Apollo Gleneagles Hospitals, Kolkata launches India’s first dedicated Department for Comprehensive Hernia Surgery

Apollo Gleneagles Hospitals, Kolkata has launched a dedicated Department of Comprehensive Hernia surgery. The department will address treatment of all kinds of hernias from the simple to the extreme, complex ones through the most modern surgical techniques. Hernia is basically a gap in the muscles and fascia of the abdominal wall through which the inner contents, small and/or large intestine, stomach, bladder etc, may protrude out from the abdomen, below the skin.

Apollo Gleneagles Hospitals, Kolkata is the first ever hospital in India to have a dedicated department for comprehensive hernia treatment. The pioneering concept ensures a more specialized approach towards treating hernias. State-of-the-art facilities and advanced equipments assist the team of expert surgeons to tackle the most critical hernias.

There are several types of hernias broadly divided into internal and external hernias. Internal hernias are not apparent on the outside and can be dangerous while external ones are the more common ones and are of several types. Following are the external hernias – Inguinal hernia, Femoral hernia, Incisional hernia, Umbilical hernia, Epigastric hernia, Lumbar hernia, Spigelian hernia, Paraesophageal and Diaphragmatic hernia, Parastomal hernias and Diastasis of recti.

Common symptoms of hernia:

• Swelling in the groin or abdominal wall which increases on prolonged standing, coughing, sneezing or even a good laugh!
• Pinching or dull aching pain in the swelling.
• Constant pulling sensation inside the abdomen.
• Constipation.
• Backache due to poor posture.
• Hernias may lead to obesity and the reverse is also true.

Surgery is the only way out to treat a hernia. In current times, laparo-endoscopic approaches have mitigated the fear involved with open surgery such as long cuts, prolonged and severe pain, delayed recovery, loss of work and wages. Using mesh is the gold standard followed worldwide to reduce the chances of recurrence. Many patients have difficult hernias that defy conventional surgical solutions. The department would serve as a tertiary referral centre for all such cases. At Apollo Gleneagles Hospitals, the latest hernia surgeries include minimal hospital stay and low pain scores. The patients are generally able to walk and eat within 4 hours of surgery and go home the next morning.

Speaking on the occasion, Dr B Ramana, Senior Consultant Laparoscopic and Hernia Surgeon, Apollo Gleneagles Hospitals Kolkata, said, “We try to ensure speedy recovery of the patient so much so that s/he can get back to normal life almost immediately after the surgery. These modern laparoscopic surgery techniques lead to reduced post-operative pain, minimal blood loss and single day hospital stays in most cases. The department would offer the entire gamut of modern AWR procedures comprising of open, minimally invasive and robotic approaches. The most advanced surgery techniques include eTEP, TAR, SCOLA, BOTOX, PPP etc.”

Incisional hernias occur to 20-30% patients who undergo any kind of open abdominal surgery. This is specially seen in women after pregnancy and C section. These hernias are typically difficult to cure using traditional surgeries and with more number of attempts to cure the hernia the complications increase along with increased failure rate. Hence the need for specialized hernia treatment using new techniques comes in picture. Women after pregnancy even have flabby abdomen due to the abdominal muscle losing its tenacity while giving space for the growth of the uterus. This goes mostly unaddressed till the belly becomes very saggy, or the patient feels low back pain. Using the modern SCOLA method, the shape and tone of the abdominal muscles may be regained, with the scars being barely visible.

The modern hernia treatments at the Department of Comprehensive Hernia Surgery would include:

• e-TEP : the most advanced surgical approach for inguinal, incisional, umbilical, epigastric and lumbar hernias in the world. One can walk and eat within 4 hours of surgery and go home the next morning.
• TAR – complex hernias, hernias with loss of domain and multiply recurrent hernias may need this complex surgery known as Transversus abdominis release. This may be an open or endoscopic approach depending upon individual case.
• SCOLA – subcutaneous onlay laparoscopic approach is a minimally invasive approach for small umbilical hernia or epigastric hernia with diastasis of recti or diastasis of recti alone.
• BOTOX – Hernia with loss of domain may need temporary paralysis of abdominal muscles for complete reduction of hernia contents.
• PPP – Preoperative progressive pneumoperitoneum is also an adjunct used in modern day hernia surgery in cases of loss of domain hernia.
• Groin pain – pain in the groin could be related to problems of hips, spine, muscle and most importantly an occult/hidden hernia.
• Mesh related complications.