Some most Commonly Asked Questions about Hernia Surgery

With the usual hernia surgery, it is very common for hernia patients to be unable to even drive a car for 6 weeks afterwards.

Whist we all differ in our recuperative powers, our hernia patients get back to normal routine very much faster than is reported by older methods, elsewhere.
Also, because our patients can, effectively, not be fearful of causing themselves a recurrence, they can be as rigorous as they like, with complete peace of mind.
Most of our patients have started travelling by Local train going to work in about 8-10 days time.
These are just a few examples of very active people and their recovery times.

Patients after hernia surgery at Vrindavan Hernia Institute, some actual cases : -

  • Senior Surgeon, around 70 Years age, operated for Bilateral Inguinal Hernia went home the same day, started operations in two days time & self driving car in 4-5 days time. He is very active & normal after 15 years of his Surgery.
  • Patient of 70 years age with Rerecurrent hernia started Bicycle riding in about 3 weeks time.
  • Patient of 40 years started swimming after one side Inguinal hernia surgery in a week time.
  • Patient of 35 years started playing Tennis in about 4 weeks time.
  • Female Patient operated for hernia started playing cricket in 6 weeks time.
  • Retired army officer, 80 years old started `marching' next day after surgery & playing `GOLF' in month's time.
  • Famous Serial Artist went for shooting in Eight days time. He went self driving & shooting lasted for 12 hours.
  • 97 years old patient with Long Standing Bilateral Inguinal Hernia with repeated attacks of strangulation and Heart ailment, operated for both Hernias and went home in a days time.
  • 105 years old patient with long standing Hernia operated under local Anesthesia & went home in a days time. Any Patient after surgery :- There is no reason why any patient should not be able to ride an Exercise - bike within hours of this operation.
We would not seek to contradict any doctor, but we are increasingly coming to the view that this can be very bad advice. As more than 10% of such patient get strangulation & mortality of strangulation is High. Strangulation needs emergency surgery, mostly under General or Spinal anaesthesia which again is not without risk.
As hernia specialists, we know that hernias ONLY tend to get Worse and every day we leave them untreated, we run the risks of complications setting in as well as facing a larger operation eventually.
The ONLY advice that should be given once a hernia is diagnosed is to get it repaired as soon as Possible.
Where, say, only old-fashioned or inferior techniques of hernia repair are available, the advice to avoid surgery because that kind of operation really WOULD pose a serious risk to the patient, might have some unfortunate merit.
However if the patient has access to the kind of specialised operation described here, it is very rare that a case exists where the patient should NOT have the hernia repaired as soon as possible.
Many of the giant, even almost inoperable high risk, hernias we see, started off being ignored due to such well meaning advice by their doctor. Apart from risk of strangulation, hernia can just get bigger and BIGGER.

I thought that (LAPROSCOPIC) KEYHOLE surgery was the best technique available. Do you agree?

