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Abdominal and Inguinal Hernia Repair

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Abdominal and Inguinal Hernia Repair

Overview

The abdominal and inguinal hernia is the formation of a balloon-like sac at a location, where anterior abdominal wall muscles and membranes weaken. The weakness of the abdominal wall may be secondary to aging, factors that increase the intraabdominal pressure (heavy lifting, coughing, straining etc.), weakness of the abdominal wall in infants and children, and the deformation of the abdominal wall anatomy due to incision, pregnancy and trauma.

The vast majority of hernias occur in the groin region, but hernias can also be seen on and around the belly button and around the incision made for an abdominal surgery.

The abdominal and inguinal hernia stay asymptomatic and it may not cause complaints for many years. However, it is usually manifested by pain when abdominal membranes and a small part of bowel are pushed into the sac. Initially, this bulge can be reduced into the abdominal cavity. When this bulge grows over time, the factors that cause onset of hernia, such as increased intraabdominal pressure, heavy lifting, straining or coughing, cause a sharp pain and sensation of burn.

When the hernia sac can no longer be reduced into the abdominal cavity, surgery becomes an option for the treatment of abdominal and inguinal hernias. In this condition, called incarceration, the hernia sac is strangulated and the blood flow to the tissues “herniating” into the sac ceases, resulting in death of tissues (necrosis). Alarming symptoms of hernia that require surgery are strong nausea and vomiting, fever, and very sharp or insufferable pain.

Hernia surgeries are indicated when the hernia causes disabling pain and swelling or when the hernia cannot be reduced into the abdominal cavity. The purpose of hernia surgery is to repair and support the weak point of the abdominal wall.

Why is this procedure done?

Hernia surgeries are indicated when the hernia causes disabling pain and swelling or when the hernia cannot be reduced into the abdominal cavity. The purpose of hernia surgery is to repair and support the weak point of the abdominal wall.

The diagnosis of the hernia is made when a bulge on the abdominal wall or the groin is seen in the physical examination. For some unclear cases, your doctor will ask you to stand still and cough. This maneuver makes the bulge appear more remarkably as the intra-abdominal pressure increases.

Although the hernia repair is performed under general anesthesia with open surgery, a laparoscopic method can also be used. The laparoscopic method has advantages such as rapid recovery, shorter hospitalization and less postoperative discomfort. In terms of patient safety, none of two methods is superior to each other.

Risks

As the case for all surgeries, there are some risks involved in hernia repair surgeries.

  • Anesthesia-related complications
  • Damage of the nerves and blood vessels around the hernia
  • Recurrence of hernia
  • Infection
  • Hematoma
  • Gastrointestinal obstruction

Although all possible measures that modern medicine allows are taken to prevent occurrence of risks, it is no means possible to warrant that the risks will be completely eliminated.

Our expert surgery team will employ all practices to minimize the risk of complications and our surgeons will preoperatively inform you about risks listed above and all other potential complications and will address all your concerns.

Preparation

The first phase of preoperative preparation is same in all Medicana Hospitals.

Hernia repair surgery is a procedure that is carried out under general analgesia. Your surgeon makes a series of assessments to plan the surgery by determining if your overall health is appropriate for this procedure, to identify and treat conditions that pose risk for the surgery.

  • Review of health history
  • A detailed physical examination
  • Necessary laboratory tests and radiology studies to evaluate surgical risks
  • Assessment by anesthesiologist and other laboratory tests and radiology studies to minimize anesthesia-related complications

After it is verified that the surgery does not pose risk, you will be asked to quit smoking, if you are a smoker, and to stop taking certain medications that increase risk of bleeding. All other prescribed and over-the-counter medications, herbal products and supplements will also be questioned and you will be informed to continue or stop taking them.

You are preoperatively informed in detail about the procedure. All details of the procedure, potential risks and healing period are explained.  

You will also be instructed to stop eating and drinking at a particular time before the surgery and you should strictly follow this instruction in order to undergo the surgery at the scheduled date.

After it is verified that the surgery does not pose risk, you will be asked to quit smoking, if you are a smoker in order to minimize risks and facilitate postoperative recovery. Prescription and over-the-counter medications that you take for other medical conditions are reviewed and you are informed about medications (i.e., blood thinners that increase risk of bleeding) that you need to stop taking before the surgery, if required. Moreover, the dose of medications you take for chronic diseases (diabetes mellitus, hypertension etc.) might temporarily be modified. All other over-the-counter medications, herbal products and supplements will also be questioned and you will be informed to continue or stop taking them.

Moreover, it is reasonable to plan discharge, post-discharge accommodation and travel at this phase in order to manage postoperative period better.

Surgery and early postoperative period

After routine preoperative preparations (intravenous drug administration, insertion of a breathing tube in the throat, etc.) are completed in the operating room, you will inhale anesthetic gas and oxygen, resulting in loss of consciousness; next, the skin of the incision area is scrubbed for open or laparoscopic surgery.

In open surgery, the surgeon makes an incision on the abdominal wall to locate the hernia sac. After the tissues entrapped in the sac are reduced into the abdominal cavity, the weak point of the abdominal wall is repaired and a support material, called mesh, is placed to avoid recurrence.

In the laparoscopic method, your surgeon makes four small incisions on your abdominal skin.

First, your abdominal cavity is inflated by CO2 gas through one of those incisions. Then, a camera is inserted into your abdominal cavity. Other incisions are used for surgical instruments to be inserted into your abdominal cavity.

Again, after the tissues entrapped in the sac are reduced into the abdominal cavity, the weak point of the abdominal wall is repaired and a support material, called mesh, is placed to avoid recurrence.

You will be closely observed until anesthesia wears off and then you will be transferred to your room.

After you recover from anesthesia and you are ready to walk, you will be mobilized by or under supervision of our healthcare professionals.

You will be given pain killer(s) after the surgery in order to manage the postoperative pain. You may also need to use antibiotics to prevent a possible infection.

What you need to do to protect your surgical area will be explained in detail. In addition, you will be informed in detail about the wound care.

It is very important that you follow all instructions of your doctor after the surgery to protect and support the outcome of the surgery.

Results

Four hernia surgeries, you may be discharged in the same day. However, if your surgeon considers it necessary, you may be hospitalized one day in order to stabilize your overall health.

If you are undergone the surgery due to a high-risk conditions, such as strangulation of hernia (incarceration), and if complications develop, your hospitalization is likely to prolong.

After hernia operations, you should primarily take care of motions that increase the intra-abdominal pressure. Until your surgical wound heals completely, you should need assistance even if you get out of the bed, or you should get up as instructed by your doctor.

It will take one to two weeks to feel completely well and continue your normal life. At this time interval, it is extremely important to follows instructions of your doctor to the letter in order to protect results of the surgery.