When fatty tissue or an organ pushes through a weak place in the surrounding connective tissue or muscle wall, it may lead to Hernia. Usually, a hernia does not get better on its own. They may become bigger and in some cases, it can lead to life-threatening cases. That’s the reason for Hernia treatment Surgery is often recommended.
Not each and every hernia need surgical intervention but it depends on the size and clinical symptoms.
So let’s discuss the important question, Do I Need Hernia Surgery?
You are an ideal candidate for hernia surgical treatment if any of these things happen:
Incarceration is a condition when tissue (such as the intestine) becomes trapped in the abdominal wall. If it is not treated it may lead to strangulation and then the blood supply to the tissue gets cut off
If the hernia becomes strangulated. This can cause permanent damage and is a surgical emergency.
If the hernia is growing larger and is causing pain and discomfort
You may be able to wait to have surgery if:
When you lie down hernia goes away or you can push it back into your belly
If a hernia is small and there are few or no symptoms,
It is recommended to keep a watch and monitor your hernia during your yearly physical.
Types of Hernia Surgery
Hernia surgery can be performed in one of two ways. Both are operated by an experienced surgeon and the patient can get discharged within a few days. With the latest advancements in technology, in many cases, the patient is discharged on the same day.
Open surgery:
This is operated under general anesthesia. Usuallysurgeon makes a cut (incision) to open the skin. The surgeon will gently push back the hernia into the place and then tie it off or remove it, and then he’ll close the weak area of the muscle — where the hernia pushed through – with stitches.
This is a more advanced method where the abdomen of the patient is usually inflated with a harmless gas. This helps the surgeon to have a better look at the organ. A small incision is made near the hernia and a thin tube with a camera on the end (laparoscope) is inserted. With the help of the laparoscope can see the image and it uses as a guide to repairing the hernia with mesh.
The biggest advantage of laparoscopic surgery is the recovery time. It is very fast compared to open surgery. A patient can get discharged on the same day and are back to their normal routine a week sooner than with open surgery.
Depending on the size, type, and location of the hernia, the doctor will recommend the types of surgery required. There are some other factors like lifestyle, health, and age-based on which the doctor will decide the type of surgery.
The abdominal muscles can develop weak spots, through which adjoining tissue can protrude resulting in a bulge, which is called hernia. An inguinal hernia occurs at the inguinal canal, a narrow passage in the abdominal wall, through which blood is fed to the testicles. A hernia can be painful, especially while bending over, coughing or heavy lifting. If left untreated, it could lead to serious complications. The bulge can put pressure on nearby structures like the intestines and cause their blood supply to be cut off. This condition is called strangulated hernia.
The most common and popular treatment for a hernia is surgery. An operation is the quickest way to repair a hernia, particularly if the bulge is growing bigger. Timely surgery also preempts any serious complications that can accompany inguinal hernia. Sometimes, the hernia can be controlled with a padded belt called a truss. However, a hernia will not go away without surgery.
The surgery is performed under general anesthesia. The surgeon makes small incisions on the abdomen. A set of surgical instruments, along with a tiny telescope will be inserted into the abdomen where the hernia has occurred. The interior preperitoneal area, where the hernia occurs is shown on a laparoscope, which guides the surgeon. The procedure entails the smoothening of the abdominal wall where the bulge occurs. Then a synthetic mesh is used to cover and strengthen the weak spot in the abdomen. The operation generally takes about one hour. If the hernia is on both sides of the abdomen, the operation can last to under an hour.
Complications
Surgical intervention to treat inguinal hernia can lead to minor complications like pain, bleeding, infection at the surgical site, scarring, and formation of blood clots. Sometimes the side effects can be more severe like:
Damage to internal organs
Development of a hernia near one of the cuts
Injury to the bowel
Surgical emphysema
Development of a lump at the site of the original hernia
Discomfort or pain in the groin
Discomfort or pain in the testicle on the side of the operation, in men
Difficulty passing urine in men
Interference with blood supply to the testicle in men
Recovery
Patients are allowed to go home the same day or the next. Convalescence may take a week before the patient can resume normal activities. You cannot lift heavy weights for two to four weeks after the operation.
