Hernia is a health condition characterised by abnormal protrusion of a part or whole of an organ into the muscular or fascial covering which protects or envelopes that particular organ.
Hernia of the intestines is most common and characterized by protrusion of intestines into the abdominal wall. There are several types of hernia of the intestines but usually, the term ‘Hernia’ when used without any specification denotes inguinal hernia.
What is Hernia Surgery?
Surgery is one of the most effective mainstream treatment methods employed to treat hernia. In case of inguinal hernia, a portion of the lower intestines protrudes through the abdominal wall which is structurally weak in the pelvic region. The intestines try to protrude externally through the inguinal canal which corresponds to the groin.
Hernia surgery involves re-positioning protruded intestines to their former state and repairing the abdominal wall defect to prevent further incidents of herniation. Surgical repair of hernia can be performed by open method or laparoscopic method.
Preparing For Hernia Surgery
Hernia surgery is usually performed after a few days of planning, unless it is an emergency. During this time period, following preparations for the surgery are done:
Patient has to undergo blood tests to rule out presence of active or remnant infection and to determine blood sugar levels. Any surgery can be performed only in complete absence of infection and when blood sugar levels are normal. Apart from this, blood tests may be requried to assess functions of liver and kidney.
A thorough physical examination pertaining to hernia is essential before surgery. During examination doctor gets an accurate idea about the location and extent of herniation. Other associated findings like swelling or tenderness of hernia indicates severity of the diagnosis. Ring occlusion test and cough reflex test are the confirmatory tests for diagnosing hernia.
Parameters like blood pressure, breathing rate, heart rate are also monitored during physical examination.
Patients suffering from hernia will often complain of pain in their groin which is dragging in nature. However, if diagnosis cannot be confirmed based on examination findings alone, sonography (USG) can be peformed to assist with diagnosis.
Doctor makes a note of any medication patients might be taking for hernia or other health conditions. Dose of these medicines may be altered for they might be stopped completely for some time till after surgery.
Hernia Surgery Procedure
The two methods used in performing hernia surgery are as follows:
A surgical incision is made in the groin of the affected side to access herniated portion of intestines. Hernia is located and manually pushed through the inguinal canal, back to its former position. The herniated portion of intestines is secured and tied to prevent recurrence of the condition. If there is necrosis of the hernia due to lack of blood supply, the necrosed portion is removed surgically. Healthy ends of intestine are connected surgically in order to maintain integrity of digestive tract.
In case of large hernias, the defect in abdominal wall through which herniation occured is secured with a mesh.
Laparoscopic surgery employs steps similar to those involved in open surgery. The main difference between open and laparoscopic surgery is the extent of surgical incision. While a single long incision is made during open surgery, laparoscopic surgery requires multiple small incisions to be made along the groin.
Through one of these incisions a flexible fibroptic deive known as laparoscope is inserted into the groin. This device helps in magnifying and visualizing exact location of the hernia and thus helps during surgery.
Remaining steps of laparoscopic surgery match those done during open surgery.
After herniated portion of intestine has been repositioned or removed, surgeon will carefully align to their original position any muscles which required to be moved during surgery. Skin incision is closed using a medically designed needle and thread.
Precautions To Be After Hernia Surgery
Completion of surgery is not the end of treatment for inguinal hernia. It is equally important to follow certain medical precautions after surgery, to facilitate complete recovery. Some of these precautions are mentioned below:
Patients are prescribed anti-inflammatory medicines, analgesics and anti-biotics after surgery. This helps in preventing swelling, pain and infection which are likely to develop after surgery. These medicines must be taken as prescribed in order to recovery from surgery without any complications.
There are strict restrictions on patients’ physical activity for a fwe weeks after surgery. Squatting, lifting heavy weights, bending forward excessively are strictly prohibited as these could cause recurrence of hernia. Patients are advised against performing any activity which will put undue strain on the muscles of upper and lower abdomen.
Dietary restrictions after surgery help to maintain a healthy digestive tract and ensure smooth bowel movements. It is important for patients to include good amount of fibers in their daily diet. Unhealthy junk food, food which is difficult to digest, caffeine are some of the food items which are strictly not allowed for a few weeks after hernia surgery.
The goal of a simple diet is to avoid constipation. Constipation requires patients to strain their lower abdominal muscles in an effort to pass stool. This will in turn put a strain on the operated intestines and could lead to health complications.
Patients are advised to visit their doctor for regular follow up sessions after surgery. This helps in monitoring whether recovery is in the positive direction. Follow ups also ensure that any health complication occuring due to surgery is diagnosed and treated at the earliest.
Hernia surgery is a more or less permanent treatment for inguinal hernia. If patients follow pre-operative and post-operative measures carefully, they are bound to have an easy and early recovery after surgery.