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Guest surgeon Dr. Nicole Callan gives us an introduction to hernias. She discusses what a hernia is, the different types of hernias, and an introduction to treatment.

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Do NOT use the Video for medical emergencies. If you have a medical emergency, call a physician or qualified healthcare provider, or CALL 911 immediately. Under no circumstances should you attempt self-treatment based on anything you have seen or read on the Video.

General information is not medical advice
The general information provided on the Video is for informational purposes only and is not professional medical advice, diagnosis, treatment, or care, nor is it intended to be a substitute therefore. Always seek the advice of your physician or other qualified health provider properly licensed to practise medicine or general healthcare in your jurisdiction concerning any questions you may have regarding any information obtained from this Video and any medical condition you believe may be relevant to you or to someone else. Never disregard professional medical advice or delay in seeking it because of something you have read on this Video. Always consult with your physician or other qualified healthcare provider before embarking on a new treatment, diet, or fitness program. Information obtained on the Video is not exhaustive and does not cover all diseases, ailments, physical conditions, or their treatment.

Learn all about the differences between these important hernias!

Do you think you have a hernia?
What are hernias?
The hernias we address in this http://DoctorsExpressHartsdale.com Medical Minute are inguinal, or groin, hernias. More common in men than women, an inguinal hernia can occur when part of the small intestine protrudes through a weakness or tear in the area between your abdomen and your thigh- or your groin. It's possible for anyone to get an inguinal hernia, but it is more commonly found in males.

Hernias form a bulge and can be accompanied by pain. Men have an approximate 26% lifetime risk of having hernia at some point in their life, where as women have a much lower chance of one- only about 3% of women will experience a hernia at some point in their life. There are other types of hernias, such as abdominal, or "hiatal" hernias but groin hernias outnumber abdominal hernias by about 3 to 1.

What causes a hernia?
The cause of a hernia is not always known, but hernias are often the result of weak spots in the abdominal wall. Weaknesses can be due to congenital defects (present at birth) or formed later in life. Some risk factors for inguinal hernia include:
• fluid or pressure in the abdomen
• heavy lifting
• straining during urination or bowel movements
• obesity
• chronic cough
• pregnancy

Hernias often form in people with weakened abdominal muscles or in those who do a lot of heavy lifting or straining, which is why we see it quite often in young men. Physiology plays a part: men have testicles and scrotum which descend through the inguinal canal-much larger in men than in women. That is part of the reason men tend to be more susceptible to hernias than women.

Symptoms of hernia

Symptoms of inguinal hernia usually include a bulge in the groin area and pain, pressure, or aching at the bulge—especially when lifting, bending, or coughing. These symptoms usually subside during rest periods. Men may also experience swelling around the testicles.


Screening and Diagnosis of Hernias
If you are having abdominal pain or pelvic bulge and pain, you want to see physician, and he or she will do an exam. They will use their finger, to see if you have a bulge in your scrotum or on your groin and they'll see if its reducible or not. If the exam doesn't give them the answer, they can then perform an ultrasound, an inexpensive test that can tell you the same day whether a hernia is present.


What to do if you think you have a hernia
Most of the time hernias do not cause problems. People often live with hernias their entire life without them becoming aggravated or painful. When they do cause pain though, there is concern that complications may have arisen. Most common hernias are what we call reducible; you can take your finger or you can lie down in bed and due to the effects of gravity, the bulge in the groin will actually disappear, which means the intestinal contents actually go back into the abdominal cavity or to the correct location. If it's not reducible by lying down or using a finger or having a physician trying to reduce it, then there are concerns about complications such as strangulation, or incarceration occurring. If those concerns are there, then you need to see a surgeon, and there may be a need for surgery.

How to Treat a Hernia
As stated earlier, hernias can often be watched for years without being treated. If however, they are causing pain, we generally refer you to a surgeon who can do a very simple laparoscopic surgery.