Regular exercise can help you return to pre-surgery activities with ease. But you should consult the surgeon or your general practitioner for advice. Inguinal hernia occasionally returns.
A haemorrhoidectomy is surgery to treat hemorrhoids or piles. Piles are soft, fleshy lumps that form inside just inside the anus. They easily bleed during bowel movements. Though they are not usually painful, they can cause itching. If the lumps grow, they can protrude outside through the anus in a condition called prolapsed pile. You can feel the lump while cleaning yourself. Hemorrhoids generally develop gradually, over a lengthy duration of time and are often related to constipation. Sometimes, the condition is genetic and made worse by pregnancy.
Treatment
Hemorrhoids can often be dealt with by eating more fiber and more intake of fluid. If these measures do not work, they may be treated with ‘banding’ or dissolving the lumps with injections. If these methods do not work, patients will need to undergo a haemorrhoidectomy to surgically remove the piles.
A haemorrhoidectomy is usually performed under general anesthesia and takes about twenty minutes. The surgeon will usually just cut away the hemorrhoids or use the staple gun technique, which does not create an open wound
Complications
A haemorrhoidectomy may cause the usual complications like pain, bleeding, infection of the surgical wound or blood clots. More serious complications may include the following:
Incomplete haemorrhoidectomy
Difficulty passing urine
Anal stenosis
Developing skin tags
Developing an anal fissure
Incontinence
Recovery
same day. The wound takes several weeks to heal completely. You should drink plenty of water during convalescence. Talk to your doctor about an exercise regime that can help you recover faster.
Laser surgery is an outpatient or day-care procedure, which offers many advantages over conventional surgery. For e.g., the laser technique not only treats hemorrhoids more effectively, but it also reduces post-operative pain. It also improves symptoms after surgeries, which were not meant to completely cure the patient. Similar results have been seen in patients external thrombosis, severe anal spasms, fissure, fistula, varicose veins, and sentinel tags. Specific advantages of laser surgery are:
Greater surgical precision
No need for general anesthesia
Faster surgeries
Discharge within a few hours
Back to routine in 3-5 days
No sutures and no scars
Less sutures with no scars
Fast recoveries
Less loss of during surgery
Minimal postoperative pain
Low risk of infection
Low risk of prolapse or rectal stenosis
Laser surgery patients look better.
Anal sphincter action is well preserved (no chances of incontinence).
Laser Proctology is the surgical treatment of diseases of the colon, rectum, and anus using a laser. Common conditions treated with laser proctology include hemorrhoids, fissures, fistula, pilonidal sinus, and polyps.
Laser proctology is the surgical treatment of diseases of the colon, rectum, and anus using a laser. Common conditions treated with laser proctology include hemorrhoids, fissures, fistula, pilonidal sinus, and polyps. The technique is increasingly being used to treat piles in both women and men.
Laser (Light Amplification by Stimulated Radiation) is a light beam of high energy. This light beam is used to burn or cut the abnormality, which was the reason for the surgery. Present, laser techniques are very advanced and much safer; they leave no scars, are bloodless and less painful. They also cause lesser complications.
Laser Surgery Vs Conventional Surgery
Laser surgery is an outpatient or day-care procedure, which offers many advantages over conventional surgery. For e.g., the laser technique not only treats hemorrhoids more effectively, but it also reduces post-operative pain. It also improves symptoms after surgeries, which were not meant to completely cure the patient. Similar results have been seen in patients external thrombosis, severe anal spasms, fissure, fistula, varicose veins, and sentinel tags. Specific advantages of laser surgery are:
Greater surgical precision
No need for general anesthesia
Faster surgeries
Discharge within a few hours
Back to routine in 3-5 days
No sutures and no scars
Less sutures with no scars
Fast recoveries
Less loss of during surgery
Minimal postoperative pain
Low risk of infection
Low risk of prolapse or rectal stenosis
Laser surgery patients look better.
