What is a hernia- Localized bulging over the abdominal wall on straining and disappear or reduces in size is called a hernia. It’s called Inguinal Hernia if occurs above the scrotal area. Unilateral if occurs on one side and bilateral if occurs on both sides. Inguinal hernia is the commonest of all hernias.

 

 

Diagnosis- Patient complains of dragging pain or discomfort over the pubic region on standing or walking and a localized soft bulging over the pubic region on standing position, reduces on lying down and comes out on straining.   Most of the inguinal hernias are diagnosed by clinical examination. Ultrasonography or CT scan is required in selected cases where detection is difficult by clinical examination.

 

 

Treatment – Treatment of hernia is surgery. Treatment is required to relieve the symptoms and to prevent complications eg. Obstruction. 

Surgery is performed by open conventional surgery and laparoscopic surgery. Recovery is better with Laparoscopic surgery. No difference in Recurrence. Dr Manoj Choudhury is one of the pioneers in laparoscopic hernia surgery in Eastern India and had done operative demonstrations in national and international forums. We also have been training young surgeons in Laparoscopic Techniques.

 

 

Ventral Hernia

Anterior abdominal swelling that increases in size on coughing, prolonged standing, subsides on lying down.  Ventral Hernia is commonest in female,  mostly seen in the lower abdomen and commonly seen following surgery. Protrusion becomes prominent on straining. It may be reducible or irreducible and even obstructed. The bulging may be associated with discomfort or pain. It becomes an emergency situation when obstructed with excruciating pain.

 

Ventral Hernia is mostly diagnosed by clinical examination. But CT scan is required in selected cases where there are diagnostic difficulties. Ventral ( Anterior Abdominal Wall Hernia) hernia can also be repaired open as well as by Laparoscopic method. Recovery is much faster with Laparoscopic method and resulting negligible infection. Laparoscopic method can also be applied in Complex ventral hernias. Laparoscopic expertise is necessary to perform this technique. Dr Manoj Choudhury is one of the pioneers in laparoscopic repair. 

 

 

Precautions before operation

Avoid and treat factors like constipation, difficulty in passing urine, Chronic cough etc. before operation. Should avoid abdominal exercise because straining may cause pain, increase in the size of hernia and even obstruction

 

 

After Operation

Patient is advised not to take anything by mouth till the patient regains full consciousness.  Plain liquid is advised after four hours. Semisolid food is advised next morning if the recovery is satisfactory

 

Patient experience some amount of pain in immediate post operative period. But pain reduces fast. Chances of wound infection are significantly less in comparison to open operation. As the operation is performed through small holes, it is also cosmetically favorable.

Patient needs to use Abdominal Binder for 3-6 months to support the operative area of  abdominal wall. Strenuous abdominal exercise should be avoided for a year (at least for 6months). But the patient can perform routine activities.

But the Patient should be well aware of 5-10% recurrence after surgery as per literature report.