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Advances In Hernia Repair Treatment

 

By Sharmili Das:

Hernia is the protrusion of an organ or the fascia of an organ through the wall of the cavity that normally contains it. This can cause a noticeable bulge under skin and the pressure of the tissue pushing its way through the weakened area can be a source of significant pain and discomfort. To make life easier, along with traditional surgical methods of treatment, laparoscopy is a new method of treatment. It actually holds the patch in place and thus helps seal the hole/incision made during surgery.

Hernia can develop in anyone though they are more common in men than women. In most cases hernias are the result of a defect or weakness in the abdominal wall present at the time of birth. The risk factors include a number of things that can put additional strain on the abdominal wall, such as: a chronic cough, obesity, straining during bowel movements, during urinating, pregnancy, lifting heavy objects, persistent sneezing caused by allergies.

All hernias are not similar. They are categorized by their location in the abdominal wall. The different kinds of hernia are Inguinal hernia, Epigastric hernia, Ventral hernia and Umbilical hernia. There are different treatments available for different hernia. While a hernia may seem not very serious it is important to see a doctor because it will not mend on its own and if left untreated can develop severe even life-threatening complications. Hernia repair is one of the most common surgical procedures done in the U.S and as with any surgery, there are risks involved with the operation. But new procedures and devices have been developed that can limit them and also minimize discomfort.

There are several hernia repair techniques in use by surgeons today. The two main categories of hernia repair are: the tension repair and the tension-free repair. For tension repair the surgeon makes a incision in the abdomen over the hernia site, pushes any protruding tissue back into correct position within the abdominal cavity and then stitches back the skin. There are several techniques for accomplishing tension-free repairs. They are Flat Mesh Repair, Plug and Patch Repair, Kugel Patch Repair and Laparoscopic Repair.

In Flat Mesh repair, after making an incision, the surgeon uses a patch made out of flat (polypropylene) mesh and stitches it over the tissue surrounding the hernia. For Plug and Patch repair, the surgeon inserts a plug and the results achieved are similar with that of flat mesh repair. For Kugel Patch repair, the Kugel patch (piece of mesh) is placed. It is surrounded by a firm outer ring that helps stabilize the patch over herniated area. For Laparoscopic repair, the surgeon inserts a laparoscope, a thin instrument with magnifying lenses through a small incision in the abdomen.

This helps to examine hernia and accurately place a mesh patch on the inside of the abdominal wall, not outside as with traditional mesh repair. Laparoscopy has made possible an advance called “posterior hernia repair”. The advantage of posterior repair is that pressure from within the abdominal cavity actually helps to holds the mesh in place. Laparoscopy must be performed under general anesthesia and is the most costly surgical method available. It sometimes requires an overnight stay in the hospital but is the most effective method. Traditional surgical methods cost around Rs.20,000. Though this method costs around Rs 1 lakh it is the safest one.

In general, the surgery will not take much time and in most cases, one can return home the same day as the surgery. Doctors often advise pain medication. Complications occur in less than one percent of all patients who undergo hernia repair. One may return to normal activity as soon as one feel able to do so. Moderate exercise usually helps to improve one’s circulation and therefore the healing process to a fast recovery.

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