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Hernia

What is Hernia?

Hernia is a medical condition caused due to the weakening of muscular tissues in an organ near the abdomen which causes the intestine or tissues to protrude through the weak spots nearby. Usually, it can occur in the abdomen between the chest and hips but may also appear in the groin areas and the upper thigh. There are several factors or reasons leading to the occurrence of a hernia, like smoking, chronic constipation, poor nutrition, consumtion of tobacco etc. Although a majority of hernias aren’t immediately severe, sometimes certain cases might require surgical procedure to prevent life-threatening complications as they don’t get cured on their own. It can appear among people of any age group.

How does it form?

A hernia forms when musclular tissues get ruptured or weak, causing internal organs like the intestines to protrude. Hernias can be classified into two groups- acquired and congenital. A person may be born with a hernia, or may acquire it from obesity or day-to-day activities such as lifting heavy weights, persistent sneezing or coughing and certain lifestyle changes.

Causes

  • Obesity
  • Pregnancy
  • Increased physical exertion in the abdomen
  • coughing or sneezing frequently
  • lifting heavy or regular weights
  • Chronic Constipation

Symptoms of Kidney Stones

  • A small lump initially in the affected area
  • Pain or discomfort in the groin or abdomen while performing physical activities
  • Discomfort while sneezing or coughing
  • Constipation
  • Discomfort while walking, sitting down
  • Pain and burning sensations in the groin or abdominal region
  • Disappearance or reduction in the size of the lump while lying down

Diagnosis

Test

In case one consults a doctor for hernia, the doctor might carry out certain tests depending upon the severity and symptoms of the hernia. Usually, it only takes a physical examination for the doctor to diagnose a hernia. However, in certain cases where the diagnosis isn’t clearl, the doctor might prescribe an imaging test like a CT scan, abdominal ultrasound or MRI.

SELF DIAGNOSIS

A hernia may affect different areas of the body differently. Hernias in and around the abdominal area or groin area are the most common types of hernia. During the initial stages, one might not feel any sort of discomfort or pain , though, they might experience a lump or swelling in and around the affected areas of the abdomen. The swelling or lump will be visible while one is coughing, sitting down or standing up and might disappear or reduce in size once the patient lies down.

Diagnosis by the Doctor

Surgery is the only treatment to permanently repair a hernia . But, before opting for surgery, the doctor will examine the protruding area physically. the patient might be asked to stand, strain or cough for an accurate diagnosis,. The doctor might also recommend watchful waiting if the hernia isn’t painful or causing any discomfort. Usually, doctors recommend a surgical repair of the hernia as they don’t generally repair themselves and can worsen with time, leading to severe life-threatening complications.

Grades

Grade I

Formation of a Lump Visible to the naked eye

Generally, in the first stage, a person might experience a lump or swelling in and around the areas of the abdomen. The lump will be clearly visible while straining, coughing, and carrying out other physical activities but the same lump might disappear or get reduced as soon as the person lies down. Initially, the person would not feel any sort of pain or discomfort.

Grade II

Obstruction

Gradually, the loop of the intestine becomes trapped, making one to lose the ability to make the bulge flat, which can lead to many complications and can also involve discomfort and severe pain. Such cases can worsen over time and may require immediate medical attention. Usually, it is a bad idea to leave it untreated as it can cause further swelling of the loop and eventual strangulation of the tissue or intestine which can be life-threatening.

Grade III

Stangulation

If the hernia resists manual pressure and can’t be popped back through the abdominal wall, it is called a non-reducible hernia or strangulated hernia. At this stage, it blocks the muscle tissue from inside, stopping blood circulation in the small intestine leading to infections in the dead cells. There may be signs like blood in stools, acute pain in the abdomen, fatigue, fever, nausea, vomiting and constant fever in case of a strangulated hernia.

When to consult a doctor ?

Though the hernia may not keep bulging in any given condition , it will also not heal on its own. Delaying its treatment can lead to severe complications as it won't even come with warning signs. The complications might appear all of a sudden which would lead the patient to be rushed in an emergency medical condition. If there is a noticeable protrusion or bulge accompanied by vomiting, fever or chills, nausea, or if one is not able to have a normal bowel movement, it might mean that the person is suffering from strangulated/incarcerated hernia and should seek medical help immediately.

Treatment Options & Cost

Non-surgical

There are certain non-surgical treatment options for treating hernia such as medication and lifestyle changes. If a person is not fit for the surgery is awaiting a surgery , they might be able to ease the pain or discomfort for some time by wearing a corset, binder, or truss. However, these are temporary solutions as a hernia usually does not go away on its own without surgery.

Surgical

Undergoing a hernia repair surgery is the only treatment to permanently repair a hernia. If the hernia does not cause any pain or discomfort, the doctor may recommend a watchful waiting and continue observing the hernia until the patient is ready to undergo a surgery. In most cases, doctors recommend surgical repair of the hernia to prevent potential complications that can be life-threatening.

