Things To Know About Risk And Recovery Of Hernias by Dr. Manjunath Haridas

ThingsToKnowAboutRiskAndRecoveryAbout Hernias

Accordingtothelateststatistics,around25percentofmalesand2percent offemalesdevelopinguinalhernia(consideredtobethemostcommonof allhernias)acrosstheglobe.Therearetwotypesofinguinalhernia,-direct inguinalherniaandindirectinguinalhernia.Indirectinguinalherniaisthe mostcommoninbothmenandwomen.

IntheUnitedKingdom,around100,000inguinalherniasarerepairedevery year;whileintheUnitedStates,it’saround750,000.InIndia,theestimated annualincidenceofinguinalherniarepairis1,957,850.

Herniaingeneral,formsinapersonwhenthereisaholeorweaknessinthe peritoneum(muscularwall)Peritoneumisanimportantpartofthehuman bodywhichplaysapivotalrole.Itkeepstheorgansintheabdominalregion inplace.Now,whentheorgansortissuesarenudgedaside,theyforma bulge,resultingintheorgansortissuesgettingherniated.Herniasmostly occurintheabdomenorupperthighsorgroinregion.Althoughtheyarenot

life-threatening,surgerytorectifytheherniaisrecommendedsoasto preventdangerouscomplicationsfromgerminatinglater.

Thatsaid,herniaisapainfulcondition,especiallywhenaninternalorgan bulgesoutfromaweakenedareainthemusclesarounditItneeds immediatemedicalattention.Thisiswhere;thebestsurgeonin BangaloreatMHSurgerywillhelptorectifyandfixtheproblem.

RISKSOFHERNIAS

Generallyinmanypeople’scases,aherniamaybepresentrightfrombirth. ItistermedasacongenitaldisorderlikecongenitaldiaphragmaticHernia; ORcoulddevelopwhenyoungasachildwithaweakabdominalwall.

Inothercases,theriskofherniaincreasesdueto

1.Increaseinage,thatis,aspeoplegrowolder.Herein,theriskof herniaismoreprevalentinmenthanwomen.

2Complicationsresultingfromabdominalsurgery.Thiswillleadto incisionherniaActivitieslikeliftingheavyitems,physicalexertion, andsmoking;andmedicalissueslikestrainingonthetoiletorto urinate;persistentcough;cysticfibrosis;obesity;abdominalfluid; enlargedprostrate;un-descendedtesticles;andpoornutrition,are primarilyresponsibleforcausingabdominalwallissues.

RISKFACTORSINVARIOUSHERNIAS INCISIONALHERNIA

Itoccursmostlyinwomen.Theherniadevelopswhenthewomenhernia patientinvolvesherselfinstrenuousactivities;orgainsexcessweight;or becomespregnant;afterthreetosixmonthsoftheherniasurgery.Allof theseputalotofpressureonthehealingtissue.

UMBILICALHERNIA

Itoccursinbabieswhoarebornprematurelyorbornwithalowbirthweight; adultswhohaveexcessweight;andwomenwhoareinvolvedinmultiple pregnancies

HIATALHERNIA

Itoccursinindividualswhoareagedoverfiftyyears;andalsopeoplewho sufferfromexcessweight.

ALLABOUTINGUINALHERNIA

InguinalherniaisalsocalledasGroinHernia.Theword‘Inguinal’means ‘Inthegroin’.

Termedasthemostcommonofallhernias,aninguinalherniaoccursina passagewayofthegroincalledinguinalcanal(runsdowneithersideofthe pelvisintothesexorgans).

Thiscanoccurdueto

1Tissuefromonebodycavityforcingitswaythroughanopeningin themusclewallintoanotherbodycavity;or

2Bellyfatoraloopofintestines,bulgingthroughanopeninginthe lowerabdominalwall,thatis,thewallthatseparatestheabdomen fromthegroin.

INWHOMITOCCURS?

Itoccursinolderadults,especiallymalesandthosewithhereditaryissues; peoplewhotendtosmokealot;andpeoplewhosufferfromchronic constipationAdditionally,italsohappensinwomenwhosufferfrom pregnancyissues;andbabieswithlowbirthweight,orbornprematurely.

TYPESOFINGUINALHERNIA

Therearetwotypesofinguinalhernia.Theyinclude:

DIRECTINGUINALHERNIA:Thistypeofinguinalherniajutsor penetratesthroughtheinguinalcanal’swalldirectly.Thecauseof thisherniaisacombinationofweakenedabdominalmusclesandchronic pressureonthemusclewall,inadults.

