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Hernia Surgery
A hernia occurs when an organ pushes through a weakness in the muscle wall or tissue that holds it in place. This results in a bulge on the skin which is often quite visible. A surgery is needed to treat the hernia as the organ may press against the muscle wall and loose blood supply and get strangulated.
A hernia can be of different types such as:
Hernia may present with the following symptoms:
- A bulge at the location of the hernia
- A sharp pain or aching sensation
- Noticeable bulge while bending, standing, coughing etc.
- Nausea and vomiting sensation due to bowel obstruction
- Acid reflux chest pain and burning sensation
- Pain in the groin area
The diagnostic procedure for a hernia depends upon the type of hernia a person has.
The following diagnostic procedures are instrumental in confirming the presence of a hernia:
- A physical exam may be sufficient to confirm an inguinal and incisional hernia as they present with an evident bulge which a doctor can easily examine when a patient tries to stand or strain.
- Umbilical hernias can be diagnosed with the help of an ultrasound or physical examination.
- A barium X-ray or chest X-ray can help in confirming the presence of a hiatal hernia.
- An endoscopy may be needed if there is a risk of complications.
- CT scans and X-rays also help in the diagnostic procedure.
There are two types of surgeries that can be performed to treat hernia:
-
Herniorrhaphy or hernioplasty- it is also known as open hernia repair surgery. In this procedure, a single long incision is made at the groin and the hernia is pushed back into place. The edges of the muscle from where the hernia bulges out are repaired by either stitching them together, or with the use of a synthetic mesh, which reduces pressure on the muscle wall.
- Laparoscopic surgery- in this procedure, a small incision is made below the navel, through which a laparoscope is inserted. Other smaller incisions are used to insert the instruments used to treat the hernia. It is then covered and fixed with a synthetic mesh.
The risks involved in a surgery for the treatment of Hernia are:
- Risk of infection
- Seromas (fluid build-up) or hematomas (blood build-up)
- Damage to the femoral artery
- Excessive bleeding at the site of incision
- Risk of injury to other organs and nerves
- Damage to the spermatic cord
- Formation of adhesions on the body
Patients can go home the same day after surgery in most cases. The recovery time is between 3-4 weeks for open surgery and lesser for laparoscopic surgery as the incision is smaller and lesser tissue is damaged. The risk of the hernia reoccurring is very low post an open surgery as opposed to laparoscopic which is a little higher. The patient should take complete rest and not indulge in any strenuous physical activity. In case of a bleed from the surgery site or any other complications, the doctor should be contacted immediately.
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Hernia Surgery
A hernia occurs when an organ pushes through a weakness in the muscle wall or tissue that holds it in place. This results in a bulge on the skin which is often quite visible. A surgery is needed to treat the hernia as the organ may press against the muscle wall and loose blood supply and get strangulated.
A hernia can be of different types such as:
- Inguinal hernia- these are the most common type of hernias and they occur when a tissue protrudes through the groin muscle
- Hiatal hernia- this occurs when the stomach pushes through the diaphragm muscle in the chest
- Incisional hernia- occurs post an abdominal surgery as a result of the scar or the surrounding weakened tissue opening up
- Umbilical hernia- this occurs in newborns and babies under six months of age. It causes a bulge in the belly button and usually goes away on its own without surgery
Symptoms
Hernia may present with the following symptoms:
- A bulge at the location of the hernia
- A sharp pain or aching sensation
- Noticeable bulge while bending, standing, coughing etc.
- Nausea and vomiting sensation due to bowel obstruction
- Acid reflux chest pain and burning sensation
- Pain in the groin area
Diagnosis
The diagnostic procedure for a hernia depends upon the type of hernia a person has.
The following diagnostic procedures are instrumental in confirming the presence of a hernia:
- A physical exam may be sufficient to confirm an inguinal and incisional hernia as they present with an evident bulge which a doctor can easily examine when a patient tries to stand or strain.
- Umbilical hernias can be diagnosed with the help of an ultrasound or physical examination.
- A barium X-ray or chest X-ray can help in confirming the presence of a hiatal hernia.
- An endoscopy may be needed if there is a risk of complications.
- CT scans and X-rays also help in the diagnostic procedure.
Treatment
There are two types of surgeries that can be performed to treat hernia:
-
Herniorrhaphy or hernioplasty- it is also known as open hernia repair surgery. In this procedure, a single long incision is made at the groin and the hernia is pushed back into place. The edges of the muscle from where the hernia bulges out are repaired by either stitching them together, or with the use of a synthetic mesh, which reduces pressure on the muscle wall.
- Laparoscopic surgery- in this procedure, a small incision is made below the navel, through which a laparoscope is inserted. Other smaller incisions are used to insert the instruments used to treat the hernia. It is then covered and fixed with a synthetic mesh.
Risks
The risks involved in a surgery for the treatment of Hernia are:
- Risk of infection
- Seromas (fluid build-up) or hematomas (blood build-up)
- Damage to the femoral artery
- Excessive bleeding at the site of incision
- Risk of injury to other organs and nerves
- Damage to the spermatic cord
- Formation of adhesions on the body
After Procedure
Patients can go home the same day after surgery in most cases. The recovery time is between 3-4 weeks for open surgery and lesser for laparoscopic surgery as the incision is smaller and lesser tissue is damaged. The risk of the hernia reoccurring is very low post an open surgery as opposed to laparoscopic which is a little higher. The patient should take complete rest and not indulge in any strenuous physical activity. In case of a bleed from the surgery site or any other complications, the doctor should be contacted immediately.