Keyhole (laparoscopic)surgery represents a great advance in many areas of surgery, such as Gall Bladders, ovaries etc.For hernia, though, we find that results that are better can be achieved without the risk of keyhole surgery. The risk associated with operations whilst watching a TV screen do not compare with the `fingertip' control . Furthermore, our preferred approach does not need general anesthesia. Keyhole surgery can only be done with general anesthesia or spinal injections, which carry additional risks.
Checking repair by making patients cough at the end of repair which tests repair as if 70 kg. wt. is lifted from ground to shoulder levels is possible only under Local Anaesthesia & not with general anaesthesia in Laproscopic Surgery. Checking of hernia is the biggest reason for recurrence rate of less than 1%.
The Royal College of Surgeons in England Has Stated that "Laparoscopic Techniques cannot be considered for everyday Practice" in external abdominal hernias.
The American College of Surgeons has similarly stated.
Laparoscopic method may be associated with a high risk of life threatening and in some instance fatal complications.
The operation requires general anesthesia, insertion of tubes through abdominal wall and the pumping of carbon dioxide gas into the abdomen, as well as fixation of mesh by tackers into the muscles. Because of this complications such as injury to the intestine, bladder and major blood vessels can arise. Even deaths have been reported. In addition respiratory arrest due to the carbon dioxide and major nerve injuries from staple guns, have been encountered.
Almost certainly. Until now, much about hernia surgery has been quite dangerous in the elderly, or for patients with other complications. Over 750 such old Patients have been successfully operated for hernia at Vrindavan Hernia Institute. Over 2000 patients over 70 years have been operated.
he operations we do are perfectly suitable for most such patients and you can be rid of the hernia problems very easily. Under local Anesthesia without much risk.
Published reports have shown that usual post-hernia repair problems of urinary retention, ischemic orchitis, vascular and embolic phenomena, long-term pain, and draining sinus tracks are negligible because of minimal dissection & Local Anesthesia. None of the Patient operated at Vrindavan had these Complication.
Patients are permitted to begin lifting up to 15 pounds, whenever desired. Assuming that the individual will feel all right, they may resume normal day-to-day activities (i.e. Dinner engagements, light exercise, walking etc.), including return to work, at their own discretion. Heavy manual labour is begun in 6 weeks and other less intensive activities (i.e. aerobic workouts, bicycling, jogging, etc.) in a proportionally shorter amount of time, in adults.
As with any implanted prosthetic material, concerns regarding their long term fate and potential side-effects must be acknowledged. However, polypropelene material unlike other prosthetic material has been in clinical use since the late 1950's. Consequently, there is a wealth of material about its biological compatibility, highlighted by a noticeable lack of adverse events.
In operating on recurrent defects, the general surgical principle is to perform as little overall dissection as possible. Accordingly, routine attempts to identify fused anatomic layers are not made. Unlike primary repairs, with a recurrent hernia the spermatic cord is not routinely mobilized since attempts at such mobilization can cause damage to an already compromised cord, In indirect recurrent hernia. The recurrent direct sac is similarly freed; It is mandatory with all recurrent hernias that the mesh plug is adequately secured with multiple sutures between it and the scarred margins of the rigid inguinal floor defect or the scarred internal ring.
The British Hernia Centre's preferred method in most cases
Under local anaesthesia, an adequate incision is made over the site of the hernia. The peritoneal bulge is returned to where it belongs, but the repair is achieved by placing a piece of fine (inert and sterile) mesh at the opening in the tissue. This is firmly held in place and the outer incision closed. The whole operation takes 25- 30 minutes to perform.

The healing process starts to take place immediately whereby, (sensing the presence of the fine mesh) the muscle and tendon send out fibrous tissue which grows around and through the mesh, incorporating it in a way similar to the placing of the steelwork inside reinforced concrete.

The results are also similar to the concrete analogy, in that the mechanical load is spread over the whole area, precisely at the area of weakness, The patient is able to walk away from the theatre immediately after surgery.

Typically, with this technique:
  • A painless operation that takes minutes to perform
  • No need for general anaesthesia in most of the cases
  • Home next day
  • Back to normal extremely quickly (back at work within days)
  • All kinds of sport possible afterwards
  • Reliable against recurrence
  • Advanced age no longer a barrier
The Shouldice repair is internationally recognized as one of the safest and most effective techniques for repairing hernias. When performed by a specially trained and well-experienced Shouldice surgeon, this pure, natural tissue repair virtually eliminates complications or repeat hernias (recurrences). For over 65 years, we have maintained a success rate of 99.5% on primary inguinal hernias - an accomplishment that sets us apart from any other medical facility, in over 3,00,000 hernia surgeries
- Mike - Boston
The Shouldice repair combines a proved surgical technique with the powerful benefits of the body's own natural healing ability. This results in a secure, reliable repair and a rapid, comfortable recovery for our patients.

Almost all of the hernia repairs at Shouldice are done using only a local anaesthetic, a sedative (sleeping pill) and an analgesic (pain pill), which adds to the safety of our technique. This approach reduces surgical complications, improves recovery and ensures that our patients are comfortable during surgery. Additional medication may be used when necessary or, in some cases, a general aesthetic may be required.
As part of the Shouldice procedure, we do a thorough search for other hernias in the area and repair them, too. This aspect of our technique is unique and not commonly practiced elsewhere as a routine. Research has shown that up to 13% of people with hernias have a second weak spot in their muscles or a "hidden" hernia. Our skilled surgeons have the time and expertise to find these hidden threats - In fact, it's one of the most important benefits of the Shouldice repair.
If a secondary hernia is not revealed during surgery, it may lead to another operation to repair it, increasing your risk of complications and future recurrences.
At Shouldice, we firmly believe that it is in the best interest of our patients to cure hernias permanently by finding and repairing all secondary hernias, by making patient cough after primary repair.
Technique Used Vrindavan Hernia Institute is combination of above two techniques where excellent tieeues repair is complemented with lite or ultralite Polyprolelene mesh material, giving excellent result of hardly any recurrence (0.1%) due to checking repair by making Patient cough. Done underlocal anesthesia with sedation.



 

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