A hernia is a condition where an organ or tissue protrudes from its normal place in the body into another unintended space of the body. There are many kinds of hernias, which can present in diverse areas of the body.
The most well-known and common hernia types are the hiatal and inguinal. The former is a hernia of the diaphragm of the abdomen; the inguinal is a hernia in the groin area.
The hiatal hernia develops when the stomach slips through the hole in the diaphragm that normally accommodates the esophageal opening. A hiatal hernia where the stomach and part of the esophagus protrude down this opening is called a sliding hiatal hernia. The hiatal hernia is common cause of the condition known as gastro-esophageal acid reflux disease (GERD) where stomach acids are forced up into the esophagus by the pressure exerted on the slipped stomach by the diaphragm.
Hiatal hernia surgery involves tightening the opening in the diaphragm; tying the stomach around the bottom of the esophagus to prevent future slippage and eliminate stomach acids and food backing up into the esophagus. Hiatal hernia surgery can be done by means of an open belly incision or via laparoscopic techniques. In the latter smaller incisions are made and the repair of the problem is guided by a video camera inserted into the body.
The inguinal hernia occurs due to improper closure of the inguinal canal in men, where the testicle descends to the scrotum during fetal development. The canal should close on its own; when it does not an inguinal hernia can occur. Often the hernia presents after the patient has strained abdominal wall muscles, and appears as a palpable bulge in the groin.
The danger from this type of hernia is that the intestine may protrude through the inguinal canal defect, strangling the organ. This results in a medical emergency, loss of blood flow can mean intestinal– and if uncorrected –patient death.
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Inguinal hernia surgery is not always performed under emergent conditions, although the medical trend with asymptomatic inguinal hernias is “watchful waiting” over surgical intervention. Often wearing a truss is recommended; when the inguinal hernia patient begins to develop symptoms surgery is then advised. Of course, in cases where the bowel is caught in the opening, the surgery becomes an emergency procedure.
Both hiatal and inguinal hernia repair surgery is done under general anesthesia where the patient is unconscious and without pain. Open hiatal hernia surgery usually involves a hospital stay; the laparoscopic version of the surgery may be done on an outpatient basis.
Barring complications the open incision hiatal hernia surgery recovery time is 4-6 weeks and laparoscopic hernia surgery recovery time is 2-3 weeks before return to a normal routine.
Hernias can occur virtually anywhere in the body, including the discs of the back which separate and cushion the vertebrae of the spine.
Lumbar discs can degenerate over time due to normal aging, injury or repeated back strain. A herniated disc occurs when the fluid inside the disc begins to leak out of the outer aspect of the disc. This causes pressure on the roots of the nerves that radiate out from the spine. A condition called sciatica can then develop as a direct result of the compromise; the symptoms of which are leg pain, numbness, tingling and weakness anywhere in the leg, down to the foot.
Herniated disc surgery (also known as bulging disc surgery or sciatic surgery) usually involves only the removal of a portion of the ruptured disc that is impinging on the nerve root to relieve the pressure on the compromised sciatic nerve.
Herniated disc surgery used to require a large incision and months of recovery time; thanks to new techniques in microsurgery this operation can now be done using small incisions which reduce healing time to 2 to 3 weeks post-surgery.
Hernia surgery cost is variable, depending on which area of the body is affected and how invasive the procedure to correct the problem is. Geography and surgeon experience also factor into final cost. A relatively minor inguinal hernia correction will be cheaper if done laparoscopically in most areas. Spinal surgery of any type, due to massive numbers of nerve roots and nerves radiating from the spinal structure is a more delicate surgical proposition and will have a higher cost than other types of hernia surgeries, whether done via open incision or laparoscope.