Hernia

Introduction

A hernia refers to an abnormal opening or defect on the wall of an abdominal cavity, that an organ such as the intestines push through to cause a bulge. It is therefore a weakened spot in your abdominal wall. While hernias may appear in the groin or upper thigh, the vast majority of hernias occur in your abdomen.

Several factors have been identified as a possible cause for the development of hernias, including genetics, age and congenital disorders. Hernias rarely present with any symptoms. However, you are likely to experience abdominal distension, discomfort, and pain in the pelvis or abdomen.

Even after being diagnosed with a hernia, your doctor may opt to do watchful waiting. This entails monitoring of the hernia to check whether there is any growth in size. The doctor will also be interested on whether the hernia causes any other medical problems. Hernia may be treated using non-surgical and surgical procedure as explained below.

Types of hernia

Hernia generally fall into the following groups:

Epigastric hernia

This type of hernia is found in the epigastric region of your abdomen. An epigastric hernia occurs due to the formation of a gap between either side of your abdominal muscles. This permits the pushing of fat tissues via your abdomen. Epigastric hernia accounts for 2-3 percent of all forms of hernias.

Hiatal hernia

This type of hernia develops following the bulging of your stomach via a weak spot in your diaphragm. The diaphragm is actively involved in breathing. Moreover, it separates your abdominal organs from the lungs.

Inguinal hernia

This type of hernia develops after the bulging of a portion of fat via the lower stomach wall. Such bulging occurs via the inguinal canal in your groin area. Inguinal hernias are more prevalent in men than in women.

Incisional hernia

This type of hernia is common following stomach surgery. This type of hernia is characterized by incision in the middle of your stomach. It is the result of incomplete healing of a surgical wound. An incisional hernia occurs in between 15 and 20 percent of individuals undergoing abdominal surgery.

Femoral hernia

This type of hernia occurs in the groin area. It is due to the pushing of tissues via a weak spot in your inner thigh or groin. Femoral hernia account for 2-4 percent of all kinds of hernia. Femoral hernias are more prevalent in women than men because the female pelvis has a larger width.

Umbilical hernia

In this type of hernia, there is a bulging of body tissues via a weak spot in the belly button region. The visible bulge gets worse during a bowel movement or when one coughs. Babies and infants are more predisposed to umbilical hernias. However, umbilical hernia undergo self-repair by the age of 5.

Treatment options for hernia

Unless you are dealing with an umbilical hernia, the other types of hernias rarely go away on their own. Most doctors prefer watching a hernia to ensure it reverts back via the abdominal wall. If a hernia has manifested in any symptoms or is large, it requires treatment.

Home remedies

While home remedies are not in themselves a cure for hernias, they, nonetheless, help to ease the symptoms. Some of the widely utilized home remedies to treat hernia include:

• Dietary fiber: Increased intake of dietary fiber is advisable as it helps to relieve constipation. Constipation leads to straining while one is having a bowel movement, thereby aggravating a hernia. Examples of foods that are rich in dietary fiber include fruits, vegetables, legumes and whole grains.
• Spicy foods: Avoid spicy or acidic foods as an acid reflux will aggravate the hernia
• Aloe vera: Aloe vera juice has soothing and anti-inflammatory properties. It is therefore helpful in reducing the symptoms of hernia.
• Ginger root: Ginger, whether consumed raw or in concentrated form helps to ease the stomach discomfort and pain
• Ice packs: An ice pack minimizes the pain and inflammation in the affected areas. Also, an ice pack offers you relief from bloating.

Homeopathy

The main homeopathic remedies for treating hernias include:

• Calcarea Carbonica: This homeopathic treatment is primarily prescribed for obese individuals. This is because the extra fat in their abdomens can lead to weakened abdominal muscles, thus predisposing them to hernia development.
• Rhus Toxicodendron: This homeopathic medicine is beneficial to individuals with weakened abdominal muscles after excessive lifting of heavy objects.  
• Silicea: Silicea is best suited for patients experiencing offensive and excessive perspiration on their feet. The remedy is also suited for obstinate and weak children.

Allopathy

Over-the-counter medication is useful in minimizing the effects of certain symptoms caused by hernias. For instance, antacids are useful in offering relief from symptoms caused by hiatal hernia. If there is no improvement after two weeks, it is recommended that you see your doctor. Some of the prescription medication to manage hernia include pantoprazole, esomeprazole and lansoprazole.

When to go for surgery

You may require surgery for your hernia if the condition does not respond to medication. In case the bulge or swelling in your abdomen continues to grow, you will need surgery. When a hernia has developed complications such as strangulation, you definitely need surgery.

Procedures/methods available under surgery

Hernia surgery falls under three major categories: open surgery, laparoscopic surgery, and robotic surgery

Open hernia surgery

During an open hernia repair surgery, the surgeon makes a cut or incision in the groin region. Once the surgeon has identified the bulging “sac”, he pushes the hernia back into your abdomen. Thereafter, the surgeon will strengthen your abdominal wall using synthetic mesh or stitches. After a successful procedure, the surgeon will let you go home for further recuperation. You will recover completely after a few days.

