Does your hernia wet your cornea ?

does your hernia wet your cornea

Does your hernia wet your cornea ?

What is a hernia? Do you have it? If you do have it, how do you know? Is it painful? Is it hereditary? What exactly causes it? Does the belly bump cause hernia, the lump? Do you need surgery to correct it? So many questions! Let’s start with addressing the first one.

What are the different types of hernia?

Depending upon the site of the uneventful, there are different types of hernias. Umbilical hernia, femoral hernia, incisional hernia, epigastric hernia and hiatal hernia. In this article, inguinal hernia is being discussed.

A Hernia – It’s an abnormal protrusion of an organ or part of it through a weak point in the body. Inguinal hernia is the most common one among hernias, affecting mainly men than women in 7:1 ratio, respectively. You don’t want equality in these matters ladies, trust me! Hernia can be direct or indirect. In GOT (game of thrones), remember Hodor? The scene where the white walkers attack Bran and they’re running for their lives? Hodor holds the door, So that the white walkers don’t kill Bran and turn him into one of them. If Hodor played security at the entrance of the tower and the white walkers still got in? It would be an indirect hernia. Here, the white walkers can be the abdominal viscera mainly the colon and Hodor is the deep inguinal ring. Similarly and also how it happened in GOT, Hodor stood at the back door of the tower and white walkers crawled out eventually. Here, it’s a direct hernia and the iconic Hodor, being the posterior wall of the inguinal canal.

What is this inguinal canal?

It is a muscular canal containing structures running through it. They are the spermatic cord (in males), round ligament (in females), Ilioinguinal nerve, there is a genital branch of what’s called a genitofemoral nerve and lastly remnant of processes vaginalis. The weak area of all groin hernias is the site between the inguinal ligament and the iliopubic tract called the myopectineal orifice of Fruchaud.

What causes hernia?

Sometimes, people are born with it. There can be a collagen disorder due to which the ligaments become weak, prune-belly syndrome is congenital and acquired collagen deficiency is due to smoking. Yes, smoking not only causes cancer but also hernia. They forgot to put that on the pack. Basically, anything increasing the intra-abdominal pressure adds to the causation of the hernia like coughing, constipation, ascites, obesity, pregnancy, straining during micturition and lifting heavy weights. Hernia cases have been recorded post appendectomy as well. does your hernia takes too much time to recover the answer to this question is, it takes a couple of weeks to recover and the way you maintain your daily diet.

Younger you are indirect hernia is a possibility and older you get direct hernia occurs. Inguinal hernia usually presents itself as a groin swelling and is painful in nature and it might be radiating to the umbilical region.


Normal investigations done for diagnosis are,

  • The routine blood tests and urine examination. The elderly might need an additional bunch few tests like a chest X-ray, ECG and PFTs. Urinary complaints are checked for prostatic enlargement and urethral problems.
  • Ultrasound can detect a sac where hernia cannot be diagnosed by clinical assessment. It is useful in postoperative swellings, hematoma and recurrence.
  • CT (computed tomography) for giant hernias.
  • MRI (magnetic resonance imaging) is ideal for sportsperson, to differentiate between muscle spasm and a hernia.

Treatment for a hernia depends on its presentation. Herniotomy, herniorrhaphy and hernioplasty are the three important operative techniques which are performed. For adolescent patients with hernia, herniotomy is preferred.

Herniorrhaphy – Modified bassini’s herniorrhaphy is in practice now for patients who have a good muscle tone with indirect and direct hernia. In this procedure, the surgeon repairs the stretched out ligament and herniotomy is also conducted. Shouldice repair is another type of herniorrhaphy where herniotomy is done with correction of the hernia using the surrounding tissues by absorbable and non-absorbable sutures in different layers.

The third operative method is the hernioplasty, which is done in patients with or without good muscle tone having indirect or direct hernia and also in recurrent hernia. This approach is done so as to strengthen the posterior wall of the inguinal canal. Firming up is done by repairing the weak posterior wall by a prolene mesh or Marlex mesh. A thick fibrous layer is hence formed as it acts as a foreign body and our immune system provides the required cement to it. An artificial deep ring is also done. This mesh technique is quiet brilliant as it has a long life, preferably socioeconomic; risk of infection is minimal when handled in a sterile environment and also due to its amazing biocompatibility. Prolene darning is also done in a few cases, which is basically sewing up the loose ends and making it stronger.

There are few other techniques like the Kuntz operation usually done in elderly, Mcvay, Nyphus repair, Stoppa repair, Marcy repair. Newer advancements are game changing procedures like the Dasarda technique, creating a hernia system which is exceptional and mesh plug repairs are gaining popularity as they have much better patient compliance.

