Laparoscopic Hernia Surgery

What is Hernia?

Occurs when contents of a body cavity bulge out of the area where they are normally contained. It is a term to denote bulges in other areas, but usually describes hernias of the lower torso (abdominal wall hernias).

What are the symptoms of hernia?

It is usually asymptomatic and presents as a painless, slowly growing bulge. If blood supply of hernia sac contents is cut off – a medical and surgical emergency!

What are the various places where a hernia is found?

Why does hernia happen in some and not in others?

Hernia develops when there are certain congenital factors present or else when either the abdominal wall is weak or if there in increased pressure in the abdominal cavity.

a) Congenital

• Persistence of processus vaginalis
• Patent canal of Nuck
• Incomplete obliteration of umbilicus

b) Acquired

• Fat
• Pregnancy
• Incision
• Infection
• Connective tissue – smoking, aging, CTD, systemic illness

Increased abdominal pressure

• Chronic constipation
• Chronic cough
• Bladder outlet obstruction – stricture, prostate
• Straining – weight lifting
• Intra-abdominal malignancy
• Vomiting
• Repeated pregnancy

Do ladies have a hernia too?

Yes, in the ratio of 10 males to 1 female.

Do all hernias require surgery?

There is no medical cure for hernia. Whereas some hernia surgeries can be postponed to a convenient time, they should not be avoided.

Why do we need to operate if there is no pain?

Hernia surgery is seldom done for pain relief. The main reason for operating on a hernia is fear of complications viz. irreducibility, obstruction and strangulation (cut off of blood supply of contents)

Is hernia surgery an emergency surgery?

It better not be. Hernia surgery is neither an elective surgery (Ex cataract, joint replacement) nor an emergency surgery (ex stab injury, head injury). It is a priority surgery.

Is it an open surgery or a laparoscopic surgery?

Although we would like to offer laparoscopic surgery to as many patients as possible (>95%), open surgery may have to be advocated in select scenarios.

The biggest advantage remains that a thorough survey of the visible parts of the abdominal cavity can be made to rule out other concomitant or mimicking pathologies and treat them simultaneously.

Other advantages include:

• Minimal post-surgical pain.
• Reduced risk of post-surgical infection.
• Shorter hospital stay.
• Early return to work.
• Better cosmetic outcome

Will I be in pain after surgery?

Not really. Principally, it is not a very painful surgery; moreover, painkillers do their job really well.

How early can I go home after surgery?

As early as 24 to 36 hours.

When can I have bath after surgery?

Almost invariably, all your dressings are waterproof permitting you to bathe the very next day.

Will there be tubes put into me?

More often than not, stomach tube or urinary catheter are not put, unless it's a very tough scenario. Very occasionally, tube drains are put inside the abdomen in difficult cases as a safety measure.

Would there be sutures that require a painful removal?

Firstly, suture or staple removal is a totally pain-free procedure. More often, surgical glue will be used to approximate skin wherein removal isn't essential.

How many times do I have to come for follow up after I get discharged?

Usually only once, around the 8th day for a wound check.