Jammu, July 20, 2021 : Team of doctors lead by Dr A K Kriplani, Director and HOD, Minimal Access, Bariatric and G I Surgery at Fortis Memorial Research Institute, Gurugram recently successfully treated two female patients of Jammu suffering from large complicated hernia associated with other medical problems.
Hernia is a common problem after repeated abdominal surgeries particularly in females. Besides causing pain, vomiting and occasionally obstruction, large hernias are associated with immobility, and lower backache due inability of the abdominal wall muscles to keep intestines in place. It also causes lot of anxiety and negative psychological connotations, mental anguish due to disfigurement of a protruding bulge and uncertainty of surgical outcomes. The first concern of the patient and attendants is usually “will it recur again after surgery”.
Dr Kriplani and his team at Fortis Hospital Gurugram have a vast experience of treating large and complex hernias by a system of surgical repair called abdominal wall reconstruction (AWR). These surgeries include a spectrum of complex laparoscopic procedures for defects upto 8 cm wide and open procedures for larger (above 8 cms) / multiple defects. They aim for a near zero recurrence after their surgeries. This is achieved with a judicious choice of the patients and procedure and proper pre-operative preparation to match the two.
Surgical repair of large hernias carry with them additional concerns. When large volume of contents (intestines) lying outside the abdominal cavity is reposited into the abdomen, it increases abdominal pressure, which presses lungs and results in breathing problems immediately after surgery. Care has also to be taken of the factors that caused the hernia e.g. asthma, chronic cough, obesity and abdominal wall weakness due to repeated/multiple surgeries etc.
Recently two patients from Jammu presented to Fortis Hospital Gurugram for hernia repair. The first patient was Seema Pandita (name changed), 51 years, 92 kgs, a known Diabetic, high BP and hypo thyroid, unable to walk because of a large right lower abdominal hernia with weak abdominal muscles that were separated apart. She was refused surgery at many places because of her weight leading to a vicious circle of immobility, weight gain and increasing distress because of the hernia. She came to us with great hope to find a solution to her surgical disease. After counselling about the functional and aesthetic outcomes, she underwent Abdominal Wall Reconstruction with 2 large meshes (30 X 30 cms). Now she is ambulating and walking 2 km without supports and has achieved better control of her sugars. Apart from that she is productive and participating in family and social activities.
Dr Kriplani added, “The second patient was a 74 years old lady who had wound dehiscence following uterus removal surgery apart from surgery for gallbladder removal 7 years back. She had a large lower abdominal wall defect more than 9 cm with discharging sinus and intestines protruding and hanging outside which could not be reduced into the abdomen. The weight of hanging intestines from the hernia made it difficult for her to walk and caused significant discomfort and imbalance. The sinus was treated first followed by Abdominal Wall Reconstruction. Her quality of life improved significantly with freedom of movements and relief from pain and discomfort of intestines protruding outside.”
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