Gurugram, July 2018: A 97 years old male with life threatening, painful, irreducible, left sided groin hernia also suffering from multiple medical problems like heart disease, Parkinson’s disease, Lung disease, diabetes, hypertension etc underwent successful lifesaving surgery at Fortis Memorial Research Institute Gurugram. Dr Ajay Kumar Kriplani, Head of laparoscopic and G I Surgery at FMRI said the surgery was extremely challenging as after 90 years of age, 19 % men die naturally every year without any surgery (due to heart attack, stroke, infection and age related issues), the risk of death after surgery is 27.8 % and after an emergency surgery it may be up to 49%. The patient age was on higher 90’s and was bed ridden with very limited activity which add to the risk. Complicated groin hernia is a serious surgical emergency needing immediate relief otherwise intestines may develop gangrene. Other challenges included a huge, irreducible, painful hernia containing large intestines and a suprapubic catheter placed in the lower abdomen near the area of surgery to control urinary infection. The patient was admitted under neurologist Dr Parveen Gupta with febrile encephalopathy and infection in the urine. Because of the Parkinson’s disease and age, the patient was uncooperative and could not be operated under local anaesthesia and hence General anaesthesia was required. The general anaesthesia was risky and difficult since the patient’s heart function was compromised (Ejection Fraction 38 %), breathing was not smooth and had a rigid neck. After explaining all pros and cons to the family which accepted the risk, anaesthesia was given by Dr Balkar Singh Head of Anaesthesia and Dr Sunil Malik. The surgical team included Dr A K Kriplani, Dr Shashank Rastogi, Dr Bijendra Sinha. The technique needed modification due to suprapubic catheter which enhances the risk of infection. The patient recovered smoothly and is now tolerating diet and is responsive as before surgery. The family, which includes many doctors, are highly thankful and appreciative of the care and treatment. Such cases are examples of patient centricity at Fortis Hospital Gurugram .
Inguinal hernia repair is a common surgery performed worldwide. In this condition part of the intestine bulges through an opening or weak area in the lower abdominal muscles. It accounts for 75% of the abdominal wall hernias and 11 % of male suffer from this condition during their lifetime. The condition is seen from new born to elderly and becomes commoner in elderly as the muscl es become weak.