Hernia-  is defined as a condition where there is the migration of abdominal contents outside of its confines that is the abdominal cavity

History- Earliest note of hernia is in the 15th century where a mention is made in the Egyptian

              Papyrus of Ebers of a swelling coming down on coughing

Over centuries surgery for Hernia evolved from a life-saving procedure to a day care surgery.

Earliest records of 19th and 20th-century show repair under tension wherein the recurrence rates were close to 100% and mortality of 7 %. Then Bassini and Shouldice showed a method of tension-free repair which was popularised by Lichtenstien. Then came the era of mesh repair and the Prolene Hernia System.

  With the advent of Laparoscopy Hernia repair became an advanced procedure from a Basic surgical procedure and is now almost Standardised with clear anatomical Delineation and placement of Mesh.

Anatomy of Abdominal Hernia

           Hernia as mentioned  is a protrusion of abdominal contents through a defect. To understand this one should view the Abdominal cavity as a cylinder with the spine at the back with layers of muscles encircling the side and front of the cylinder. The top of the cylinder is formed by the Diaphragm, and the floor is formed by the Pelvic Diaphragm and bony pelvis.

Defects in the Roof- Diaphragm

          Diaphrgmatic hernia- congenital or Adult- left or Right- Morgagni or Bochdalek hernia

          Hiatal Henia – defect in the opening through which the food pipe comes into the abdomen

Defects in the floor – Pelvis

          Uterine and Rectal Prolapse

Hernia of the Wall

         Midline hernia- Epigastric and umbilical

         Incisional hernia

         Inguinal and femoral hernias

         Special hernia- spigelean and lumbar hernia

In our center 80% of hernia surgeries are done Laparoscopically. We repair Abdominal wall hernia defects upto 15cms in width – laparoscopically.The advanced techniques like Lap E-Tep and SCOLA techiques are done by us. In the last 2 yrs we have done more than 75 procedure by these techniques.

       We undertake Hiatus Hernia repairs Laparoscopically , where the pt is discharged in 1 day. Our sucess rates have been 100%

       Only for Large defects we have been forced to do open surgeries. Also for complicated hernias.

Comlication usually is Obstruction of Intestines or Gangrene.