Hernia

A. INGUINAL HERNIA

An inguinal hernia occurs when Fat or intestine or part of the intestine — protrudes through a weak point in the abdominal muscles. The resulting bulge can be painful, especially when you cough, bend over or lift a heavy object. It can lead to life-threatening complications. For this reason, your doctor is likely to recommend surgery to fix an inguinal hernia that’s painful or becoming larger. Inguinal hernia repair is a common surgical procedure.

Some inguinal hernias don’t cause any symptoms. You might not know you have one until your doctor discovers it during a routine medical exam. Often, however, you can see and feel the bulge created by the hernia. The bulge is usually more obvious when you stand upright, especially if you cough or strain.

Inguinal hernia signs and symptoms include:

• A bulge in the area
• A burning, gurgling or aching sensation at the bulge
• Pain
• Weakness or pressure in your groin
• Occasionally, pain and swelling around the testicles when the protruding intestine descends into the scrotum

You should be able to gently and easily push the hernia back into your abdomen when you’re lying down.

Incarcerated hernia

If you aren’t able to push the hernia in, the omentum or a loop of intestine can be trapped (incarcerated) in the abdominal wall. An incarcerated hernia can lead to a strangulated hernia, which cuts off the blood supply to your intestine. See your doctor urgently ,if such a condition is encountered. See your doctor if you have a painful or noticeable bulge in your groin on either side of your pubic bone.

CAUSES

• Being male. You’re far more likely to develop an inguinal hernia if you’re male.
• Family history. Your risk of inguinal hernia increases if you have a close relative, such as a parent or sibling, who has the condition.
• Certain medical conditions. People who have cystic fibrosis, a life-threatening condition that causes severe lung damage and often a chronic cough, are more likely to develop an inguinal hernia.
• Chronic cough. A chronic cough, such as from smoking, increases your risk of inguinal hernia.
• Chronic constipation. Straining during bowel movements is a common cause of inguinal hernias.
• Excess weight. Being moderately to severely overweight puts extra pressure on your abdomen.
• Pregnancy. This can both weaken the abdominal muscles and cause increased pressure inside your abdomen.
• Certain occupations. Having a job that requires standing for long periods or doing heavy physical labor increases your risk of developing • an inguinal hernia.
• Premature birth. Infants who are born early are more likely to have inguinal hernias.
• History of hernias. If you’ve had one inguinal hernia, it’s much more likely that you’ll eventually develop another — usually on the opposite side.

Complications of an inguinal hernia include:

• Pressure on surrounding tissues. Most inguinal hernias enlarge over time if they’re not repaired surgically. Large hernias can put pressure on surrounding tissues. In men, large hernias may extend into the scrotum, causing pain and swelling.
• Incarcerated hernia. If the omentum or a loop of intestine becomes trapped in the weak point in the abdominal wall, it can obstruct the bowel, leading to severe pain, nausea, vomiting, and the inability to have a bowel movement or pass gas.
• Strangulation. An incarcerated hernia may cut off blood flow to part of your intestine. This condition is called strangulation, and it can lead to the death of the affected bowel tissue. A strangulated hernia is life-threatening and requires immediate surgery.

A physical exam is usually all that’s needed to diagnose an inguinal hernia. Your doctor is likely to ask about your signs and symptoms and to check for a bulge in the groin area. Because standing and coughing can make a hernia more prominent, you may be asked to stand up and cough or strain as part of the exam.

There are two general types of hernia operations — open hernia repair and laparoscopic repair.

Herniorrhaphy

In this procedure, also called an open hernia repair, the surgeon makes an incision in your groin and pushes the protruding omentum or intestine back into your abdomen. The surgeon then sews together the weakened or torn muscle. The weak area often is reinforced and supported with a synthetic mesh (hernioplasty). After the surgery, you’ll be encouraged to move about as soon as possible, but it may be four to six weeks before you’re fully able to resume your normal activities.

Laparoscopy

In this minimally invasive procedure, the surgeon operates through several small incisions in your abdomen. A small tube equipped with a tiny camera (laparoscope) is inserted into one incision. Guided by the camera, the surgeon inserts tiny instruments through another incision to repair the hernia using synthetic mesh. Most people who have laparoscopic repair experience less discomfort and scarring after surgery and a quicker return to normal activities. Laparoscopy may be a good choice for people whose hernias recur after traditional hernia surgery because it allows the surgeon to avoid scar tissue from the earlier repair. Laparoscopy also may be a good choice for people with hernias on both sides of the body (bilateral inguinal hernias). Some studies indicate that a laparoscopic repair may have an increased risk of complications and of recurrence following surgery. These risks can be reduced if the procedure is performed by a surgeon with extensive experience in laparoscopic hernia repairs.

Laparoscopic hernia repair may not be for you if:

• You have a very large hernia
• Your intestine is pushed down into the scrotum
• You’ve had previous pelvic surgery, such as prostate surgery (prostatectomy)
• You can’t receive general anesthesia

B. VENTRAL HERNIAS

A Ventral is the group of hernias which occur on the abdominal part of the body . These hernias are also known as Umbilical , Incisional , Lumber hernia etc. An incisional hernia, also called a ventral hernia, is a bulge or protrusion that occurs near or directly along a prior abdominal surgical incision. These hernias also present similar to the Inguinal hernias and will have the same complications as the inguinal hernias as described above .