#hernia #kimshospitals #herniaoperation
​ Another common fear of patients with hernia is doctor you are going to do my hernia operation will it come back again, someone they know had undergone the hernia operation five years back and today their hernia is back, I have also herd similar stories from my friends so I have been discouraged that if I get it done now it is just going to come back after five or ten years, so , will I get my hernia back?Short answer is - it depends , the long answer is it depends on what? Hernia repair is an operation where we try to recreate the weak abdominal wall using reconstruction of the muscles and also using a mesh, but the final success of the operation depends on multiple factors, because when the healing is good the scar is healthy.
Is patient a diabetic ? if they have very high blood sugar the tissue quality is poor and the healing is poorer, and if they dont maintain good sugar control the scar tissue which is formed will be weak.And the patients with diabetes can have a higher rate of failure of hernia operation in the long run if they do not maintain good sugar control.
Obese patients : Patients who are extremely obese their muscle mass is thinner, or if a patient gains a lot of weight after hernia repair, then because of excessive stretching the scar tissue is pulled or stretched and thereby the hernia repair can give way.
Smokers : The quality of the cement, the body scar can be reffered to as cement,The cement that the body produces to heal any wound the quality of that cement or collagen is directly affected by smoking, so if the patient continues to smoke after the operation the quality of the scar is very poor and the hernia can come back again.
Patients who have recieved pervious radiation therapy : The tissues are generally damaged by the radiation and these hernias can recurr again.
Other factor such as : Patients who have chronic severe coughing , or patients who do very strenious activity very early after the hernia operation, these patients can have weakening of the scar.
The second group depends on the treatment:
What is the experience of the surgeon?
What was the technique that was used for the hernia repair? Was the technique appropriate for that type of hernia? As we have discussed certain hernias as best treated by laparoscopy and certain hernias are best treated by open surgery. Right operation for the right patient the chance of success is very high.
Generally the result of an operation is discussed with the patient before the surgery where we asses all these factors and give them a rough estimate of what is the chance of success of a hernia operation.
One common question of patients is If I undergo this operation when will I recover from this surgery fully. There are various meanings to the term recovery
1. Recovery from pain : When will I be pain free or when can I sleep peacefully without pain?
2. Recovery to normal daily activities : When can I get up on my own? When can I go to the toilet without anyone’s help? When can I get down from the bed on my own? When can I walk around the house?
3. Recovery to resume day to day activities and going to the office
4. Recovery to do fitness and sport activities
1. Recovery from pain : Most of the hernia operations pain management techniques which we have seen advanced over the days and we have excellent pain management techniques in the present day wherein majority of our patients are pain free the following day after the hernia operation, they are able to lay down comfortably and turn around and have a peaceful night sleep without continuous pain.
2. Recovery to normal daily activities : Most patients undergoing hernia operations are able to do this the next day. If the patients are very obese or elderly they may need another couple of days to resume their daily care activities around the house.
3. Resume going to the office or outdoor activities: Usually takes a week to ten days after the laparoscopic repair and maybe 2-3 weeks for an open hernia operation.
4. Recovery to do fitness and sport activities : It varies from patient to patient and depending upon the type of hernia repair there is a difference. Laparoscopic groin hernia patients can resume their stretching and cardio exercises 1 month from their operations, and 3 months from surgery they can start weight training and other high intensity exercises. Open hernia patients are generally advised to stay away from heavy lifting and other high intensity activities for 3 to 6 months after the surgery depending upon the type of repair, but they can resume walking, stretching, yoga four weeks after the surgery.
by
Dr. G. Parthasarathy
Sr. Consultant, Surgical Gastroenterology,
Laparoscopic & Hepato-Pancreaticobiliary Surgery
KIMS Hospitals , Secunderabad