Laparoscopic hernia surgery

This is a minimally invasive procedure. The method makes use of an instrument known as a laparoscope. The surgeon first makes a small incision at the belly button and then inserts the laparoscope. A laparoscopic hernia repair surgery takes place under general anesthesia. This means your surgeon will have to assess your general state of health before surgery. This may entail lab work , medical history and physical examination.

Laparoscopic hernia surgery is not painful. The laparoscope contain a tiny video camera that allows the surgeon to see the inside of your abdomen. A harmless gas such as carbon dioxide enables the surgeon to view the internal structures of your abdomen clearly. This aids in exposing the weak spot in your abdominal wall. Thereafter, the surgeon places a mesh in the inside of your abdominal wall. The aim of this mesh is to cover the defect. The mesh further assists with tissue strengthening. The next step is for the surgeon it close the abdominal incision using surgical tape or stitches. A laparoscopic hernia surgery is associated with less pain, smaller incision, and faster recovery.

Robotic hernia repair

The use of robotic technology enables the surgeon to perform hernia surgery while seated at a console in the operating theater. The surgeon is able to operate with the surgical tools while seated at the console. Robotic surgery is beneficial in treating hernias located in weak areas. In addition, robotic surgery helps with the reconstruction of the abdominal wall. Robotic surgery is preferred to laparoscopic surgery in that it affords the surgeon a three-dimensional image of the abdomen. Consequently, the surgeon is better able to identify the location of the hernia with a high level of precision. Robotic surgery enables the surgeon to place a mesh and suture inside the abdomen with relative ease. The procedure also helps to minimize the size of the scar. The procedure is less painful in comparison to open hernia surgery.

Surgery options

There are many healthcare facilities in India that offer different types of hernia surgery. The healthcare facilities can be broadly categorized into either small clinics or large hospitals. You stand to gain certain benefits by choosing to have the procedure at a small clinic over a large hospital, and vice versa. In the same way, there are certain limitations for undergoing hernia surgery at a small clinic or your doctor’s office over the large hospitals and vice versa.

Small clinics

In case you choose to have hernia surgery at your doctor’s office or at a small clinic, one advantage is that you are more likely to be familiar with your doctor. Such familiarity is beneficial as it helps to reduce the fear and anxiety of surgery. Another benefit of having surgery at a small clinic is the personalized care and attention you will receive. This is because small clinics conduct a few surgeries. Therefore, the surgeon and surgical team will probably dedicate more time to patient care.

However, there may be fewer clinics with advanced equipment to perform hernia surgery. Also, small clinics lack enough expertise to take care of any complications that might come up during the procedure. You are also likely to pay more for a hernia procedure at a small clinic in comparison with the cost incurred at a public hospital, for example.

Hospitals

Large private and public hospitals also offer hernia surgery. The advantage of undergoing hernia surgery at a large private or public hospital is that the surgeon in such facilities will have conducted hundreds of similar procedures. An experienced surgeon is in a better position to handle post-op complications. Having a hernia surgery at a public hospital is also significantly cheaper than would be the case in a small clinic. Larger hospitals have the facilities to conduct such a procedure. This includes the recuperating ward as well.

In contrast, large hospitals are likely to have a backlog of surgical operations, some of which could be emergency cases. For this reason, you may experience delay before undergoing hernia surgery. Another limitation of having a hernia surgery at a large hospital is the lack of personalized care and attention provided by the small clinics.

Cost of hernia surgery in different setups

The cost of hernia surgery in India differs from one healthcare set up to another based on various factors:

• Surgeon’s fees: The surgeon’s fees differ from one specialist to another depending on their level of experience and whether they are in private practice
• Location: Hospitals and small clinics in the major cities across India charge relatively more for a hernia procedure than their counterparts in the remote parts of the country
• Type of surgery: The cost for open hernia surgery is different from laparoscopic surgery or robotic hernia surgery

The cost for laparoscopic surgery in Indian ranges between Rs. 65,000 and Rs. 2,60,000 depending on whether the procedure takes place at a public hospital, private hospital or a small clinic. In Mumbai, You can pay as much as Rs. 77000 for laparoscopic surgery. In Chennai the maximum amount is Rs. 66,500.

Post-op care

You are more likely to recover faster after robotic hernia surgery or laparoscopic hernia surgery than with an open surgery. You might feel pain and sore in the area of surgery. This is normal and such pain will usually go away after a few days. However, your doctor may prescribe medication to manage such pain. Some of the activities that will promote quicker recovery include:

Walk every day as this helps to increase blood flow

Avoid lifting heavy objects or engaging in strenuous activities

Increase your intake of dietary fiber to promote your bowel movement and reduce constipation

Increase your intake of fluids and in particular, water

At goficure, we walk with you through the journey of hernia treatment from diagnosis up to and including post-op care. We liaise with leading surgeons in hernia surgery so that you can get the best treatment at discounted rates. Our team will also assist with filling out any paperwork, including your insurance claim. This includes making arrangements for your transport to and from home on the day of your surgery.

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