FAQ Section
Hernia Surgery is surgery undertaken to push back hernia of any type. It involves repairing the hernia to relieve the patient of the pain and help them get back to their maximum physical level.
It typically involves making an incision to repair a hernia and using a mesh to strengthen the abdominal wall while it heals.
You have to undergo hernia surgery because there is no other way to cure a hernia. If nothing is done, the hernia might grow and become more painful. It can put pressure on the nearby tissues and cause swelling and pain. A portion of your intestine might get trapped in the abdominal wall and obstruct the bowel movement along with considerable pain. If the blood flow gets blocked, the intestinal tissues might get strangulated, get infected and die. This will lead to nausea, vomiting, and fever. In some cases, these might even become life-threatening.
Risks factors of a hernia surgery include –
- Difficulty in urinating
- Fluid and subsequent pain in the abdomen
- Bleeding or some other drainage from the incisions
- Difficulty in breathing
- Allergic reaction to anesthesia and medications used during and after the surgery
- Infection at the site of surgery
- Abdominal pain or pain in the groin
- Injury to the bladder by the mesh
The body might reject the mesh which is used in the surgery whose symptoms are as follows
- Bloating at the site
- A lump in and around the area of the surgery
- Fever
- Nausea
- Vomiting
These risk factors can be avoided if the surgery is done properly by a qualified surgeon using proper equipment and taking care so as not to strain yourself for at least six weeks. If you see any symptoms, contact your doctor immediately. Hernia recurrence can be minimized by not putting any strain on the operated area.
Hernia surgery is 100% effective if a good quality mesh is used in the operation and proper care is taken to not put too much pressure on the affected area.
Hernia surgery is usually conducted as soon as possible from the time the hernia is diagnosed.
Delay in conducting the surgery may increase the risk of serious infection.
No, a hernia cannot be healed without surgery. No external processes will help neither will it heal on its own.
The analysis before the surgery would include the following.
- Physical Examination
- Total Erythrocyte Count, to rule Anemia and Hypoxia
- Urinalysis testing
- Coagulation testing, to determine whether any clotting factor is absent or not.
- Metabolic analysis of your organs
- Electrolyte status
- ECG/EKG to check the status of your heart
- An imaging test (Ultrasound, CT scan or MRI) to know the correct placement of a hernia.
Hernia surgery can be of two types.
- Open surgery – You will be administered local or general anaesthetic and an incision will be made on your skin near your hernia. The incision will be around 2.5-3 inches in length. Your surgeon will then push your hernia back into your abdomen. The incision is then stitched closed. Generally, a mesh is placed over the hole and fixed using fine stitches. Your own tissue will grow through the mesh to strengthen the weakened area without putting tension on the surrounding tissues.
- Laparoscopic surgery – You will be administered general anaesthesia. The surgeon will make a number of minute incisions. He/she will then use specialized equipment including a small camera view the inside of the abdominal wall and aid in repairing the hernia. A mesh may then be placed to reinforce the abdominal wall and help prevent reoccurrences.
The surgery will last around one hour. Most of this time is taken in preparing the patient for the surgery.
In both open and laparoscopic surgery, a mesh made of synthetic material or animal skin is used to provide support to the abdominal wall. The synthetic mesh is a permanent implant while the mesh derived from animal skin will dissolve over time.
The procedure is invasive and will cause some degree of pain after the surgery when the anaesthesia wears off. However, the pain will subside over a few days and recovery will often be uneventful and smooth.
Recovery time heavily depends both on the type of a hernia and the type of surgery performed. Laparoscopic surgery patients take less time than open surgery patients to recover. Generally, you should be able to do light activities like walking by four days. After 1-2 weeks, you can continue normal work. However, lifting heavy objects or activities which put considerable strain on your abdomen should be avoided. You will be at 100% of your capacity by 5-6 weeks post which you can resume your usual activities.
Normal activities can be resumed within 4 days but heavy lifting or strenuous activities should be avoided. On the same day as the surgery,you should be able to walk. If you were under anaesthesia during the operation, refrain from doing complex activities like driving, operating machines, etc until 48 hours.
The cost of hernia surgery in India varies across different hospitals and cities-
| CITY | COST |
| Cost of Hernia Surgery in Mumbai | INR 150000- INR 350000 |
| Cost of Hernia Surgery in Banglore | INR 130000- INR 330000 |
| Cost of Hernia Surgery in Delhi | INR 130000- INR 330000 |
| Cost of Hernia Surgery in Chennai | INR 110000- INR 310000 |
Yes, people from countries with scarce medical facilities do come to India to undergo surgery. Also, since surgeries tend to cost lesser in India as compared to developed countries, some people from these countries might also come for surgery.
While choosing a hospital for the surgery, any hospital with proper infrastructure for surgeries and qualified surgeons will do. Make sure that the components used (mesh) is of high quality. Most surgeons will be able to perform a hernia surgery but make sure that the surgeon is properly qualified and has a good track record.