A hernia is the protrusion of an organ through the protective tissue that surrounds it. Hernias can often be treated successfully with a simple surgical procedure consisting of pushing back the herniated tissue, and performing repairs to mend the weakened area. Traditional approaches involved surgical stitching, but postoperative complications associated with these techniques led to development of more effective modern practices. Various non-surgical options are also available, but should not be considered without consulting a doctor.
Open Tension Repair
First described in the 1889, and published in "Padua," open tension repair is a procedure in which the edges of the herniated tissue are sewn back together without the use of any other reinforcing materials. This form of surgery is not used very often due to the high rate of recurrence and post operative pain, according to hernia.org. The problem with using surgical stitches is that localized pressure is often created, leading to a rupture of the tissue or stitches, resulting in relapse.
Open Tension-Free Repair
Replacement of stitching with this mesh-based tissue repair method spreads tension much more evenly around the organ, thus dramatically reducing the chances of a relapse. In the open tension-free repair method, a synthetic mesh is placed over, and sometimes behind, the herniated region, as demonstrated in the pioneering surgical study published in January 1986 in "International Surgery." Muscle and tendon sends out fibrous tissue through and around the mesh, resulting in the formation of a protective barrier that repairs the hernia, according to hernia.org. This procedure is frequently performed under local anesthetic, and the patient returns home within a few hours.
Laparoscopic Repair
Keyhole or laparoscopic surgery is a technique whereby a small incision is made and a telescope inserted through into the body cavity. In keyhole surgery, a repair mesh is placed behind the herniated area, as opposed to over it, and a protective barrier forms in the same manner as the open-tension free repair technique.
Best Treatment Option
In common with many other surgical practices, hernia operations are moving towards keyhole techniques due to the decreased bleeding, reduced postoperative infections, rapid recovery rate and short operation time in comparison with traditional open surgery techniques, according to research performed by the National Institute for Health and Clinical Excellence. With large hernias that require complex and lengthy surgical repair, open surgery is the best available option, as visibility and access to a large area of herniated tissue is often better, according to hernia.org.
Non-Surgical Options
Various non surgical options are available for treating different types of hernias, including belts or briefs that apply constant pressure to the abdomen and pelvic region respectively. However, in many cases, surgery is the best or only available option. The importance of consulting a doctor cannot be underestimated, as patients with improperly treated hernias may develop life-threatening complications, according to the website, Herniabrief.
References
- PubMed: International Surgery: Ambulatory Outpatient Hernia Surgery: Lichtenstein IL & Shulman AG: Jan 1986
- National Institute for Health and Clinical Excellence: Hernia - laparoscopic surgery review
- hernia.org: What Methods of Repair are there?
- "Padua": Nuovo Metodo Operativo per la Cura dell'ernia Inguinale: Bassini E: Nov 1889
- Hernia Brief: Introducing Treatment Options Available for Hernias
