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Submitted by:- ANSHIKA GUPTA

BPT 4TH YEAR

WHAT IS HERNIORRHAPHY?
 A herniorrhaphy refers to the surgical repair of a
hernia, in which a surgeon repairs the weakness in
your abdominal wall.
 A hernia occurs when a weak area in the muscles of
your abdominal wall allows an internal part of your
body to push through.
 If you have a direct hernia, which bulges from your
abdominal wall, the surgeon will push the bulge
back where it belongs and then repair the weak spot
in your muscle wall by stitching the edges of the
healthy muscle tissue together. When the area of
muscle to be repaired is large, surgeons may sew a
synthetic mesh over it to reinforce it. This procedure
is referred to as a hernioplasty.
 CLASSIFICATION OF
ABDOMINAL HERNIA
 Anatomical location –
1. Inguinal hernia
2. Femoral hernia
3. Umbilical hernia
4. Epigastric hernia
5. Diaphragmatic hernia
6. Incisional/recurrent hernia
 SIGN AND SYMPTOMS
 Swelling/protrusion
 Weakness or pressure in the groin
 pain or discomfort in the groin, especially
when bending over, coughing or lifting
 Occasionally, pain and swelling around the
testicles when the protruding intestine
descends into the scrotum
 Causes
 Anything that causes an increase in pressure
in the abdomen can cause a hernia, including:
• Lifting heavy objects without stabilizing the abdominal
muscles
• Diarrhea or constipation.
• Family History—Although family history may not guarantee a
hernia, research shows it is a reliable predictor of one
occurring.
• Persistent coughing or sneezing.
• Obesity, poor nutrition, and smoking (all weaken muscles and
make hernias more likely).
• Pregnancy—The risk is small, but studies show that pregnancy
is associated with an increase in the risk of hernia recurrence.
• Injury—Most sports-related hernias occur in the groin and
 REHABILITATION
Pre-operative physiotherapy

 Deep breathing and coughing to improve vital

capacity.(TO BE ABLE TO GET RID OF POST
ANAESTHETIC SECRETIONS)
 Strong sustained isometric contraction to glutei,
quadriceps, hamstrings.(TO IMPROVE STRENGTH
AND ENDURANCE)
 ROM and strengthening
 Mentally prepare the patient to for painful active
stage ahead.
 POST-OPERATIVE TREATMENT
 GOALS:-
• Ensure wound healing
• Edema and pain control
• Improve flexibility
 EXERCISES:-
• Ankle-toe pump (TO ABLE TO GET RID OF
SECONDARY COMPLICATIONS SUCH AS DVT)
• Walking
• ROM/Stretching
 SURGERIES PREFORMED

Hernias can be repaired with either open

or laparoscopic surgery.

• Laparoscopic surgery uses a tiny camera and miniaturized

surgical equipment to repair the hernia using only a few small
incisions. It’s also less damaging to the surrounding tissue.

• Open surgery, the surgeon makes an incision close to the

site of the hernia, and then pushes the bulging tissue back
into the abdomen. They then sew the area shut, sometimes
reinforcing it with surgical mesh. Finally, they close the
incision.
 SURGICAL PROCEDURE…
 The steps of the procedure itself are as follows:
1. You will be given a local or general anesthesia
depending upon the specifics of the surgery.
2. Following anaesthesia, you may need to be shaved
to expose the skin.
3. An incision will then be made parallel to the line of
your inguinal ligament.
4. Once the hernia sac has been identified, the
surgeon will place the protruding organs back into
place and then either stitch your abdominal wall or
insert the mesh for larger areas.
5. They will then close their original incision and apply
a suitable dressing.
 DIAGNOSIS
 Abdominal ultrasound - high-frequency
sound waves to create an image of the
structures inside the body
 CTscan, which combines x-rays with
computer technology to produce an
image
 MRI scan
 Endoscopy, which involves threading a
small camera attached to a tube down
the throat and into esophagus and
stomach
 PREVENTION
Tips to Decrease the Risk of a Hernia
 Maintain a healthy weight. Rapid weight loss and weight gain place
pressure on the abdominal wall.
 Don’t smoke.
 Lifting stance. Lift with the legs, not the back.
 Change your diet to improve bowel movements. Increasing fiber
intake may help to relieve constipation that can cause straining
during bowel movements, which can aggravate a hernia. Some
examples of high-fiber foods include whole grains, fruits, and
vegetables.
 Dietary changes can also help with the symptoms of a hiatal hernia.
Try to avoid large or heavy meals, don’t lie down or bend over after a
meal, and keep your body weight in a healthy range.
 To prevent acid reflux, avoid foods that may cause it, such as spicy
foods and tomato-based foods.