Hernia Treatment Guide: Know Current Recommendations and Treatment for Hernia from Dr. Arun Prasad

Hernia is a protrusion of the body contents through the weakness in the muscles and tissues. Depending on its cause, a hernia can develop quickly or over a long period of time. Most hernias occur from within the abdominal cavity. Not all hernias require urgent treatment but, if your hernia is growing large or causing pain, then surgery is the best option. According to Dr. Arun Prasad, Sr. Consultant, General, GI and Bariatric Surgery, Apollo Hospitals, New Delhi, there are several surgical procedures available to repair a hernia, but laparoscopic and robotic hernia repair surgeries are getting preference over traditional open surgery. 

What is a Hernia?

Our intestines are situated inside the abdomen in a delicate balloon-like bag and protected by 3 layers of muscles all around them. When these muscles get damaged at some spot, then it becomes a weak spot or a hernia hole from where hernia formation takes place. Bulging out of tummy contents through this causes pain and there is a danger of the intestine getting strangulated. The problem increases with time and unfortunately, the only treatment for this condition is surgery.

There are several types of hernias, including, inguinal hernias, umbilical hernias, femoral hernias, and Hiatal hernias. It is commonly seen in the groin, the upper part of the stomach, belly bottom, and surgical scar. If you have a hernia, it’s important to treat it quickly.

Causes of hernia

Muscles weakness and strain play a main role in developing a hernia. There are several reasons that can lead to a hernia include:

• A congenital condition that presents from birth.
• A family history of hernias.
• Pregnancy.
• Aging.
• Damage from an injury or accident.
• Chronic Constipation.
• Chronic coughing.
• Smoking.
• Being overweight or obese.
• Strenuous exercise or lifting heavy objects.

Treatment options for Hernia

There are mainly 3 options for hernia treatment.

• Supportive care
• Devices
• Surgery

During the current situation, supportive care and devices can help you to ease the pain and symptoms of a hernia, However, this is not the complete solution you have to get the surgery done for the best outcome.

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How are hernias treated?

Hernias are typically repaired using a synthetic or biologic mesh (net). The mesh can be inserted using different surgical techniques, to patch the defect in the abdominal wall. All over the world hernias are repaired with the use of a mesh as this provides a good result with a low recurrence. If a patient does not want mesh being inserted, then hernia can repair with stitches, it is called sutured repair. 

Types of Hernia Surgery

There are three surgical procedures available for hernia treatment. Which surgical procedure is chosen for a patient depends on his/her overall health, lifestyle, and type of hernia. Each type of surgery has its advantages and disadvantages. But the preferred methods are laparoscopic or robotic surgery.

Traditional open surgery

In open surgery an incision usually around 2.5-3 inches is made to the skin near the hernia and the hernia will push back into the abdomen. Most patients who have open hernia repair surgery are able to go home the same day. Recovery time is about 3-6 weeks. People, who are not fit for general anaesthesia due to their medical condition and can not undergo laparoscopic surgery, need open surgery as the last option because it can be done under spinal anaesthesia or local anaesthesia. 

The main problem with open surgery is that it takes more time to recover, there is a higher chance of infection and the chance of the hernia coming back is more.

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Laparoscopic surgery

Laparoscopic hernia repair is rapidly gaining popularity all over the world.In this procedure, 3-4 tiny incisions of ½ inches are made to allow for the insertion of surgical tools to complete the surgery. This way, the already weak muscles were not disturbed and the mesh is placed through these holes. 

Laparoscopic surgery is an efficient technique that compares favourably to current open surgical techniques. Patients are relatively pain-free following this procedure and can return to work and normal activities much quicker than following conventional hernia repairs. And chances of the hernia coming back are almost nil.

The two real problems of the laparoscopic hernia repair are the cost of the operation, due to the expensive imported instruments that are needed; and the necessity for general anaesthesia. However, the increased cost should be compared with the pain associated with a quicker and more productive return to work with the majority of the patients.

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Robotic surgery

Robotic surgery is an advanced version of laparoscopic surgery and is performed in the same manner. But it differs from laparoscopic surgery in that the surgeon handles the surgical instruments from the console in the operating room and the use of robots provides excellent three-dimensional images of the inside of the abdomen. It is generally used for complex hernias. Now it is also being used in abdominal wall reconstruction (AWR).

Postoperative care

Postoperative care is an important part of hernia repair surgery. Proper care after surgery speeds up the recovery process and decreases the risk of the hernia coming back. Your surgeon will let you know when you can return to your normal routine. If, after getting the surgery done, you feel pain around the surgical site or infection such as redness or drainage, contact your doctor promptly.

Open repair surgery often requires a longer recovery time (3-6 weeks) than laparoscopic surgery (1 week). Patients should follow the diet and medication instructions as provided by the doctor. Regular follow-up is important and necessary after a hernia repair procedure.

Conclusion

Science and technology have become advanced and there are many surgical treatments for almost all health issues that cannot be treated otherwise. If you are diagnosed with hernia, you must consult a doctor and talk about possible treatments for your hernia condition. An experienced doctor can suggest the best method that assures positive results. Besides, keep exercising other preventive tips that the doctors give to secure your health.

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