Anal sphincter action is well preserved (no chances of incontinence).
Least rates of recurrence
Fewer visits to the doctor after surgery
Higher success rates
Anorectal Diseases That Require Laser Surgery
Hemorrhoids or Piles are enlarged veins located at the junction of the anus and rectum. The veins get enlarged due to excessive blood flow in arteries, which in turn causes the haemorrhoidal plexuses to dilate and get congested.
Anorectal Fissures
The lining of the anus can tear or crack when passing large or hard stools. The tear is called anal fissure and leads to pain and bleeding while passing stool.
Anal Fistula
Anal fistulas are small, infected connections that form between the skin near the anus and end of the bowel. An anal fistula is mostly the result of contagion in an anal gland, which spreads to the skin.
Pilonidal Cyst
Pilonidal cysts are formed at the end of the tailbone and just above the sacrum when hair penetrates the skin. The cysts also contain skin debris. The body responds to the hair as a foreign substance and creates a sac around the hair. If the cyst and the overlying skin become infected, it can lead to a painful abscess.
Symptoms of Anorectal Diseases
Many anorectal medical conditions go undiagnosed and remain untreated in adults because people feel shy or embarrassed to bring it to the notice of a doctor. This is especially true of women. The symptoms of anorectal conditions are noticeable, and should immediately be brought to the attention of a medical practitioner. Early diagnosis leads to lessening discomfort and faster treatment. Some of the symptoms are:
There are three types of laser surgeries for hemorrhoids:
Hemorrhoidal Laser Procedure (HeLp)
HeLP is a minimally-invasive laser procedure for piles, which does not require anesthesia. A Doppler is used to identify the affected branches of the rectal artery. Once they have been identified, a laser diode fiber photocoagulation the branches.
Laser Hemorrhoidoplasty (LHP)
LHP is similar to HeLP, but in this surgery, blood is stopped from flowing to the hemorrhoidal plexus by photocoagulating the affected branches of the rectal artery.
Laser Haemorrhoidectomy
Also called laser cauterization, this is a procedure in which the surgeon shrinks the swollen piles by burning them with the laser. Sometimes, the surgeon used a narrow laser beam and focus only on the hemorrhoids to avoid damage to nearby tissues. The narrow beam is passed through the anus and focussed on the mass of the piles. The controlled exposure of the submucosa zone to the energy of the laser causes a mass to shrink.
The fibrosis is reconstructed to create connecting tissue. This enables the mucosa to adhere to the underlying tissue. This prevents prolapsed. This is a safe surgery and cause minimal bleeding and heals faster.
FILAC Technique (Fistula–Tract Laser Closure)
This is a minimally-invasive technique to treat anorectal fistula, which preserves the sphincter. The affected tissue, called epithelialized is neutralized by focusing the laser in a controlled, circular movement.
Lateral Internal Sphincterotomy (LIS)
Doctors may prescribe LIS when chronic anal fissure does not respond to medication and conventional treatments. The laser is used to remove a small portion of the sphincter muscle. This helps alleviate pressure, reduce pain and allows the fissure to heal.
Before the Surgery: Your doctor or surgeon will explainthe entire procedure to you and the expected results. The medical team will give you specific instructions on what to do and what not to do before the surgery. They will also conduct some pre-operative examinations.
During Surgery: The surgery will be carried out by a team of anesthetists, the surgeon and support staff. The procedure will be carried out under local anesthesia. Depending on the condition, the operation lasts from a few minutes to one hour.
After Surgery: Laser proctology surgeries are usually conducted as out-patient procedures, but some patients may be monitored overnight. The time of recovery varies from patient to patient, but you can expect to resume normal activities in one or two days
Dr Manas Ranjan Tripathy 