Hernia Specialist in Pune, Dr. Abhijit Gotkhinde
What is HERNIA?
It’s nothing but the abnormal exit of tissue or organ ( such as intestine, omentum, etc) through the wall of the cavity in which it normally resides. A hernia occurs when the inside layers of the abdominal wall weaken and then bulge or tear. This, in turn, can cause a loop of intestine or abdominal tissue to slip into the sac, causing severe pain and other potentially serious health problems.
Hernias by themselves may or may not produce symptoms as they are asymptomatic and can cause slight to severe pain.
What are the Types of Hernia?
There are numerous arrangements to name and type the hernia. To streamline for persistent we name hernia according to the area where it shows up.
1. GROIN HERNIA
A. Inguinal Hernias
Men are more prone to inguinal hernias than women because of basic differences in anatomy & The area where hernias occur most often has a very different function in men than in women.
Inguinal hernias are located in the lower abdomen i.e. groin, they appear as a bulge usually after coughing or straining. Sometimes it goes towards the scrotum, It usually occurs when fatty tissue or part of the bowel, bulge out through a part of the lower abdominal wall known as the inguinal canal.
A direct inguinal hernia occurs due to weakness in the floor of the inguinal canal, commonly seen in chronic conditions that increase intra abdominal pressure like chronic cough, chronic constipation.
Indirect inguinal hernia may occur at birth or later in life. Indirect hernias are more common in males. They occur when the inguinal canal fails to close before birth. The hernia may appear in a male’s scrotum or in the fold of skin at the opening of a female’s vagina.
B. Femoral hernia:
It is commonly seen in women. They occur due to a weakness in the lower groin region usually as a result of pregnancy and child. These hernias are more prone to complications and hence should be repaired once they are diagnosed.
2. Naval hernia (Umbilical / Para umbilical Hernia)
It happens when part of the digestive tract projects through the umbilical opening in the abs. These hernias may happen in newborn children at or soon after birth and may resolve by three or four years old. Notwithstanding, the zone of shortcoming can continue all through life and can happen in men, ladies, and youngsters whenever. In grown-ups, umbilical hernias won’t resolve and may continuously compound after some time. They are in some cases brought about by stomach pressure or because of overweight, unreasonable hacking, or pregnancy.
3. Post surgery hernia (Incisional hernia)
It happens from the scar left from a past careful activity in the stomach divider. The patient may see torment or lump at recently worked locales. It is generally found in a persistent condition that expands Intraabdominal pressure and large patient. It might likewise be seen with now and again deferred the mending of wounds because of any explanation. Much the same as an inguinal hernia, it might confound and needs a crisis medical procedure.
4. Upper abdomen hernia (Epigastic hernia):
It occurs above the belly button.
5. Spigelian hernia:
It happens through the Spigelian sash. (its the aponeurotic layer between the rectus muscle and semilunar line)
Adult hernia never get better with time. Surgery is the only way to cure a hernia as it cannot go away on its own.
There is tremendous evolution in the surgery of hernia. It can be done by an Open approach with or without mesh application or the second approach which is gaining more popularity nowadays is – Laparoscopy.
A laparoscopic hernia surgery is a minimally invasive approach that involves the use of laparoscopy and allows a laparoscopic surgeon to repair the weakened area through several small incisions (about a half-centimetre), hernia sac is removed and if required closure of the defect . This closure is accomplished by attaching a mesh patch to the outside of the abdominal wall just beneath the layer of muscle .
Due to the use of mesh, the chances of reoccurrence of hernia is significantly decreased.
Its always divided on the basis of related to surgery and related to the patient. Though chances are less Infection, bleeding injury to the surrounding structure is possible. The risk of complications increases if the patient smokes, takes drugs, or is a heavy drinker, or has other medical conditions.
- Minimal pain and patients are able to return to work more quickly as compared to open surgery.
- Heals faster. Early return to work and normal activities is possible.
- If it’s a recurrent hernia then laparoscopic techniques are easier.
- It is possible to check for and repair a second hernia on the opposite side at the time of the operation.
About Dr. Abhijit Gotkhinde – Hernia Specialist in Hadapsar, Pune
Dr. Abhijit B. Gotkhinde
Consultant Laparoscopic & Laser Surgeon
MBBS, DNB (GEN SURGERY), FMAS,
FIAGES, Fellow in Adv lap.
Dr. Abhijit B. Gotkhinde is one of the Qualified basic & advanced Laparoscopic Surgeons and the best Laser Surgeon in Hadapsar, Pune. He believes in delivering the most authentic and top-class services in Piles, fissures, Fistula Treatments also Hernia Treatments like Epigastric Hernia, Umbilical hernias, Epigastric hernia, Inguinal hernia, Femoral Hernia. He is the best Appendix doctor in Hadapsar, Pine
He has extensive experience in GI & Colorectal surgeries. He has a special interest in Laparoscopic surgery (cholecystectomy, Appendectomy, Hernia, Hysterectomy & Hiatal surgery) and minimal access to proctology surgery. (Piles, fissure & fistula).