INDIRECTINGUINALHERNIA:Thistypeofinguinalherniaentersthe inguinalcanalthroughthetop.Itresultsfromabirthdefectinaperson. Therearesomefetuseswheretheopeningtotheinguinalcanaldoesnot closenormallyallthewayduringthedevelopmentoftheuterus

PATHOPHYSIOLOGYOFINGUINAL HERNIA

Thepathopysiologyofinguinalhernialiesinweaknessoropeninginthe lowerabdominalwall.Thisallowstheabdominaltissuetopushthroughthe weakenedabdominalwall

Thecauseofthisissueismultiplefactorslike

1.Weakeningofmusclesasonegrowsold.Themuscleswillgiveout fasterasonegetsolderduetochangesinthecellulargrowthprocess broughtonbyfreeradicals.

2.InflammatorymusclediseaselikeMyositiscausedbyabacteriaor virusorparasite.Duetothis,themusclefibersaccumulatemultiple proteinstherebycreatingweaknessandpaintothemuscles.

3.Muscledeficiencywithglycogenstorage.Thiscausesthemuscleto weakenandinjureeasily.Itisadisorderthatisgenerallygenetically inherited.

Asidefromthis,theinguinalherniaalsoindicatesmultiplefactorslike

1.Openingorweakspotalreadypresentatbirthoftheperson;OR presentduetoearlierabdominalsurgery.

2Stressorincreaseduseoftheabdominalmuscles

3MusculardamageThisinvolvesmultipleproblemsinthecellsofthe muscleleadingtodamages

4Congenitaldisorderinthestrengthoftheconnectivetissuecalledas collagen

5Chroniccoughingorsneezing;orstrainingtopooporpee.

6Multiplepregnanciesinthecaseofwomen,andcarryingsmall children.

7.Jobtasksthatnecessitatecontinualstandingforhoursatatime.

8.Intrabdominalpressureresultingfromchronicobesity.

9.Frequentboutsofstrenuousexerciseormanuallabor.

10.Normalage-relatedtissuedegeneration.

AnothersignificanceofInguinalherniaisthattheinguinalherniacouldbe largeenoughtoblockarterialbloodflowtotheareaoftheherniasacThis aspectiscalledassstrangulation,alife-threateningissuethatshouldbe treatedsurgicallyrightaway

SYMPTOMSOFINGUINALHERNIA

Notalltypesofinguinalherniashavesymptoms.Therearetimeswhenthe symptomscomeandthendisappearlikeinthecaseofchildrenwhenthey sleep.Likewise,onotheroccasionstheherniamaygetinandoutofthe opening;ormaybefeltduringcertainkindofactivities;inchildrenitcanbe detectedfromalumpontheirgrointhatwillappearbiggerwhentheycry Onsomeotheroccasions,itmaynotbefeltevenwhenthespecificareaof thebodyistouchedThatisbecausetheinguinalherniamaybetucked behindmusclefibers

HOWITCANBEDETECTED?

Itcanbedetectedbyabulgeoneithersideofthepelvicbonethat’scaused byabdominaltissuepushingthroughanopeninginthelowerabdominal wall.Theopeninginthelowerabdominalwallcanbecongenital,thatis, presentatbirth;orduetonormal,age-relateddegenerationofthemuscle.

Asidefromthis,itcanalsobedetectedby

1.Pressureorheavinessfeltonthegroin.

2Painfeltinthegroin,especiallywhenonestrainsorliftsorcoughsor bendsover

3Burningortinglingsensationradiatingthroughthepelvisordownthe leg

HOWTOPREVENTITFROM OCCURING?

Inguinalherniacanbepreventedbyreducingtherisksofthecausesor symptomsofinguinalhernia

1.Avoidingtheliftingofheavyobjects.Orresistingtheurgetolift heavyobjects.

2.Avoidingputtingonexcessweightandinsteadmaintainingahealthy andproperweight.

3.Stoppingthehabitofsmokingorresistingtheurgetosmoke.

4.Eatinglotsoffiber-richfood.

Asidefromthis,itisalsoimportanttotakepropercareaftersurgeryto repairapreviousinguinalhernia.ELSE,thereliesahighchanceof contractingaherniaagaininthefuture.

OPENINGUINALHERNIAREPAIR

Inanopeninguinalherniarepairsurgery,thesurgeonwillcreateanincision intheabdomen.Thenpushestheherniabackintotheabdomen;andlater repairtheholethatallowedtheherniatopushthroughtheabdominalwall.

Anopeninguinalherniarepairsurgeryprocessbythesurgeongoesas follows:

1.Administrationofgeneralanesthesiaincaseofbigsizehernia;or localanesthesiaincaseofsmallsizehernia.Inthecaseofbigsize hernia,patientwillbekeptasleepduringthesurgery;thiswillhelpto preventexperiencingofanypainthatcanoccurduringthesurgery ONtheotherhand,inthecaseofsmallsizehernia,thepatientwillbe awakeduringthesurgeryprocedure,butatthesametimewillreceive medicationstonumbthepain,ifanyfeltduringthesurgery;andstay relaxed.

