be responsible for any act or omission arising from the interpretation of the content present on this page.