Open inguinal hernia repair (herniorrhaphy, hernioplasty) in india
For open hernia repair surgery, a single long incision is made in the groin. If the hernia is bulging out of the abdominal wall (a direct hernia), the bulge is pushed back into place. If the hernia is going down the inguinal canal (indirect), the hernia sac is either pushed back or tied off and removed.
Mesh patches of synthetic material (Gore-Tex, Teflon, Dacron, Marlex, or Prolene) are now being widely used to repair hernias (hernioplasty). This is especially true for hernias that recur and for large hernias. Patches are sewn over the weakened area in the abdominal wall after the hernia is pushed back into place. The patch decreases the tension on the weakened abdominal wall, reducing the risk that a hernia will recur.
During the surgery in india
An anesthesiologist (a physician who specializes in pain relief) will recommend a type of anesthesia according to the patient’s condition and health status. Anesthesia will make a person immune to pain.
- The abdomen and groin are prepared with an antibacterial solution.
- A small incision or cut is made in the skin.
- The hernia “sac” containing the bulging intestine is identified.
- The surgeon pushes the intestine back into its proper location behind the muscle wall and back into the abdominl cavity.
- The muscle wall is reinforced with stitches or synthetic mesh to contain the intestine and complete the repair.
- The abdomen is closed in layers after ensuring that all the bleeding points are secured.
Although there are many types of hernia repair that have been practiced and modified over the last century the current thinking is that the use of a synthetic mesh like material can help with the long term results and prevent the recurrence of hernias. This is especially true for direct hernias and moderate sized inguinal hernias. The principles of the synthetic mesh like the Prolene mesh is similar whether it is done by open or laparoscopic surgery. The PROLENE Hernia System is generally a two-layer patch that is held together by a connector and it is fixed in the space in the defect area next to the spermatic cord towards the midline.
Why It Is Done
Surgical repair is recommended for inguinal hernias that are causing pain or other symptoms and for hernias that are incarcerated or strangulated. Surgery is always recommended for inguinal hernias in children. Infants and children usually have open surgery to repair an inguinal hernia.
- Children who need to have inguinal hernia repair surgery
- Adults who need to have inguinal hernia repair surgery
How Well It Works in india
Open surgery for inguinal hernia repair is safe. The recurrence rate (hernias that require two or more repairs) is low when open hernia repair is done by experienced surgeons using mesh patches. Synthetic patches are now widely used for hernia repair in both open and laparoscopic surgery. The chance of a hernia coming back after open surgery ranges from 1 to 10 out of every 100 open surgeries done.
Healthy children who have a hernia repair have few risks. The surgery usually is done on an outpatient basis.
- The surgeon may check to see whether a child younger than 1 year also has a hernia on the other side of the groin. If there is one, it may be repaired during the same surgery to avoid the risks of a second surgery. In males, this practice involves putting both testicles at risk at the same time.
- Males with hydrocele and hernia may have both problems repaired at the same time to avoid the risks of a second surgery.
- Premature babies are at risk for heart and lung complications during surgery.
Adults and children who have a hernia repair are at risk for : –
- Reaction to anesthesia (main risk).
- Infection and bleeding at the site.
- Nerve damage, numbness of skin, loss of blood supply to scrotum or testicles resulting in testicular atrophy (all infrequent).
- Damage to the cord that carries sperm from the testicles to the penis (vas deferens), resulting in an inability to father children.
- Damage to the femoral artery or vein.
What to Think About
The following people need special preparation before surgery to reduce the risk of complications : –
- Those with a history of blood clots in large blood vessels (deep vein thrombosis)
- Those taking large doses of aspirin
- Those taking anticoagulation medicines (such as warfarin or heparin)
Most inguinal hernia repair surgery on adults of all ages and healthy children is done on an outpatient basis. This lowers costs (as much as 50% lower than inpatient surgery, which requires a stay in the hospital) and may reduce infection. Outpatient surgery takes about 1 hour.
Inpatient surgery is sometimes recommended for people who have : –
- Unusual, recurrent hernias.
- Very large hernias.
- Hernias on both sides (bilateral hernias).
- Severe illnesses (such as heart or lung disease), or who are taking anticoagulant medicines
Infants with the following conditions may need to be hospitalized for hernia surgery : –
- Lung problems, such as bronchopulmonary dysplasia
- Seizure disorders
- Heart disease from birth (congenital heart disease)
- Premature birth or the need for a breathing machine (ventilator)