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Hernia Surgery

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Hernia Surgery

The only effective form of treatment for a hernia is surgery. Depending on the type of hernia, surgery can be either laparoscopic or open. Both types of surgery are performed under general anaesthetic.

Laparoscopic hernia repair

In laparoscopic surgery, also known as keyhole surgery, surgical procedures are performed using fine instruments which are inserted into a series of small `1-1.5cm incisions in the body. A camera, known as a laparoscope, is also inserted into the body. The camera projects high-resolution imagery onto screens in the operating room.

Example: Laparoscopic Inguinal/femoral hernia repair 

Incisions

Insertion of laparoscope

A mesh patch is then placed into the weak area in the abdominal wall using glue, absorbable screws or stitches. The mesh reinforces and decreases the tension on the weakened abdominal area.

Surgeon’s view, small right inguinal hernia

Placed mesh

When compared with open surgery, laparoscopic surgery can result in less pain, less scarring, a shorter recovery time and less risk of complications.

The most common types of hernias that can be operated on laparoscopically are inguinal, femoral, hiatus and incisional hernias.

Open hernia repair

During open surgery for hernias, an incision over the bulge is made and the hernia is pushed back into the abdomen. Similar to the key whole technique a mesh patch is then placed into the weak area in the abdominal wall using screws or stitches. The mesh reinforces and decreases the tension on the weakened abdominal area.

Umbilical hernias are usually treated with open hernia repair.

Knowledge

Hernia Surgery

Where to Have a Hernia Procedure in the Brisbane, Gold Coast and Northern River areas

If you have a hernia, it is not likely to get better on its own. Hernias tend to get bigger and will often eventually lead to dangerous complications if left untreated. Doctors typically recommend hernia repair (also called hernia removal surgery) if certain conditions present themselves, such as tissue becoming trapped in the abdominal wall, strangulation of a hernia, or a hernia that is growing larger or causing pain.What is a hernia?

A hernia occurs when an organ or tissue pushes against or through the protective layer that surrounds it. If parts of your body experience unusual weakness, including your abdomen, groin, or diaphragm, those parts may become susceptible to hernia formation.

Types of surgery

During hernia surgery, bulging tissue or organs are put back in proper alignment in your body. Your surgeon may strengthen the surrounding tissue or muscle with sutures or mesh to support and stabilise the area.

In many cases, patients can return home the same day; others will usually be able to go home within a day or two. There are two ways to perform a hernia procedure. The two types of hernia removal are the following.

  • Open surgery: If you have open surgery, you’ll receive either local or general anaesthesia. Your surgeon will make an incision in your skin that allows them to either remove a hernia or push it back into place, followed by closure of the defect.
  • Laparoscopic surgery: During this hernia procedure, your abdomen will be inflated with gas to make it easier to see your organs. We then use a tiny camera on a thin tube as a guide to help them repair the hernia. This procedure is done under general anaesthesia. In general, recovery is faster and easier after laparoscopic surgery than open surgery.

The type of surgery you need depends on several factors such as the size, location, and type of a hernia, and your health, age, and lifestyle. Dr Harald Puhalla will discuss your case with you and make recommendations for the best treatment path for you.

Are there alternatives to surgery?

If you aren’t able to have surgery or need temporary relief while you wait for your surgery date, you may wear a binder or corset to provide gentle pressure and help keep a hernia in place. These garments may also help lessen pain or discomfort. Be sure to ask your doctor before using binders as they may make some hernias worse or conceal the signs of strangulation.

Based at the Gold Coast Private Hospital and Pindara Private Hospital, Dr. Harald Puhalla, General Surgeon, offers hernia repair surgery along with a range of other procedures including weight loss surgery, gallbladder surgery, and operations for the pancreas and liver. He uses minimally-invasive techniques and provides the best care possible for his patients, during procedures and in support of long-term care. Contact Dr. Puhalla here to book an appointment.

Recovery time after hernia surgery can be as quick as one week and as long as several months, depending on the type of hernia and the surgery performed.