Laparoscopic surgery or open surgery? In my opinion, open is a better choice for this condition. But both have their own pros and cons. Open surgery does interfere with the bowl function. Also, if there are any complications during the laparoscopic surgery the surgeon would have to open up and go old school. Plus, open surgeries are cheaper as compared to laparoscopic but the recovery period varies indistinguishably.

Complications are often common after a surgery. They can be during, before or after the surgery. They aren’t worrisome but few need to be attended by the surgeon. Care must be taken to avoid post-operative wound infection by the patient or their care takers. In very few cases patients complain of lower abdominal pain a characteristic dragging pain months after surgery which might be due to injury to the surrounding nerves. This is treated by nerve blocks with anaesthetic agents and steroidal injections.

If hernia is not treated at the right moment it can give rise to a number of complications which are troublesome like,

  • An obstructed hernia.
  • A strangulated hernia is quiet notorious as it can cause shock and sepsis and need immediate surgical care as the bowel might get gangrenous.
  • A Sliding hernia is an incarcerated hernia in which the fecal matter may slide into it.
  • Inflammation is yet another impediment which might range out from a simple hernia to a life threatening one.
  • Recurrent hernia is common is 10 percent of the lot who has been treated earlier.


With all due advancements in the surgical and medical field hernia is one of the most common cases till date which need effective, relentless and instantaneous treatment. So, don’t ignore a lump because it is not so Gump.

Written By (Dr) Apoorva Manjunath

When something that you love makes you weak in the knees!

ACL surgery cost in bangalore

When something that you love makes you weak in the knees!

Before your mind runs wild, let me make it clear that this isn’t completely dirty and painful. Or is it? Each person is on their own, picking up what they like and love persuading towards that particular activity. While you’re at it, doing what you love there are often times when a small misjudgment or a miscalculation might end up giving months of terrible and excruciating pain. One such incident might be A LIGAMENT TEAR.

Ligament tear usually occurs in the joints of our body when a great force is applied on a particular joint. Let’s focus on the knee joint as of now. Knee joint has 4 ligaments namely,

  • Anterior cruciate ligament(ACL)
  • Posterior cruciate ligament(PCL)
  • Medial cruciate ligament(MCL)
  • Lateral crucial ligament(LCL)

These ligaments hold the knee joint in place and help in locking and unlocking the joint. When you walk, run, dance, gym or jump these ligaments work continuously. When the knee joint is locked, the greater force applied on it ends up tearing the ligament depending upon the direction of this unaided force.

Injury to PCL – Ligament tears are also common in a road traffic accident. Usually in a car accident, the posterior cruciate ligament is torn. The harm occurs when the tibia is forced backwards to the femur. This is rather rare in a sport person whose anterior cruciate ligament is at risk.

Injury to ACL – Twisting a semi flexed knee, which already made you say “ouch” is quite cumbersome to deal with as it often causes injury to the medial meniscus and MCL. (O’Donoghue triad)

Injury to MCL – Any force the pushes the tibia towards the femur in an inside fashion causes the rupture of this ligament.

Injury to LCL – MCL and LCL are attached to the either side of the joint, medial is on the inner side and lateral on the opposite. So the damage to the lateral ligament occurs when the force is applied to adduct the tibia to the femur.


So now, describing the proper anatomy. The knee joint is a hinge joint.

A hinge joint is one which is made up of more than 2 bones, and moves along one axis only. Elbow joint is another such synovial joint. Knee joint consists of the tibia and the femur, a tibio-femoral joint. Then there is patella which glides over the front of the tibial end of femur, forming patello-femoral joint. The knee Ligaments act like the joint’s best friend, providing support and stability. When this harmony is disturbed, a painful unstable state happens to be.

The ligament injury can be associated with,

  • Chipping of the bone to which the ligament it is attached.
  • A mid-substance tear ( tear in the ligament)
  • Severity may vary on the tear being complete or incomplete.
  • One ligament involvement or more.

The combination depends upon the force acting on the joint. More severe the injury   more intricate the treatment regimen gets.

Diagnosis can be made through clinical examination and a detail on the event of the grievance. Complications that present with the tear are dislocation of the joint, blood clots, swelling. The pain maybe localized over the torn ligament. Radiological examination of the knee joint is important to check if the bone has been chipped off, which might have been avulsed from the ligament attachment. Contrary to the Stress X-rays, MRI is a non-invasive method to diagnose ligament injuries. Arthroscopic examination may be needed in few cases.

Treatment of this condition was conventionally done by non-operative methods. Now that there are better techniques and with the recent advances better results are achieved through operative reconstruction. Operative reconstruction has become popular in high demand athletic individuals like Tom Brady, Alex Morgan Adrian Peterson and a lot more NBA players. Celebrity or not we are all made up of the same cells and same anatomy and ligament injury can be treated and normal functioning of the knee can be obtained and hence decreasing your time not spent on doing what you love.