There are various types of Hernia occurred in people. These hernias types include hiatus, incisional, and umbilical hernias. Symptoms are present in about 66% of people with Groin Hernias. So many treatments can be done for various Hernia Treatment within Laparoscopic Surgery Treatment. After trying various methods without complete information and knowledge many people fail to achieve the desired Laparoscopic Surgery or Laser Surgery for Hernia and Piles Treatment.
Different people feel varying degrees of pain. Sometimes it’s completely pain-free but may associate with discomfort. Some patient may feel dull aching sensation, and feeling pain while lifting weight
- Irreducibility- contents of hernia like omentum , does not go back ,even on gentle pressure.
- Obstruction: when intestine is the content it may also result in obstruction (intestinal blockage), which is extremely dangerous.
- Strangulation: It occurs when the blood supply to the herniated intestine is cut off or greatly reduced, causing the bowel tissue to die or rupture
A. Medical management
1. High fiber diet(fruits, vegetables, etc)
2. Adequate hydration(proper intake of water)
3. Stool softener (in case of constipation)
4. To decrease the time spent on the toilet
B. surgical Management
Usual treatment options :
1. Change of diet and lifestyle (Grade I)
2. Lotions, medicaments, ointments (Grade I)
3. Rubberband, sclerotherapy, infrared coagulation (Grade I + II)
4. Closed surgery: Stapler Hemorrhoidopexy (Grade III)
5. Open surgery: Milligan-Morgan, Parks (Grade III + IV)
6. Hemorrhoid Laser Procedure(all grades).
1. Couple of days to a week in the hospital
2. Pain for 7-10 days
3. Postoperative bleeding
6. Problems with sitting
7. Open wounds need 4-6 weeks to heel
8. Necessity of taking baths
- Minimally invasive laser therapy of hemorrhoids
- Controlled hemorrhoidal shrinkage
- Very good hemostasis
- Maximized preservation of continence
- Small wound sizesLaser HemorrhoidoPexy (LHP)
Also known as LaserHemorrhoidoPlasty
This approach is used for the treatment of hemorrhoids under appropriate anesthesia. The fiber of the laser is inserted centrally into the hemorrhoidal node and energy is delivered. By this technique, hemorrhoids can be treated according to their size without causing any damage to the anoderm or mucosa.
- If surgery is indicated, this therapy will provide you with an improved patient outcome especially regarding pain and recovery compared to conventional surgical proceeding for 2nd, 3rd, and 4th-degree hemorrhoids.
- Under proper local or general anesthesia, the controlled laser energy delivery obliterates the hemorrhoids from the inside and preserves the mucosa and sphincter structures to an extremely high degree(Tissue reduction in the hemorrhoids).
- The controlled emission of laser energy, which is applied submucosally, causes
the hemorrhoidal mass to shrink.
- In addition, fibrotic reconstruction generates new connective tissue, which ensures that the mucosa adheres to the underlying
- This also prevents the occurrence or recurrence of prolapse. Laser hemorrhoidopexy is not associated with any risk of stenosis. Healing/result is excellent because, unlike conventional surgeries, there are no incisions/cut or stitches.
- Access to the hemorrhoid is achieved by entering through a small perianal port. By this approach, no wounds are generated in the area of the anoderm or mucosa. As a result, the patient experiences less post-operative pain and can return to normal activities within a shorter space of time.
1. No incisions
2. No excisions
3. No open woundsThree treatment principles with laser:
1. Reduction of the hemorrhoidal tissue, not total destruction/excision
2. Reconstruction of the natural anatomy
3. Nontouch of the anoderm
I met Dr. Gotkhinde for laparo chole surgery for gall stone. I want to treat it with medicine only. But with his knowledge of subject , crystal clear thinking and confidence I decided my mind and operated with him. In operation room I remember only one injection and when I woke up, surgery was over. Very little pain after surgery. Got discharge in 2 days.Thanks doctor.
After my difficult c section, I developed a hernia, I was really scared. My gyne sends me to Dr. Abhijit. It was a great decision to go with him. He done laparoscopy. My experience of surgery was exactly the same as what he told me before. He is a perfectionist surgeon.
Dr. Abhijit Gotkhinde sir operated my father for piles using a laser technique. Initially, we were quite anxious but after discussing with him about the procedure we felt confident. Surgery was done in less than 30 min & it was absolutely pain-free. He recovered in a single day. Within 1 week he is ready to work. Now we are thinking we would have done the procedure prior only. I must say, Dr. Gotkhinde is the best laser surgeon for piles.