If you suspect a hernia, but have not been diagnosed, you should see your doctor, and of course, we are happy to see you here at Doctors Express

Endoscopy in Hiatal Hernia.

this video about identifying a hernia vs a cyst

Patient Glenn Williams had a hernia measuring 20cm x 30cm. Consultant Graham Offer has performed ground breaking surgery to help Glenn.

In this video, Professor Dan Reinstein performs a bilateral LASIK procedure filmed in real-time to demonstrate the full 8 and-a-half minute procedure from multiple angles. The superior design and experience of the Carl Zeiss Meditec Visumax femtosecond Laser for flap creation is seen, where the patient is only in contact with the device for about 30 seconds with extremely low contract force such that the patient feels effectively nothing, there are no red splodges (subconjunctival haemorages) left behind. From the surgeons' standpoint there is no device that is easier to use or faster for LASIK flap creation. The Carl Zeiss Meditec MEL80 excimer laser portion of the procedure is seamlessly integrated and incorporates all the features that make clinical outcomes so reproducible including the unique cone-for-controlled-atmosphere (CCA) and high efficiency, high sensitivity calibration test which can be performed for each individual patient to compensate for minor changes in energy that occur with excimer laser devices during the course of a day.

For reference to the clinical outcomes for LASIK with the MEL80 in presbyopia using PRESBYOND Laser Blended Vision see:

Reading glasses presbyopia (ageing eyes) only:
LASIK for presbyopia correction in emmetropic patients using aspheric ablation profiles and a micro-monovision protocol with the Carl Zeiss Meditec MEL 80 and VisuMax.
J Refract Surg. 2012 Aug;28(8):531-41. Reinstein DZ, Carp GI, Archer TJ, Gobbe M.
http://www.ncbi.nlm.nih.gov/pubmed/22869232

Short sighted, astigmatism and presbyopia (ageing eyes)
LASIK for Myopic Astigmatism and Presbyopia Using Non-Linear Aspheric Micro-Monovision with the Carl Zeiss Meditec MEL 80 Platform.
J Refract Surg. 2011 Jan;27(1):23-37. Epub 2010 Mar 1.
Reinstein DZ, Archer TJ, Gobbe M.
http://www.ncbi.nlm.nih.gov/pubmed/20205360

Long-sighted, astigmatism and presbyopia (ageing eyes)
LASIK for hyperopic astigmatism and presbyopia using micro-monovision with the Carl Zeiss Meditec MEL80 platform.
J Refract Surg. 2009 Jan;25(1):37-58. Reinstein DZ, Couch DG, Archer TJ.
http://www.ncbi.nlm.nih.gov/pubmed/19244952

For more information about laser eye surgery and PRESBYOND Laser Blended Vision, please contact the London Vision Clinic on 020 7224 1005.

Contact us to find out more http://www.londonvisionclinic.com/contact-us/ Mr Carp explains the risks involved in losing sight as being extremely rare. Only 1 in 5 million may lose sight in one eye.

LIVE SURGERY by Prof. Bellemans - Total Knee Replacement

This live video will show you a Total Knee Replacement Surgery done by Prof. Dr. Bellemans.
#Kneeprosthesis
#Kneearthroplasty
#Journeyknee

Watch Dr. Robert Thomas, of Panorama Orthopedics & Spine Center, perform a Mako Knee replacement. He narrates each step of the process.

Carpal tunnel release (part 1). Skin incision and retraction. Procedure performed by Deepak Kapila, MD, Broward Health, Fort Lauderdale, FL. Courtesy of BroadcastMed (http://ortho.broadcastmed.com/....4229/videos/carpal-t

There are hundreds more procedural videos as well as news, features, resources and references on Medscape.com. Join today for free.

