Inguinal hernia repair

 

Being the most frequently performed procedure in general surgery, it might be thought that there is nothing new to Inguinal hernia repair, considering that this procedure was mastered quite a long time back and tension free repairs have been conducted efficiently. Hernia repair has been, and continues to be a wide spectrum in medical literature. This branch of medicine is constantly evolving, as newer techniques come into light, allowing more durable repairs along with less morbidity, earlier return to physical activity and more importantly, leaving the patient free from chronic discomfort or pain.

An inguinal hernia arises when the peritoneum and abdominal structures protrude through the anterior abdominal wall via the inguinal canal. This can be broadly classified as Direct and Indirect. Indirect hernias enter the canal through a congenital defect in the internal inguinal ring and often present in infants or young children. Direct hernias, however, protrude through an area of weakened fascia in the posterior wall of the canal, commonly affecting older individuals. This process might be instigated due to obesity, ascites or increased abdominal pressure due to, for example, pregnancy or chronic cough.

Recently there has been a significant focus on the development of these hernias and worldwide herniologists have accepted a generalized connective tissue disorder, known as herniosis, to be a causative factor in most patients.

Since the years of hernia repair involving a big incision and keeping the patient in a plaster of paris hip spica cast for 7-10 days, there have been huge advances in the field of inguinal herniorrhaphy. Eliminating the tension from the abdominal wall layers during hernia repair has been the greatest advancement in hernia surgery. The prosthetic materials used in the [procedure overlays the anterior surface of the internal oblique muscle and conjoint tendon laterally and the rectus abdominis and pubis medially, attaching below to the inguinal ligament.

This has been made possible due to the development of prosthetic materials such as polypropylene, Dacron and extended PTFE initially. More recently, biological materials including Alloderm and PermacolTM.

The most notable name for the best general surgeon in Kolkata is Dr. Gaurav Kumar, who has been constantly working in Narayana Superspeciality for the last 5 years, in the department of GI surgery, Minimal Invasive Surgery & General surgery. He mentions the importance of letting your patients know about their diseases and making them aware of what their diagnosis means, explaining the risk factors and so on so as to make sure that there is full awareness of decisions and a clarity during the whole procedure, leaving no place for misunderstanding.