Dr Shivaram is a dear colleague. We often chat over black Tea about everything from surgery to local politics. I was at our office doing just that when this young lad walked in, he had a surgical scar over his groin: his story tells it all. He was diagnosed to have a hernia some years ago and was advised surgery. Like most others having been told this he decided to procrastinate! Then it happened, his hernia strangulated, he was rushed in for surgery and was lucky to have come through without a complication. In the process he had to lose more than a foot of his gut. This could have been avoided if he had undergone surgery when it was first diagnosed. Our discussions went on to hernias and this is what Shivaram has to say about the whole subject;

A Hernia is a “window of weakness” that has opened up in the muscles of the abdominal wall. Hernias can occur in several places in the body. Anybody of either sex can get a hernia at any age.

A hernia is usually noticed as a lump commonly in the groin or navel area. It appears when a portion of tissue which lines the abdominal cavity (peritoneum) breaks through a weakened area of the abdominal (belly) wall.

This can give rise to discomfort as the hernia enlarges and can sometimes be dangerous if a piece of intestine becomes trapped (strangulated) inside.

There is almost no limit to how BIG a hernia could get if left untreated!

The opening of a hernia cannot heal itself; neither can any medicine be used to cure the condition. The long term course, therefore, is for a hernia to become steadily worse as time goes on, sometime slowly and sometimes quickly.

The only way to stop a hernia getting worse is to repair the defect surgically, but that doesn’t mean that one will be invalid for a long time.

The traditional (and still widely used) method of hernia repair is to push back the hernia contents under anesthesia and close the defect with stitches or with a patch of mesh.

A newer method of hernia repair is the laparoscopic technique. In this method the surgeon inserts small tubes into the abdomen. A video camera lens passed through one such tube helps to look at the insides and through the other tubes the surgeon operates while looking at the image on a television monitor.

This approach is more technically demanding and requires considerable training and expertise.

The advantage of this technique is that only a small incision is required (“Key-hole” Surgery) and hence post operative pain and discomfort are minimal. The recovery is fast and one can resume ones normal activity and office work within a week’s time. Strenuous activity and sport can be resumed a little later.

No particular after care is required with this operation; there are not even any stitches to remove.

This method is cost effective since return to normal work is achieved early and any loss of earnings from a protracted period of recuperation is avoided.