2Incisionismadethroughtheaffectedspottocreateahole.Thiswill helptolocatetheherniaandseparateitfromthesurroundingtissues.

3.Herniatedtissueispushedbackintoplaceintheabdomen.

4.Stitchesaredonetoclose-upthetear;orstrengthentheweak abdominalmuscles.Inthecaseofweakabdominaltissues,surgeon mayattachmeshtostrengthenit.Thiswillhelptoreducetheriskof anotherherniahappeningagain.

RISKSOFOPENINGUINALHERNIA REPAIR

Therisksofopeninguinalherniarepairincludeallergicreactionsto anesthesiaandothermedications;bleeding;breathingissues;andinfection. Asidefromthese,otherrisksincludeprolongedpainatthesiteofthehernia; damagetobloodvessels(inthecaseofmen,theirtesticlescangetharmed whereconnectingbloodvesselsaredamaged);damagetonervesornearby organs;orchancesofherniacomingback.

RECOVERYFROMOPENINGUINAL HERNIAREPAIR

Generally,recoveryfrominguinalherniadependsonthetypeofprocedure undertaken;andthesizeandseverityoftheherniaoftheaffectedperson. Overall,therecoveryfromsurgeryvariesfrompersontoperson.

Inmostpeople’scases,itcouldtakeuptosixweeksforacompleterecovery.

Afterrecovery,thepatientcanfeelacertainamountofdiscomfortorpain forsomedaysafterthesurgery.Also,thepatientcanfeelnumbnessorpain aroundthegroinarea,ifthesurgeonhaddamagedanerveduringtheopen inguinalherniarepair.Asidefromthese,thepatientshouldalsowatchout forsymptomslikedrainage,heat,redness,swelling,orworseningpain aroundtheareaofincision.

Overall,oneintenpeoplewillcontinuetoexperiencepersistentpainafter openinguinalherniarepair.Toalleviatethem,thesurgeonmayrecommend painreliefdrugsormedication.Thiswillhelptoblocktheaffectednerve. Therearetimes,ifallofthesefail,furthersurgerymayberequired.

Tostaysafe,thepatientmusttalktothesurgeonaboutwhatneedstobe donetomanagethepainAdditionally,thepatientmustalsolookforoutany unwantedchangesthatmightindicatethataninfectionisoccurring.

Comingtogettingbacktoworkafterrecoveryprocess,itdependsoneach person’scase.Incase,theperson’sjobdoesnotinvolvetaskslikelifting andsuchlikes,thenhe/shecanreturnafteronetotwoweeks.Thesurgeon willgivenecessaryprecautionarytipslikeavoidingheavyliftingand physicalactivitiesforafewweeks.

MANAGEMENTOFINGUINAL HERNIA

Themanagementofinguinalherniavariesfrompersontoperson.

Urgentsurgicalinterventionintheformofopeninguinalherniarepairor laparoscopicrepairwillberequiredinthefollowingcases.

1PeoplewhoexperiencestrangulationEveryyear,about2percent chancesofrisksofstrangulation(likepainoutofproportionto clinicalfeatures;orderangedbiochemicalresults)withaninguinal hernia.

2Peoplewhosufferfromasymptomaticinguinalhernia(thatis,from significantmassorfeelingofdiscomfort).

Aroundathirdofpatientswithaninguinalhernianeverexperienceanykind ofsymptoms.However,theyneedtokeepintouchwiththeirsurgeon regardingchancesofsymptomsofpotentialstrangulation,andfuture surgicalintervention

Surgicalinterventionisundertakenonlyafterevaluationofthepatient’s health,fitness,andsurgicalpreference.

Likewise,alaparoscopicsurgeryisrecommendedforthosewithbilateralor recurrentinguinalhernias;andincertaincases,thosepatientswithaprimary unilateralhernia,especiallythosewithahighriskofchronicpain;or femaleswhosufferfromanincreasedriskofthepresenceoffemoralhernia.

CONCLUSION

ConsultthebestsurgeoninBangaloreatMHSurgeryforinguinalherniaon whatneedstobedonetorectifyit.

Basedontheseverityofyouringuinalhernia,thebestsurgeonin BangaloreatMHSurgerycouldrecommendtwotypesofherniasurgeries–openinguinalherniarepairorlaparoscopic.

MHSurgeryhassomeofthebestsurgeonsinBangaloreandIndiawho possesshighexpertiseandskillsintreatinghernias

BookanappointmenttodaywiththeDr.ManjunathHaridastoknowmore aboutyouringuinalherniaandwhatcanbedonetogetridofit.