High Quality Surgical videos and uncut stories ▶ https://surgeoncut.com

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Trabeculectomy, also called Filtration Surgery, is a surgical procedure performed for treatment of glaucoma. The treatment involves removing part of the trabecular meshwork and creating a new escape route for the aqueous humor. When successful, it allows the aqueous fluid to drain from the eye into an area underneath the conjunctiva where it is subsequently absorbed by the body's circulatory system or filtered into tears.
In this procedure:
- A conjunctival pocket is created and maybe treated with Mitomycin or other antimetabolites for a few minutes. These drugs are used to prevent scarring of the operation site. Scarring, if occurs, may clog the new drainage canal, and is therefore the major reason the procedure may fail.
- A half thickness flap is then made in the sclera and is dissected all the way to the clear cornea.
- A block of scleral tissue including part of the trabecular meshwork and Schlemm's canal is then removed to make a hole into the anterior chamber of the eye.
- As the iris may plug up this hole from the inside, a piece of the iris maybe removed at this time. This is called iridectomy.
- The scleral flap is then sutured loosely back in place. These sutures can be released gradually during a couple of weeks after surgery. This allows adjustment of the aqueous flow in order to achieve target pressure and to avoid the complication of having a too low intraocular pressure.
- The conjunctiva is sewn back in place to cover the area.
After surgery, aqueous humor drains into a filtering area called a "bleb" under the conjunctiva. Since the surgery is usually performed near the top of the eye, the bleb can easily be concealed behind the upper eyelid.

A new procedure helps patients with unattractive bunions and hammertoes.

Lumpectomy means that a focal area of cancer is going to be removed. A lot of patients with a lumpectomy don’t need any specific breast reconstruction, explains Dr. Miguel Angel Medina, Director of Microsurgery with Miami Cancer Institute.
Al the end of surgical treatment, all those patients go on to need radiation therapy. For patients who have large breasts, physicians have to take a larger lumpectomy than normal.

Orthopedic spine surgeons and vascular surgeons at UW Health in Madison, WI work together to perform minimally invasive anterior lumbar interbody fusion (Mini-ALIF). With this type of spinal fusion surgery, patients have smaller incisions, usually spend less time in the hospital and typically return to daily activities more quickly. Learn more https://www.uwhealth.org/ALIF

It used to be when a woman needed a hysterectomy she could expect full abdominal surgery with a long recovery time. Dr. Melissa Lee uses less invasive methods that can cut the patients downtime in half.

"We were trained in more laparoscopic and minimally invasive cases so of course that's what I'm more comfortable with doing right now."

She sees a new generation of patients opting for laparoscopic surgery.

"Laparoscopy is the use of small cameras with small incisions and instruments that are guided by the hand, and you're able to see directly into the abdomen without actually fully opening the abdomen," says Dr. Lee, an obstetrician-gynecologist with Lee Memorial Health System.

Nowadays, even a large mass or uterus can be removed using the slender tools.

"There are multiple different laparoscopic instruments that you can use. Whether they're blunt dissections or just dissectors that hold and retract back or actual scissors or cutting instruments, there are multiple different options," says Dr. Lee.

While a standard abdominal hysterectomy requires a four to eight inch incision, the laparoscope needs only a quarter to half inch. It's enough to make a big difference in terms of recovery.

"They're able to get up and move around faster. They're able to recover faster, their pain level and their need for pain medicine is much lower," says Dr. Lee.

The laparoscopic procedure also cuts down on scarring and more importantly, shortens the hospital stay. The trend now is home within 24 hours.

"Where the patient is done early in the morning, they're doing well they're tolerating oral intake they're able to getup and move around. And those patients a lot of times will feel comfortable to go home that same nigh after a major surgery," says Dr. Lee.

New studies show women who've had a laparoscopic hysterectomy viewed their quality of life as better than those who had an open abdominal procedure, making this a good option for the right patient.

View More Health Matters video segments at leememorial.org/healthmatters/

Lee Memorial Health System in Fort Myers, FL is the largest network of medical care facilities in Southwest Florida and is highly respected for its expertise, innovation and quality of care. For nearly a century, we've been providing our community with everything from primary care treatment to highly specialized care services and robotic assisted surgeries.

Visit leememorial.org