Dr Puhalla will be able to provide you with a realistic timeframe of healing and recovery and what can and can’t be done in the weeks following your surgery.

The area where the surgery occurred may be swollen, tender or numb for several days following your surgery and may occasionally be bruised. You will probably feel tired and you should be mindful of preventing wound infection and taking steps to promote optimal healing, such as consuming a healthy diet, engaging in mild forms of exercise, avoiding heavy lifting and getting rest.

Some patients are able to return to work as soon as one week after surgery while others need more time.

A hernia occurs when the muscular wall surrounding the abdominal organs (such as intestines) is weakened, causing organs and tissues to protrude or “herniate” through the muscle. This produces a bulge, known as a hernia.

If left untreated, the protrusion or hernia can widen which may result in serious complications. (e.g. intestine becomes trapped and potentially strangled) In Australia, hernias are common. Surgery is the best long-term treatment option, and more than 40,000 hernia surgeries are performed annually.

In Australia, hernias are common, more than 40,000 hernia surgeries are performed annually.

Most hernias develop on pre-existing “weak“ spots of the abdominal wall
(e.g. groin, belly button).

When there is increased intra-abdominal pressure, a force pushes at this weak spot from the inside to the outside and may slowly start to form a small protrusion (hernia). This enlarges over time and can also contain some intestines or body fat.

In some cases, a hernia can occur after abdominal surgery, as the entry point of a previous operation can be a “weak“ spot.

Other causes of hernia can be attributed to:

  • Constipation and straining to urinate
  • Obesity and overweight
  • Heavy lifting
  • Excessive, long-term coughing
  • Abdominal fluid
There are over 20 different types of hernias, but the most common hernias are:

Inguinal hernia – inner body fat, the intestine or bladder protrudes into the inguinal canal in the groin

Incisional hernia – the intestine or body fat pushes through the abdominal wall where there may have been previous surgery

Umbilical hernia – part of the small intestine or body fat passes through the abdominal wall near the belly button

Hiatus hernia – when the top part of the stomach protrudes through the hiatus (an opening in the diaphragm through which the esophagus passes)

Femoral hernia – the intestine or body fat enters the canal carrying the femoral vessels into the upper thigh

Inguinal Hernia
1. Inguinal canal 2. Intestine 3. Herniated bowel

A common revealing sign of most types of hernias is a visible lump or swollen area. This lump tends to disappear when the patient lies down and enlarge when the patient coughs.

Doctors can often diagnose a hernia by palpating the site of the bulge and asking the patient to cough. If a hernia can’t be diagnosed in a consultation, an ultrasound or CT scan may be required to assess the area in more detail.

Some hernia patients have no symptoms, while others may experience signs and symptoms including:

  • Tenderness where the lump is
  • Discomfort in the abdomen which can worsen during
  • Physical activity, heavy lifting, straining or standing
  • Constipation and other digestive complaints
  • Acid reflux and heartburn (in cases of hiatal hernia)

Most hernias can be gently pushed back into the abdominal cavity. These are known as reducible hernias. Those which can’t return to the abdominal cavity when pushed in are known as irreducible hernias and can lead to complications such as strangulation.

Strangulated hernias

In serious circumstances, parts of the bowel or intra-abdominal fat may be caught by the hernia, compromising blood supply. This is known as a strangulated hernia

Strangulated hernias require urgent surgery and in some cases a bowel resection.

Hernias that cause severe pain, nausea, vomiting and abdominal swelling that is firm and tender to touch require immediate medical attention.

Hernia surgery is considered a safe procedure and complications are rare; however, as in all type of surgical procedures, complications may occur.

The most frequently reported risks associated with hernia surgery include:

  • Wound infection
  • Clots
  • Bleeding
  • Recurrence
  • Difficulty urinating
  • Nerve injury
  • Allergic reactions
  • Fluid build-up in scrotum
  • Spermatic cord injury
  • Testicular artery injury

 

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