Know What Is A Down Surgery

The descending operation is a procedure surgery to treat hernias, especially hernia that is large and causes pain. Operation go down or have surgery hernia this can be done with two method, namely open surgery and laparoscopy.

Hernia is a condition when an organ in the body pushes against the muscle tissue or weak connective tissue around it until the organ protrudes. The most common type of hernia is an inguinal hernia, which is a hernia that occurs when the small intestine protrudes into the groin.

Hernia surgery is done by pushing the protruding organ back into place. This surgery can also strengthen weak muscle tissue by performing a patch. Thus, the tissue that has been patched can hold organs in the body better so that the risk of hernia recurrence is reduced.

Types of Downsizing Operations

The descending surgery can be performed by open or laparoscopic surgery. The method used will be adjusted to the size and location of the lump, age, health condition, and the patient's own decision.

The following are the methods of hernia surgery and their explanations:

Open operation
This method is most commonly used to treat hernias. Open surgery can use local or general anesthesia. This method of surgery is performed by making an incision in the skin, then pushing back or cutting the protruding part.

Laparoscopy
Compared to open surgery, the incisions made in this method of surgery are smaller. The incision becomes the entrance to the camera and tube used to repair the hernia. This operation requires general anesthesia.

Indications for Downhill Operation

Not all cases of hemorrhoids or hernias need surgery. Hernias that are small, cause no symptoms, and can still be returned to the abdomen with a finger push generally do not require surgery. Meanwhile, hernias that need to be treated with surgery are as follows:

Hernias that are getting bigger
Hernia accompanied by pain or pain that gets worse
Hernias that make it difficult to carry out daily activities

In addition, descending surgery or hernia surgery also needs to be done immediately for patients who have hernia complications in the form of:

Incarcerated hernia, which is when an organ in the abdomen is pinched against the abdominal wall
Strangulated hernia, which is when the tissue is pinched until the flow or blood supply is blocked, which can lead to tissue death (gangrene) and permanent damage

The hernia complications above can be characterized by several symptoms, namely:

Fever
Severe pain in the hernia lump
Nausea and vomiting
The bumps turn black
Faster heart rate
The lump that was able to be pushed back can't be pushed back with the fingers

Operational Downswing Warning

To reduce the risk of complications, patients need to inform their doctor if they have the following conditions before undergoing vaginal surgery:

skin infection
Upper respiratory tract infection
Type 2 diabetes
Allergy to anesthetics or prosthetics
History of blood clotting disorders

In addition, please note that there are several conditions that can increase the risk of hernia recurrence even after undergoing surgery. These conditions are:

Cirrhosis, because the patient can experience accumulation of fluid in the abdomen (ascites) which can increase pressure in the stomach and make the hernia recur
Enlarged prostate or chronic constipation, because this condition can make the patient have to strain to urinate or defecate, resulting in increased pressure in the abdomen
Undergoing radiotherapy in the groin area, because it can slow down the healing of the surgery
Chronic cough, because coughing will increase the pressure in the stomach

Before the Surgery Down

Some things that need to be done before undergoing hemorrhoid surgery are:

Don't smoke a few days before surgery
Do not take blood thinning drugs, such as aspirin or warfarin, as directed by your doctor
Didn't eat or drink anything from the night before the surgery
Undergo screening tests, such as blood, urine, EKG and X-ray tests in preparation for surgery
Invite family or friends to accompany and accompany until the operation is complete

Downhill Surgery Procedure

As explained earlier, descending surgery can be performed by two methods, namely open surgery and laparoscopy. With both open and laparoscopic surgery, descending surgery generally takes 30–45 minutes. The full explanation is as follows:

Open surgery procedure

Surgical descent with open surgery method is divided into herniotomy and hernioraphy or hernioplasty. Before the operation begins, the doctor will give general anesthesia, local anesthetic at the surgery site, or an anesthetic half the body down.

The stages that will be carried out by the doctor in the descending surgery using the open surgery method are as follows:

The surgeon will make a 6–8 cm long incision near the area where the hernia occurs.
The doctor will push the extruded tissue or organ back into the abdominal cavity and remove the hernia sac. This procedure is called a herniotomy.
After that, the doctor will strengthen the inner abdominal wall where the organ or tissue comes out by sewing it. This procedure is called a herniation.
If the hole in the weak tissue is large enough, the doctor will use a synthetic mesh (mesh) to close and strengthen the hole. This procedure is called a hernioplasty.

After the above steps are completed, the doctor will close the incision area in the patient's abdomen with sutures or special surgical adhesive.

Laparoscopic procedure

Laparoscopic hernia surgery uses a special tool in the form of a thin tube with a camera called a laparoscope. The patient will be given general anesthesia to fall asleep and not feel pain during the operation.

After the anesthetic works, the doctor will perform a laparoscopic procedure with the following steps:

The doctor will make 3 small incisions in the patient's abdomen.
Through one of these incisions, the doctor will insert a reportoscope that displays the condition of the inside of the abdomen on the monitor.
The doctor will then insert an instrument to perform the operation from the other two openings.
During surgery, the doctor will deliver gas into the abdominal cavity, so that the patient's abdomen is bulged and the area of the operation can be seen clearly.
The doctor will push the organ or tissue that has been expelled back into place.
After that, the weak muscle tissue or connective tissue will be sutured and covered with synthetic mesh (mesh).
If there are no other problems, the doctor will remove the laparoscope and deflate the abdominal cavity again.

After the above steps are completed, the doctor will close and suture the incision in the skin.

After Surgery Down

Generally, patients are allowed to go home after surgery, without having to undergo hospitalization. However, patients are advised to rest for 3 weeks after open surgery or 1–2 weeks after laparoscopic surgery.

To speed up the healing process and prevent complications, patients are advised to do the following:

Cold compress the swollen area every few hours for 15 minutes
Taking medication, such as paracetamol, whose dose has been adjusted by the doctor to reduce pain
Avoid strenuous exercise for 4 weeks for patients undergoing laparoscopic hernia surgery, and 6 weeks for patients undergoing open surgery
Do light activities, such as getting out of bed and walking, about every 2-3 hours to prevent blood clots
Wash hands before and after touching the surgical wound, to prevent infection

Complications Downhill Operation

Surgical descent is generally safe to perform. However, this does not mean that this operation has no risks at all. The following are some of the complications that may occur after hemorrhoid surgery:

Bleeding or infection of the surgical site, especially in open surgery
Infection in synthetic nets
Hematoma or blood clot
Nerve injury around the hernia
Numbness of the skin
Damage to organs in the abdomen or male genital organs, such as the testes or sperm ducts
Hernia comes back
Drug allergic reaction