Pictorial............................................................................................................ 8

These glamorous looking ladies ensured the guest were comfortable during the party. Catherine Gitonga (L), Priscilla Tuwei (2nd R) and Rhoda Mwatela (R) of housekeeping had a special gift to Mr Gordon Odundo.

Having opened the first Gertrude’s clinic at the coastal town of Mombasa, a present such as this would be a memorable one especially handed by Mombasa clinic manager, Edwin Barine (R).

With 12 Outpatient clinics and two outreach clinics opened under his tenure, managers of these outlets gave something matching his achievements.

It was meant to be a joyful exit and truly it turned out to be one as Mr Gordon Odundo enjoyed every bit including the dance. The staff union representatives made sure that his support for them did not go unrewarded.

Pictorial

Hernia Repair

A. What is hernia?

A hernia forms when the abdominal wall weakens, bulges, or tears. The inner lining of the abdomen and small intestine can poke out of this weakened area. A hernia repair is a surgery to push the abdominal material back where it belongs and to repair the abdominal wall. At times the stomach may protrude into the chest cavity. This is called hiatus hernia. A hernia around the umbilicus is called umbilical hernia while those around the groin are called inguinal hernias.

B. Why is Hernia repair done?

Hernia repair is done to prevent the hernia from becoming strangulated. A strangulated hernia is one where the hernia is trapped and blood supply to it has been cut off. This leads to the death of the tissue affected.

C. How is it done?

Before the procedure, a detailed physical examination will be done. Blood tests may also be done. Hernia repair is usually done under general anaesthesia. Regional anaesthesia may be used in some instances. An incision is made over the hernia site. The hernia will be moved back into the abdominal cavity. In the case of hiatus hernia, the stomach is moved from the chest cavity back down to the abdominal cavity. For some, the weakened muscles that allowed the hernia to develop are sewn together. At times, if the weakened area is large or in the groin, a piece of mesh will be placed over the area to create a new wall. If a mesh is used, the muscle is not sewn together. The incision will be closed with stitches or staples.

D. Possible complications of hernia repair

Complications may arise from the general anaesthesia or the surgery itself. These may include side effects of the medications or damage to neighbouring organs or structures such as, intestines or bladder and infection and bleeding. Detailed assessment shall be done so as to ensure that one is fit to undergo hernia repair surgery to minimize the risk of complications occurring. Written consent is required to authorize the surgery after understanding the need, benefits and risks of the procedure.