Hernia is a protrusion of an abdominal organ or its part through the wall of the cavity that normally contains it. The abdominal cavity is wrapped in muscles that protect it and maintain its shape. In the cavity wall, there are spots where the cavity wall is weakened, naturally or acquired. During exertion or prolonged overloading, penetration of the organ through this weakened place may occur. Within the abdominal cavity, there are also recesses and folds of intestine supporting apparatus formed by connective tissue where hernia can also develop.
General Information about Hernia Surgery
Hernia is a quite common disease; hernia surgery is therefore also quite common operation. Hernias affect more often men than women; mainly adults are affected. Small children may suffer from congenital hernias that can be diagnosed shortly after birth. If surgery is necessary in children, the effort is to operate the hernia as soon as possible. In every hernia surgery, the aim is to minimize negative aspects of the operation on the patient – shorten the stay in the hospital to minimum, use easier and less demanding techniques.
Anesthesia in Hernia Surgery
Anesthesia means eliminating pain and thermal sensations during operation. Hernia surgery can be performed either under general anesthesia, or in local anesthesia. General anesthesia means total unconsciousness induced by inhalation or intravenous administration of anesthetics; these days both methods of administration are usually combined. It must be performed by an anesthesiologist. This type of anesthesia poses the patient at risk of complications. In hernia surgery general anesthesia is usually not necessary; local (or regional) anesthesia is preferable in this type of operation. It desenses only a specific region of the body, according to hernia location. During the operation, the patient is still conscious; it has lower complication rate than general anesthesia. Local anesthesia also shortens the stay in hospital and has fewer side effects. The method of anesthesia and type of surgery is always decided by the doctor according to the overall condition of the patient.
Methods of Hernia Surgery
In recent years, the trend in surgery is to minimize the consequences of the operation. When operating hernias in so-called classical way, there was a big incision in the place of hernia that resulted in a big scar. Nowadays, more and more hernias are operated using so-called laparoscopic techniques. It is a complex method that uses video tubes and special tools to enable the doctors to operate hernias or other problems from the inside of the abdominal cavity. After the operation, the patient has only three to four very small scars, one centimetre in diameter the maximum. It also shortens the stay in hospital, smaller scars indicate less postoperative pain and shorter healing. As well as in the decision about anesthesia type, also the method of surgery is to be decided by the doctor. In case the condition of the patient permits both operation types, the will of the patient may be taken into account.
Hernia Surgery Technique
Surgical treatment is the only definitive solution for a hernia. Before the surgery, hernial content and hernia status should be examined. If the hernia is strangulated, the risks for the patients are higher than in uncomplicated hernias. Strangulated hernia must be operated instantly, otherwise the strangulated hernia might rupture or inflame. Both these conditions are very serious and may result in death of the patient. The strangulated part of the hernia must be removed during the operation. In case of an uncomplicated hernia, the whole hernial sac and its contents are pushed back to its original position in the abdominal cavity and the abdominal wall carefully sewn. A special mesh may be used to strengthen the abdominal wall and prevent the hernia from reoccurrence. If the surgery was performed under general anesthesia, the patient stays under the supervision of the anesthesiologist after the surgery until fully awaken; afterwards is transferred to a inpatient department.
Complications of Hernia Surgery
Complications after hernia surgery are not very common. Occasionally, some complications may occur during both, the surgery itself as well as the postoperative treatment. Among the most common complications we can find:
- damage to blood vessels and nerves in the area of the operation
- damage to the vas deferens in inguinal hernia surgery in men
- damage to other abdominal organs
- complicated wound healing
- allergic reactions
- pulmonary complications
If you have been diagnosed with hernia of whatever type, your physician will probably suggest surgical treatment to you. Surgical treatment is the only causal treatment for a hernia; no other therapy can fix the defect of the abdominal cavity wall. If the hernia is not surgically treated, the situation can worsen slowly in time or even suddenly after incarceration. Surgical treatment of hernias has excellent outcomes; using the latest techniques has very few complications. Naturally, complication rate varies depending on the particular patient, technique and type of anesthesia.