Laproscopy, Hernia, Endoscopy, Tharascoscopy Surgery Specialist in Pune

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Examination of Hernia
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Predisposing factors ???
What is hernia?
Hernia protrusion of a viscous or part of
viscous through an abnormal opening in the walls
of its containing activity.
WHY HERNIA OCCUR?
Obesity
Straining
Smoking
Abdominal distension
Coughing
Causes
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Causes of abdominal Herniae

• Anatomical weakness

• Acquired weakness

• Structures passing through the abdominal wall
• Muscle fail to develop
• Scar tissue

• Trauma
• High intra-abdominal pressure
• Coughing
• Straining
• Abdominal distension

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Various types of Herniae?(common)
Inguinal Umblical Incisional
Femoral Epigastric
Other rare herniae
Spigelian Obturator
Lumbar Gluteal
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Relation to the surrounding structures 1.Anterior
wall Medially-external obliqueaponeurosis
Lateral- internal oblique muscle 2.Posterior
wall Medially strong conjoint tendon
Lateral- fascia transversalis 3.Floor Medial-
Lacunar ligament Lateral- inguinal
ligament 4.Roof Arching of fibers of into
oblique and transverse muscles.
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Differences between direct and indirect inguinal
hernia
Indirect inguinal hernia Direct inguinal hernia
Any age but common in young Elderly
Via deep inguinal ring and long the inguinal canal Via transversalis fascia (hasselbachs triangle)
Patent or reopen processes vaginalis Weak abdominal wall/muscle
Unilateral in 2/3 case (right side more common) Bilateral in gt ½ case
Enter scrotum (complete) Does not enter scrotum (incomplete)
Reduced by patient/doctor (manually) Reduced on lying down (automatically)
Narrow neck- more liable to strangulate Broad neck
Zieman technique- impulse on index finger Impulse on middle finger
Deep ring occlusion test- control Bulge out
Little finger invagination test- impulse on finger tip Impulse on pulp
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Dr. Sanjay Kolte
MBBS - OCTOBER 1995-BHARATI VIDYAPEETH'S MEDICAL
COLLEGE, PUNE, INDIA FCPS (General Surgery) -
SEPTEMBER 2000, MUMBAI, INDIA  (FELLOW OF
COLLEGE OF PHYSICIANS AND SURGEONS) DNB (General
Surgery) - MAY 2001-KING EDWARD MEMORIAL
HOSPITAL, PUNE, INDIA (DIPLOMATE OF NATIONAL
BOARD, NEW DELHI) MNAMS - MEMBER OF NATIONAL
ACADEMY OF MEDICAL SCIENCES, NEW DELHI
Contact Details Laparoscopic Surgery Clinic,
Parihar Chowk, Aundh, Pune, M maharashtra
411007Mobile [phone]Email  doctorsa
njaykolte_at_gmail.com http//www.drsanjaykolte.in/