Methods that are undertaken are,

  • Conservative method – The blood clot/ hematoma is aspirated and the knee is immobilized in a cylinder cast or a knee immobilizer. If the injury is grade I or grade II, conservative method is successful for treatment. Followed by this, strengthening physiotherapy is required.
  • Operative methods – These are to be done when there is a combination of ligament injuries, involving multiple ligaments especially in young athletes or dancers. Usually the surgery is done 2-3 weeks after the injury when the inflammation is fairly reduced.

What do the surgeons do actually? They first go by repairing the ligament. It is performed on grade III ligament tears, which means the ligament is completely torn. If the surgery is done after the 2-3 weeks, an additional reinforcement is provided by a tendon or fascial graft as the original torn ligament would have lost the strength due to complete tear.


Secondly, they reconstruct the instable knee injuries which present later than usual. An allograft or an autograft of a tendon or a fascia lata is used; a synthetic graft can also be used. Auto is better than allo as there are lesser chances of rejection.


Knee ligament tears are very common and are often undiagnosed. Ligament tears are usually not seen on X-rays and might get neglected. The usual presenting symptom is the instability of the knee joint. Treatment is biased depending upon the activity level of the patient. If you’re a ninja then you’ll probably need surgery. If you’re person who probably has a sedentary lifestyle, the doctor might perhaps recommend physiotherapy. Usually the ACL tends to get damaged more often than the others. ACL reconstruction is done with the help of an autograft and bio-absorbable screws. Arthroscopic ACL reconstruction is the surgery of choice as it is minimally invasive, and results are outstanding as the patients revert back to normal with negligible risks.

By Dr Apoorva Manjunath.

Bariatric Surgery Cost In Bangalore

Baritric surgery cost in bangalore

Bariatric surgery cost in Bangalore is minimal and cost effective. There are many ways to get your bariatric surgery done in Bangalore or any other states of the India, the reason for it is India as a nation has grown and developed with multispeciality hospitals in each cities. There are many ways to get it done but the ultimate decision is yours whether you want it done by working out on your fitness or by surgery, if you are looking to loose your weight by doing physical exercise in gym or outdoors then it is your hard work and dedication that makes you fit and healthy but if you are choosing the easiest way then you might end up with having a bariatric surgery which includes a different kind of procedures performed on people who have severe obesity. Weight loss is attained by cutting the size of the stomach with gastric band procedure or by removing a portion of the stomach which is called as sleeve gastrectomy or by resecting and re-constructing the small intestine to a small stomach pouch which is also called as gastric bypass surgery.

Severe obesity is one of the most dangerous stages of obesity. You may often find yourself awkward with your weight and low in self confidence. In addition, you most likely have tried various diets and ended up with no results.

Bariatric Surgery Cost In Bangalore.

You can hit our official website for any bariatric surgery we will provide you with cost and surgeon details. In Bangalore there are list of hospitals who are associated with us to provide bariatric surgery. Our platform provides other than bariatric we provide the cost and other details of various surgeries fell free to contact us.

How it is helpful to you ?

When combined with all elements to the treatment plan, bariatric surgery may work effectively to provide you with long term weight-loss and help you boost your quality of health. Bariatric surgery has been shown its improvements or resolve many obesity-related states like type 2 diabetes, high blood pressure and heart disease Frequently, individuals who improve their are not concerned with the medications. The other factors you can loose you your weight is the hard core version of it by removing your fat not by a surgery but by controlling the food and doing the right exercise will make you fit and lean in the other words it will boost your health.

Bariatric surgery is a vast chapter if you want to dig in there are different kinds of surgeries such as gastric bypass, gastric sleeve, and laparoscopic adjustable gastric banding each surgeries has it own special abilities, working by tweaking the ergonomics of your gastrointestinal tract (stomach and digestive system) or by causing various physiologic changes in your body that change your energy stability and fat metabolism. Regardless of which bariatric surgery procedure you and your doctor opts is best for you, to achieve weight loss it also depends on many other vital factors, such as nutrition, exercise, behavior modification, and more.


There are 7 types of weight loss surgery (also called “bariatric surgery”)

LAP-BAND® – feel full sooner while eating
Gastric Bypass – feel full sooner while eating & absorb fewer minerals
Gastric Balloon – temporarily feel full sooner while eating (balloon removed after 6 months)
Duodenal Switch – feel less hungry & full sooner while eating, absorb fewer calories and minerals
vBloc Therapy – feel full between meals & less hungry while eating
AspireAssist – drain a portion of stomach contents after eating
Gastric Bypass – feel full sooner while eating & absorb fewer minerals
Gastric Sleeve – feel less hungry & full sooner while eating


No matter what you choose among the various kinds of bariatric surgery make sure when you are consulting the surgeon you explain the causes and tough phases you have been through so that it gets easier to the surgeon to choose the appropriate bariatric surgery which suits you.