Hernia Surgery in Delhi, Laparoscopic hernia treatment, Hernia signs and symptoms скачать в хорошем качестве

Hernia Surgery in Delhi, Laparoscopic hernia treatment, Hernia signs and symptoms

A hernia is said to be present when an organ moves or is displaced from its normal position to an abnormal location in the body. The cause of hernia is a defect in a particular compartment of the body which allows this movement to take place. The defect may be congenital which means that it is present since birth or may develop later in life due to stretching or weakness of the tissues. The abdomen is the most common site of hernia and in males, the most common location of hernia is groin it may be unilateral or bilateral and it can present in childhood or infancy as a congenital hernia or later in life. In young adults, the hernia is because of the persistence of the embryonic tract through which the testes descend into the scrotum. In older men, it arises because of persistently raised intra abdominal pressure as a result of chronic cough, constipation or straining at micturition. In females, the most common site of hernia is usually the umbilical area, i.e. the belly button which often appears after pregnancy or childbirth. It may arise because of abdominal distension due to other causes like obesity or ascites. Other common hernias are at the sites of previous incisions for any abdominal surgery due to weakness in these areas. Others include hiatal hernia in which the upper part of the stomach migrates through the diaphragm into the chest which leads to heartburn and acidity. Rare varieties of hernias include hernias in the lumbar area, paraspinal locations between the muscular tissues of the abdomen. The diagnosis of hernia is usually made on the basis of history and clinical examination but may require confirmation by Ultrasound of the abdomen. The most common site of hernia is the abdomen and it commonly presents as a visible swelling. This swelling initially increases on standing/straining and often disappears on lying down. There may sometimes be a dragging pain associated with this swelling. In some cases, the hernia becomes bigger, it may become complicated by obstruction or strangulation in which there is severe pain and may be accompanied by vomiting and distension of the abdomen. In children, the swelling of hernia increases on crying and playing and usually subsides when the child is sleeping. In some cases, because of diagnostic dilemma or some complicating factors, a CT scan may be indicated. It provides valuable information regarding the site of hernia, its contents and presence of obstruction/strangulation. Since the natural history of any type of hernia is progression, it should be treated once it is diagnosed. The treatment of hernia is corrective surgery which, if delayed, can lead to the complication of obstruction and strangulation. In obstruction, if the contents of the hernia include intestines, they get blocked which leads to their swelling. The person then develops vomiting and distension of abdomen. In strangulation, the blood supply of the contents get compromised which can lead to death of tissues within the hernia sac. This is an emergency which requires urgent operation and removal of the dead or devitalised tissue to save the patient’s life. The surgery can be done by open or laparoscopic route usually involves repair of the defect by sutures and placement of a mesh for reinforcement. In open surgery, the mesh is placed on top of the muscle layer whereas in laparoscopy, the mesh is placed underneath the muscle layer. The advantage of laparoscopy is that the operation can be done through small key hole incisions which are placed away from the site of hernia. Thus, the area of weakness is not cut open as in an open surgery. Moreover, in laparoscopic surgery, a larger mesh can be placed and because of the biomechanics of the abdominal wall, it leads to lower recurrence and greater long term success as compared to open approach.The risks of complications like pain, bleeding and infection are minimised in laparoscopic surgery which leads to a better outcome and faster recovery.