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hernia after delivery
Discussion in 'All Categories' started by anita thakur - Feb 26th, 2012 12:57 pm.
anita thakur
anita thakur
i have a baby of 10 months through sigerian, i got problem of pain in right side of my abdominal, after scan i got it is hernia.
re: hernia after delivery by Dr M K Gupta - Mar 3rd, 2012 7:58 pm
Dr M K Gupta
Dr M K Gupta
Dear Anitha Thakur

You have developed hernia and dow you need to have laparoscopic repair. In laparoscopic hernia surgery, a telescope attached to a camera is inserted through a small incision that is made under the patient's belly button.

Two other small cuts are made in the lower abdomen. The hernia defect is reinforced with a mesh and secured in position with stitches/staples/titanium tacks or tissue glue, depending on the preference of your individual surgeon.

Ventral Hernia Repair (Laparoscopic)

Incisional, Ventral, Epigastric, or Umbilical hernias are defects of the anterior abdominal wall. They may be congenital umbilical hernia or incisional. Incisional hernias form after surgery through the incision site or previous drain sites, or laparoscopic trocar insertion sites. Incisional hernias are reported to occur in approximately 4-10% of patients after open surgical procedures. Certain risk factors predispose patients to develop incisional hernias, such as obesity, diabetes, respiratory insufficiency lung disease, steroids, wound contamination, postoperative wound infection, smoking, inherited disorders such as Marfan's syndrome and Ehlers-Danlos syndrome, as well as poor surgical technique. Approximately 90,000-100,000 incisional hernia repairs are performed annually in the United States.

These hernias present much the same way inguinal hernias do. That is, they present with a bulge near or at a previous incision. Some patients may experience discomfort, abdominal cramping or complete intestinal obstruction, or incarceration as a result of these hernias.

The principle of surgical repair entails the use of prosthetic mesh to repair large defects in order to minimize tension on the repair. A tension free repair has a lesser chance of hernia recurrence. Traditionally, the old scar is incised and removed, and the entire length of the incision inspected. Generally, there are multiple hernia defects other than the one discovered by physical examination. The area requiring coverage is usually large and requires much surgical dissection. A prosthetic mesh is used to cover the defect, and the wound closed.

This is a major surgical procedure and often complicated. Infection rates following repair may be as high a 7.0%. Recurrence can be up to 5%, or higher, depending on the patient's preoperative risk factors. While the use of prosthetic mesh has decreased the number of recurrences, it has also been implicated in increased infection rates, adhesion or scar formation of the abdominal contents to the anterior abdominal wall leading to intestinal obstruction and fistula formation. However, overall, recovery is usually excellent and patients return to normal activity within a matter of weeks.

The laparoscopic repair of ventral hernias was designed to minimize operative trauma to the patient. As mentioned, these are often complicated repairs requiring large incisions and extensive tissue dissection. The principles governing a laparoscopic ventral hernia repair are based on those of open Stoppa ventral hernia repair. A large piece of prosthetic mesh is placed under the hernia defect with a wide margin of mesh outside the defect.

The mesh is anchored in to place with eight full thickness sutures and secured to the anterior abdominal wall with a varying number of tacs, placed laparoscopically.

A patient is a candidate for laparoscopic incisional hernia repair if they are medically able to undergo general anesthesia. Also, the defect must "allow" the surgeon to place the laparoscopic trocars in such positions that repair are ergonomically possible. In some very large or giant hernias, the abdominal wall is distorted to such a degree that it is impossible to safely place laparoscopic trocars. Ancillary studies, such as CT scan of the abdomen and pelvis are helpful in making this decision. Patients are also given a bowel preparation to evacuate the colon and decrease the number of intestinal bacteria prior to surgery.

Patients are admitted the same day of their surgery. Following the procedure and recovery from anesthesia, they are taken to a hospital room where they spend the night. We encourage our patients to move as quickly as possible. It is extremely important to be active early in order to stave off some of the complication seen postoperatively, such as pneumonia, deep venous thrombosis and pulmonary embolism (clots in the legs that break off and go the lungs). Postoperative pain is variable, and can be considerable during the first 24 hours. As such, patients are given I.V. narcotics as needed, and are changed to oral analgesics the next day. Generally, most patients stay in the hospital 1 or 3 days following surgery. Patients are then seen, by the surgeon, one to two weeks after discharge. There is no dietary restriction. Activity level is restricted by the patient's comfort level. However, it is generally not advisable to engage in any strenuous exercise or heavy lifting for several weeks, to allow the hernia repair to heal.

With regards

M.K. Gupta
re: hernia after delivery by atiye - Mar 13th, 2012 7:53 am
No Jim you don't know my background or the job I do to pay my bills. I enulotevr my time for Breath of Hope no paycheck and sometimes I work on that 50 plus hours a week. As for Malaria, the company I work for is International. What I know from that Awareness Day is that Malaria is becoming resistant to treatment out there. (I work for a Clinical Research Organization perhaps you should Google that and see what they do. I am currently on several Pediatric Clinical Drug Studies why I know of MPS.)As for the Childhood Cancer we have a hospital in my area which has a Pediatric Cancer Department. I also had a dear friend who lost her daughter to cancer. The CRO I work for does extensive studies in cancer drugs.So you know a bit of the background and training I have had. When we launched the Congenital Diaphragmatic Hernia Awareness Day in 2007 (when Breath of Hope started it's operation as a NPO), we did extensive research on other organizations and how their own Awareness Campaigns were implemented. (Learn by example.)I respect the point that there are some out there that use these Awareness campaigns to profit from in less than productive ways. An example is the Breast Cancer Awareness Campaign. It has become a way for Corporate America to Pinkwash their products to make profit. Something we don't want to happen to the Congenital Diaphragmatic Hernia Awareness Campaign. (Though those with little minds do not understand the business undertaking nonprofits must undertake.)
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