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In a human body every organ has designated, specific location and it is kept in that location by surrounding organs, fascial layers and muscles. Heart is in the centre of rib cage, wedged between two lungs, Liver is in upper abdomen on right side and kept in position by ligaments, fascial attachments to surrounding muscular wall etc.

Maintaining this position is very important for normal functioning of that organ and to avoid twisting/ pinching of its blood vessels.

When any organ leaves its designated place and protrudes out through it’s containing muscle wall, it’s called HERNIA.

Symptoms and complications of Hernia

1. Appearance of bulge

This is the most common symptom. The bulge appears whenever pressure inside the abdomen increases, like

during coughing, sneezing, lifting heavy weight, straining to pass stools or urine.

2. Pain

Dragging Pain May be felt at the site of hernia. Sometimes blood supply of the herniated intestines is compromised causing severe pain. This is called strangulation. It needs emergency surgery to prevent gangrene of intestines.

3. Obstruction

Sometimes intestines herniating through the muscles get pinched by the muscles. Because of this air and food inside the intestines can’t move forward. Patient experiences distention of abdomen, severe abdominal pain and vomiting. Urgent operation is required to save the intestines.

Treatment of Hernia

1. Open Repair

In open repair, cut is taken at the Hernial site. Defect is manually closed and it is strengthened by fixing a mesh.

2. Laparoscopic Repair

Hernias can be easily tackled by keyhole surgery. Operation is done through small holes of size of maximum 1 cm. Large mesh is passed inside and fixed inside the body with help of an instrument called tacker. It is preferable method of repair as many defects can be covered through same holes.

3. Divarication of Recti

There are two vertical muscles in the center of abdomen which start from breast bone and go right upto pelvic bone (pubic bone). Sometimes due to increased abdominal pressure, the two

muscles split in midline and further get separated due to outward pull of flank muscles. This gives rise to big midline defect. Usually it can be seen in female patients who had multiple

pregnancies. Along with this there Is fatty, pendulous abdomen. This gives back strain.

The condition can be effectively tackled by abdominoplasty. This surgery brings two recti together and recreates new , strong midline. Excess of loose skin and fat excised. This gives beautiful, taught abdomen and scar is hidden inside the bikini line.

4. Abdominal wall Reconstruction

This is newer modality wherein very large defects, recurrent hernias, multiple hernias at different sites in abdomen are effectively treated. Practically whole of the muscular, front wall of the abdomen can be reconstructed. ­

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