Types of surgery

1) Open Hernia Repair Surgery – It is the conventional and most commonly performed surgery for hernia repair around the globe. In an open surgery for hernia repair, the surgeon makes an incision or a cut in the groin after which the hernia “sac” containing the bulging intestine is identified. He then pushes the hernia back into the abdomen and closes the abdominal wall with stitches. In case the opening is large, the surgeon may use a synthetic mesh to strengthen the closure through which the hernia protrudes.
2) Laparoscopic Hernia Repair Surgery – It is a much-advanced procedure for inguinal hernia treatment. Laparoscopic hernia repair surgery, also known as minimally invasive surgery is the surgical procedure performed through tiny incisions instead of a large opening. The surgeon will make minute incisions depending upon the severity of the hernia, through which a thin laparoscope with a camera attached to it is inserted and the abdomen is inflated with a harmless gas (CO2), creating space for the surgeon to view the internal structures. The surgeon might use a synthetic mesh to strengthen the abdominal wall. After the procedure is completed, the small abdominal incisions are closed and within a month, they are barely visible. Doctors don’t recommend this procedure of hernia repair for children and pregnant women.

Surgery Preparation

As with most surgeries, preparation for hernia surgery will involve restrictions in terms of diet. To ensure a safe treatment, one will be asked to refrain from drinking water, food, or any other fluids for six hours prior to the treatment as food present within the digestive system might lead to certain complications during the surgery.
While some drugs might be prescribed to be taken beforehand to aid the surgery, a certain number of drugs should be avoided for up to a week before the surgery because of the various effects they can have over the body.
Drugs like aspirin, blood thinners, anti-inflammatory medications (arthritis medications) and Vitamin E should be avoided prior to a week before the surgery.
Preoperative preparations include medical evaluations such as blood tests, chest x-rays and electrocardiography tests depending on the person’s age and medical condition.
It is recommended to take a shower before going for the operation as the surgical area must be kept dry after the operation.

What to expect during the surgery?

The patient will be given a general anaesthesia so that the patient does not feel any sort of pain or discomfort during the surgery.
Depending upon the severity of the given condition, small incisions will be made around the affected area, which will help the surgeon to push back the hernia inside.
Through one of the incisions, the surgeon inserts a laparoscope which is a medical device having an inbuilt camera which enables them to view the internal structures.
A surgical mesh is inserted through the incision which supports the damaged tissue around the hernia as it heals.
After placing the mesh over the open hernia, the surgeon uses additional medical devices such as tacks, sutures, and surgical glue to hold the surgical mesh in its place.
The small incisions are then closed with stitches or sutures that dissolve on their own over time.

After the surgery

It is advised to avoid lifting anything that can make one strain and exert physical pressure for a particular time duration as it can lead the hernia to reoccur and can also invite certain other complications post the surgery.
It is important to maintain a diet which includes a good amount of fibre and fluids after a hernia surgery to not have constipation. Obe must follow the diet prescribed by the doctor.
The surgical area must be kept dry and clean for at least 48 hours and even if one takes a shower, the area surrounding the surgery should be patted dry to avoid any infection.
One should be hydrated and drink as much water as possible to avoid complications like constipation or straining during bowel movements.

Cost of Laparoscopic hernia repair surgery in India with Surgical Sathi

The cost of a laparoscopic hernia surgery may vary depending on various factors such as the type of hernia, severity of the condition and hospitalization. The cost of a laparoscopic hernia repair surgery may vary between Rs 65,000 to Rs 1,25,000. To find out about a hernia surgery cost for yourself, you may contact the medical assistance team of a particular Surgical Sathi clinic or hospital.

Before & after the surgery comparison

The intestine or the protruding tissues through the abdominal wall are pushed back and a surgical mesh is placed around the damaged tissue. Over a period of time, the hernia will heal itself. However, to prevent the recurrence of hernia, it is extremely important to avoid physically stressful activities and take adequate precaution to get the most effective results.

Insurance Coverage

Hernia treatment is generally covered under health insurance. Most insurance companies offer a specific amount of coverage for different types of Hernia. The amount of coverage you have will depend on the policy you buy.
One thing you should know is that medical treatment for hernia won’t be covered in the insurance policy. Only the expenses of surgical treatment are covered and you also need to be hospitalized for at least 24 hours to file for a claim. You can opt for cashless payment or get reimbursement claims from your insurance providers as well.
If your claim is approved, you will be able to cover the entire cost of treatment, including diagnostic tests, medications, hospital stay, bed charges, and other consumables. Some of the best and most popular healthcare insurance providers are Oriental, Religare Health, Manipal Cigna, United India Insurance, Care Health, New India Insurance, Star Health & Allied, Bajaj Allianz General Insurance, ICICIA Lombard, Max Bupa Health Insurance.

Recovery Rate

Surgical repair possibilities come in two different categories. Recovery from open hernia surgery, in which the surgeon makes a lengthy incision to force the protruding organ back into place, typically takes at least three weeks. In the case of a laparoscopic hernia repair, recuperation takes one to two weeks.
Post discharge instructions recieved in the discharge summary and advise from the Operating surgeon is to be followed for complete recovery.

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