Mrs Swati (name changed), 45 years old woman had already been operated three times for her hernia. Despite that, she was suffering from it again leaving her with a large ugly bulge with scars that aggravated on standing. She had to wear a belt to hide it and could not wear saris too. She had to give up on her dancing that she was fond of. Her doctor told her that the hernia contained foodpipe that could turn dangerous anytime. Also, she had gaineda lot of weight as she gave up dancing. Her doctor explained that she should lose weight before getting the surgery done. She was scared of operations, having undergone three times earlier. She was also disgusted with the ugliness of the scars because of the previous operations. She wanted a comfortable and reliable solution to her problem.
She visited us with this request two years back and consulted us for her sorry condition. We understood her plight. A detailed evaluation of her condition was done and cause of failure of previous operations ascertained.
It was found that the first two surgeries were done without a mesh (an artificial sheet that bridges the defect without causing harm to the body). The mesh is now known to be an essential method to reduce failures from hernia surgery. The third surgery was done by traditional approach and a defect was missed. The patient’s excess weight along with the above mentioned factorswere responsible for the failure of the surgery.
We explained to her that we would need to reduce her weight first by diet. Then we would go for laparoscopic surgery during which we would look for all the defects from inside and cover it with the largest possible mesh from underneath. This should her chances of failure. The part that she liked the most was that in the laparoscopic procedure, there would befewer scars, less pain and less chances of would infections.
We also gave her the options of various modern meshes and fixation devices available for hernias. The modern meshes would be softer and more pliable that would give her more comfort. The newer fixation devices would get absorbed in her body with time adding to the comfort.
She agreed to the plan, lost some weight and got operated two years back. Her large bulge at the lower belly due to the hernia is now all gone. She has taken up dancing once again that she used to love.
It is distressful for the patients with hernia when their surgery fails. Patients should know their options of hernia surgery and the types of modern mesh that are available before submitting themselves for surgery. Hernia patients who are obese should get their weight reduced ideally before taking the surgery. All this should reduce the failures in Hernia surgery.
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