Type of Surgery
Last updated: 11/24/2009
Reviewing the patient's symptoms and medical history are the first steps in diagnosing a hernia. The surgeon will ask when the patient first noticed a lump or bulge in the groin area, whether or not it has grown larger, and...
how much pain the patient is experiencing. The doctor will palpate the area, looking for any abnormal bulging or mass, and may ask the patient to cough or strain in order to see and feel the hernia more easily. This may be all that is needed to diagnose an inguinal hernia. To confirm the presence of the hernia, an ultrasound examination may be performed. The ultrasound scan will allow the doctor to visualize the hernia and to make sure that the bulge is not another type of abdominal mass such as a tumor or enlarged lymph gland. It is not usually possible to determine whether the hernia is direct or indirect until surgery is performed.
Patients will have standard preoperative blood and urine tests, an electrocardiogram, and a chest x ray to make sure that the heart, lungs, and major organ systems are functioning well. A week or so before surgery, medications may be discontinued, especially aspirin or anticoagulant (blood-thinning) drugs. Starting the night before surgery, patients must not eat or drink anything. Once in the hospital, a tube may be placed into a vein in the arm (intravenous line) to deliver fluid and medication during surgery. A sedative may be given to relax the patient.
When gastroesophageal reflux disease or GERD is not well controlled through lifestyle or medical interventions, surgery may be required. One surgical treatment for GERD is called a Nissen fundoplication. The steps involved in a Nissen fundoplication are discussed in this narrated animation.
Inguinal hernias (IPA: /╔¬n╦łgwin╔Öl ╦łh╔Łni╔Öz/) are protrusions of abdominal cavity contents through the inguinal canal. They are very common (it is estimated that 7% of the population will develop an abdominal wall hernia) and their repair is one of the most frequently performed surgical operations.
Surgical correction of inguinal hernias, called a herniorrhaphy or hernioplasty, is now often performed as an ambulatory, or "day surgery," procedure. There are various surgical strategies which may be considered in the planning of inguinal hernia repair. These include the consideration of mesh use, type of open repair, use of laparoscopy, type of anesthesia, appropriateness of bilateral repair, etc. During surgery conducted under local anaesthesia, the patient will be asked to cough and strain during the procedure to help in demonstrating that the repair is "tension free" and sound.
Biliary colic is the presenting symptom in 80% of patients with gallstone disease who seek medical care; however, only 10-20% of all individuals with gallstones experience severe gallstone pain.
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