Hernia – Mini incision technique

Dhiren Nehra

Mr Dhiren Nehra MPhil, FRCS
Consultant Surgeon, St Anthony's Hospital

For appointments 0208 337 6691, 01372 221 441, 0208 335 4501
Email: dnehra@doctors.org.uk
website: www.mrdnehrafrcs.com



Definition

Hernia is a general term for a bulge or protrusion of an organ through a part of the body in which it is usually contained.


Description

There are many different kinds of hernias. The most familiar are those that occur in the abdomen. In this type of hernia, a part of the intestines protrudes (sticks out) through the wall of the abdomen. An abdominal hernia can occur in different areas. The name given to the hernia depends on the location in which it occurs. Some examples of abdominal hernias are the following:

  1. An inguinal hernia appears in the groin. It may come and go depending on various factors, such as the amount of physical activity. Inguinal hernias account for 80 percent of all hernias. They are more common in men.
  2. Femoral hernias are similar to inguinal hernias, but they occur lower in the body. They are more common in women, and commonly occur during pregnancy.
  3. An incisional hernia. The name reflects the fact that it often occurs at the location of an old surgical scar (incision). A ventral hernia is caused by the stretching of scar tissue.
  4. A paraumbilical hernia occurs at or near the navel.

Treatment

The surgical treatment for hernia is relatively simple. The hernia is pushed back into the abdominal cavity. A mesh is inserted over the weakened muscle lying on top of the hernia and is sewed back into place.

I employ a 3cm 'keyhole incision' to insert a special double layered mesh illustrated in the pictures above which is stapled in. The procedure can also be performed under a local anaesthetic.

The advantages of this technique are:

  1. Less pain (Local anaesthetic inserted immediately after completion of operation to numb wound)
  2. Quick recovery
  3. Early return to work
  4. Very low recurrence

This method has all the advantages of laparoscopic hernia repairs and is safer with much lower recurrence rate.


Aftercare

  1. No external stitches (absorbable sutures used)
  2. Walking immediately after operation
  3. Resume normal activity including lifting and driving within 2-3 days of the operation
  4. Sports including swimming within 7-10 days

Information provided by Mr Dhiren Nehra MPhil. FRCS

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