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Is your hernia watering the cornea?
What is a hernia? Do you have it? If you have it, how do you know? Does it hurt? Is it hereditary? What exactly is it caused by? Does a lump in the stomach cause a hernia, lump? Do you need surgery to fix it? So many questions! Let’s start by dealing with the first one.
What are the different types of hernias? There are different types of hernias depending on where they occur. Umbilical hernia, femoral hernia, incisional hernia, upper abdominal hernia and hiatal hernia. This article is about inguinal hernia.
Hernia – It is an abnormal protrusion of an organ or part of it through a weak point in the body. An inguinal hernia is the most common of the hernias and occurs mainly in men than in women in a ratio of 7:1. You don’t want equality in these things, ladies, trust me! A hernia can be direct or indirect. Remember Hodor in GOT (Game of Thrones)? The scene where the white walkers attack Bran and run for his life? Hodor holds the door to prevent the White Walkers from killing Bran and turning him into one of them. If Hodor was playing guard at the entrance to the tower and the white walkers still got in? That would be an indirect hernia. Here, the white walkers can be abdominal viscera, mainly the colon and Hodor’s deep inguinal ring. Likewise and also how it happened in GOT, Hodor stood at the back door of the tower and the white walkers eventually crawled out. Here it is a direct hernia and the iconic Hodor, which is the posterior wall of the inguinal canal.
What is this inguinal canal? It is a muscular channel that contains the structures that pass through it. They are the spermatic cord (in men), the round ligament (in women), the lymphatic nerve, is the genital branch of the so-called genitofemoral nerve, and finally the remnant of the vaginalis processes. The weak spot for all inguinal hernias is the point between the inguinal ligament and the pubic duct, called the myopectinal foramen of Fruchaud.
What causes a hernia? Sometimes people are born with it. It can be a collagen disorder, as a result of which the ligaments weaken, the plum-belly syndrome is congenital, and the acquired collagen deficiency is caused by smoking. Yes, smoking not only causes cancer, but also hernia. They forgot to put it in the package. Basically, anything that increases intra-abdominal pressure increases the causation of a hernia, such as cough, constipation, ascites, obesity, pregnancy, straining while urinating, and lifting heavy weights. Hernia cases have also been recorded after appendectomy.
When you are younger you have an indirect hernia is a possibility and when you are older you get a direct hernia. An inguinal hernia usually appears as inguinal swelling and is painful in nature and may radiate to the navel area.
Normal tests that are done to make a diagnosis are
• Routine blood tests and urinalysis. Elderly people may need additional tests, such as a chest X-ray, EKG, and PFT. Urination problems are examined for prostate enlargement and urethral problems.
• Ultrasound can detect a pouch where a hernia cannot be diagnosed by clinical evaluation. It is useful for postoperative swelling, hematoma and recurrence.
• CT (computed tomography) for a giant hernia.
• MRI (magnetic resonance imaging) is ideal for athletes to distinguish muscle spasms and hernias.
Hernia treatment depends on its presentation. Herniotomy, herniorrhaphy and hernioplasty are three important surgical techniques that are performed. Herniotomy is recommended for young patients with hernia.
Herniorrhaphy – Modified Bassini’s herniorrhaphy is now in practice for patients with good muscle tone in indirect and direct hernias. In this procedure, the surgeon repairs the stretched ligament and also performs a herniotomy. Shoulder repair is a type of herniorrhaphy in which a herniotomy is performed to repair the hernia using the surrounding tissues with absorbable and non-absorbable sutures in different layers.
The third surgical method is hernioplasty, which is performed on patients with good muscle condition or not, with indirect or direct hernia and also with recurrent hernia. This approach is done to strengthen the back wall of the inguinal canal. Strengthening is done by repairing the weak back wall with prolene mesh or Marlex mesh. For this reason, a thick fiber layer is formed, which acts as a foreign body and our immune system provides it with the necessary cement. An artificial deep ring is also made. This network technology is quiet brilliant because it has a long life, preferably socio-economic; the risk of infection is minimal when handled in a sterile environment and also thanks to its amazing biocompatibility. In a few cases, Prolene parsing is also done, which is basically sewing and strengthening the loose ends.
There are few other techniques such as Kuntz operation usually done for elderly people, Mcvay, Nyphus repair, Stoppa repair, Marcy repair. More recent advances are game-changing, such as the Dasarda technology, which creates a hernia system that is exceptional, and mesh plug repairs are gaining popularity because they have much better patient compliance.
Laparoscopic surgery or open surgery? I think open is a better choice for this space. But both have their pros and cons. An open cut interferes with the function of the bowl. Also, if complications arise during laparoscopic surgery, the surgeon would have to open up and go old school. In addition, open surgeries are cheaper than laparoscopic ones, but the recovery time clearly varies.
Complications are often common after surgery. They can be during, before or after surgery. They are not worrisome, but few require surgical treatment. Care must be taken against postoperative wound infection caused by the patient or his caregivers. In very rare cases, patients complain of lower abdominal pain, which is a typical dragging pain for months after surgery, which may be due to damage to the surrounding nerves. This is treated with nerve blocks with anesthetics and steroid injections.
If a hernia is not treated at the right time, it can cause several serious complications, such as
• Obstructed hernia.
• A strangulated hernia is silent infamous because it can cause shock and sepsis and needs immediate surgical treatment because the bowel can be lost to gangrene.
• A sliding hernia is an incarcerated hernia into which stool can slide.
• Inflammation is yet another obstacle that can range from a simple hernia to a life-threatening one.
• Recurrent hernia is common in 10 percent of those previously treated.
With all the advances in surgery and medicine, hernia is one of the most common cases that require effective, relentless and immediate treatment. So don’t ignore the piece because it’s not so Gump.
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