Dr Venkata Mukunda

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Hernia Treatment

Hernia Treatment

What is Hernia?

Hernia is a Protrusion or bulge noted commonly over abdomen or groin due to an organ or fatty thing pushing out through a defect in the surrounding muscle or connective tissue. 

What are common type of hernia?

  • Groin hernia: types are Inguinal hernia, Femoral hernia
  • Ventral hernia:
  1. Umblical: hernia arising from navel region
  2. Incisional: from surgical scar tissue
  3. Epigastric: from midway between navel and sternum
  1. Hiatus Hernia: stomach and esophagus moving upwards through defect in diaphragm 

A combination of excessive and repeated abdominal pressure and weakness in the muscles of stomach or connective tissue leads on to the formation of hernia.

Common causes include:

  1. Chronic cough, asthma 
  2. Chronic constipation 
  3. Lifting heavy things repeatedly
  4. Inherent Weakness of abdominal wall layers
  5. Chronic straining on urination
  6. Post surgery: larger the cut higher the chances of poor wound healing in postoperative period, wound infection 
  7. Connective tissue diorders, fluid in abdomen 
  1. A bulge over groin or abdomen which disappears usually on lying down and prominent on exertio
  2. Dragging sensation / heaviness noted
  3. Pain when it get stuck
  4. Vomitting, fever, inability to pass gas/ stools in an event of strangulation (contents getting stuck and losing blood supply leading to death of tissues)
  1. Clinical diagnosis is the most appropriate way to confirm the diagnosis 
  2. Ultra-sound is used to measure the defect size, know the contents, know the presence of silent hernia, other side ( in case of groin), know the presence of intestines (risk of strangulation )
  1. Repair of hernia
  2. Strengthening the abdominal wall 
  1. Herniotomy: In young children only for congenital hydrocele 
  2. Herniorrhaphy: Repair of hernia without placing mesh for children, in case of strangulation 
  3. Hernioplasty: Repair of hernia plus placement of mesh 

Mesh is made up of non absorbable material ( polypropylene), it can be absorbable ( biological mesh) or composite (polypropylene coated with cellulose/ collagen)

  1. Laparoscopic surgery repair helps in early resumption in activity and back to regular activity within the first week of surgery 
  2. Complete recovery to resume strenuous activity happens usually by three-four weeks after surgery 
  3. Lifting weights to be resumed after 2-3 months after surgery
  4. Avoidance of smoking (smoking leads to poor wound healing increasing reoccurrence chances), treatment of coexisting conditions causing the abdominal strain which is repetitive Ex: BPH treatment,  asthma or  URTI treatment, constipation treatment