hernia فتاق

WHAT IS A HERNIA?
A hernia occurs when the inside layers of the abdominal muscle have weakened, resulting in a bulge or tear. In the same way that an inner tube pushes through a damaged tire, the inner lining of the abdomen pushes through the weakened area of the abdominal wall to form a small balloon like sac. This can allow a loop of intestine or abdominal tissue to push into the sac. The hernia can cause severe pain and other potentially serious problems that could require emergency surgery. Both men and women can get a hernia.
HOW DO I KNOW IF I HAVE A HERNIA?
The common areas where hernias occur are in the groin (inguinal), belly button (umbilical), and the site of a previous operation (incision).
It is usually easy to recognize a hernia. You may notice a bulge under the skin. You may feel pain when you lift heavy objects, cough, strain during urination or bowel movements, or during prolonged standing or sitting.
The pain may be sharp and immediate or a dull ache that gets worse toward the end of the day.
Severe, continuous pain, redness, and tenderness are signs that the hernia may be entrapped or strangulated. These symptoms are cause for concern and immediate contact of your physician or surgeon.
WHAT CAUSES A HERNIA?
The wall of the abdomen has natural areas of potential weakness. Hernias can develop at these or other areas due to heavy strain on the abdominal wall, aging, injury, an old incision or a weakness present from birth. Anyone can develop a hernia at any age. Most hernias in children are congenital. In adults, a natural weakness or strain from heavy lifting, persistent coughing, difficulty with bowel movements or urination can cause the abdominal wall to weaken or separate.
WHAT PREPARATION IS REQUIRED?
Most hernia operations are performed on an outpatient basis, and therefore the patient will probably go home on the same day that the operation is performed.
Preoperative preparation includes blood work, medical evaluation, chest x-ray and an EKG depending on patient age and medical condition.
HOW IS THE PROCEDURE PERFORMED?
There are few options available for a patient who has a hernia.
Use of a truss (hernia belt) is rarely prescribed as it is usually ineffective.
Most hernias require a surgical procedure.
Surgical procedures are done in one of two fashions.
I. The open approach is done from the outside through a three to four inch incision in the groin or the area of the hernia. The incision will extend through the skin, subcutaneous fat, and allow the surgeon to get to the level of the defect. The surgeon may choose to use a small piece of surgical mesh to repair the defect or hole. This technique is usually done with a local anesthetic and sedation but may be performed using a spinal or general anesthetic.
II. The laparoscopic hernia repair. In this approach, a laparoscope (a tiny telescope) connected to a special camera is inserted through a cannula, a small hollow tube, allowing the surgeon to view the hernia and surrounding tissue on a video screen.
Other cannulas are inserted which allow surgeon to work "inside." Three or four quarter inch incisions are usually necessary. The hernia is repaired from behind the abdominal wall. A small piece of surgical mesh is placed over the hernia defect and held in place with small surgical staples. This operation is usually performed with general anesthesia or occasionally using regional or spinal anesthesia
WHAT SHOULD EXPECT AFTER SURGERY?
Following the operation, patient will be transferred to the recovery room where patient will be monitored for 1-2 hours until patient are fully awake. Once patient are awake and able to walk, patient will be sent home.
With any hernia operation, patient can expect some soreness mostly during the first 24 to 48 hours. patient are encouraged to be up and about the day after surgery.
With laparoscopic hernia repair, patient will probably be able to get back to normal activities within a short amount of time. These activities include showering, driving, walking up stairs, lifting, working and engaging in sexual intercourse.
WHAT COMPLICATIONS CAN OCCUR?
Any operation may be associated with complications. The primary complications of any operation are bleeding and infection, which are uncommon with laparoscopic hernia repair.
There is a slight risk of injury to the urinary bladder, the intestines, blood vessels, nerves or the sperm tube going to the testicle.
Difficulty urinating after surgery is not unusual and may require a temporary tube into the urinary bladder for as long as one week.
Any time a hernia is repaired it can come back. This long-term recurrence rate is not yet known.