How is the operation to remove an umbilical hernia performed? Postoperative hernia Surgery to remove a postoperative abdominal hernia

The anterior abdominal wall has several anatomically weak areas: the inguinal region, the umbilical ring and the linea alba. In these areas, a pathological process such as a hernia can be observed. Protrusion of internal organs under the skin and into the adjacent cavity occurs under the influence of high pressure against the background of muscle weakness.

These factors become the main causes of ventral hernias in young children, adults and the elderly. The formation on the abdomen requires surgical treatment, otherwise the pathology is complicated by conditions such as inflammation, strangulation, necrosis, and coprostasis.

Abdominal hernia surgery is performed as planned; surgery offers an open method and laparoscopy for this, and the choice of technique will depend on the severity of the disease and the patient’s condition. The postoperative period is even more important for recovery, and after the abdominal wall defect has been removed, treatment is just beginning.

All operations to remove a hernia have their own contraindications and risks, therefore, before choosing a technique, the surgeon prescribes a comprehensive examination and thorough preparation is carried out, including the sanitation of foci of infection, cleansing the intestines and the selection of conservative treatment options in the postoperative period.

Why do you need surgery for a hernia?

Surgery to remove an abdominal hernia is prescribed to everyone without exception, because no non-surgical treatment method can lead to closure of the abdominal wall defect. It is important to operate on the patient in order to return the organs to their place, followed by suturing the hernial orifice, which can be closed with the patient’s own tissue or a mesh implant.

Gymnastics, diet, bandage and medications are already measures after removal of the hernia, when the body is restored.

Even useful physical activity will not help eliminate the hernia, but, on the contrary, can become a factor in organ infringement. Exercise therapy will be prescribed after surgery to remove the tumor to strengthen the muscles in order to prevent relapse. As for the bandage, it is also harmful in case of a hernia, but it is needed as a retaining agent to prevent even more of the organ from coming under the skin.

A special belt does not cure, it helps before and after surgery to reduce the load on the abdominal muscles. Dietary nutrition is important during any period of the disease, because the state of the gastrointestinal tract depends on the quality of food and the frequency of food intake, and this directly affects the symptoms of a hernia. It is important to prevent bloating, constipation and diarrhea, all those phenomena that increase pressure inside the abdominal cavity and affect well-being.

Only after removal of an abdominal hernia is the risk of complications from the stomach and intestines reduced, because being in the hernial sac, these organs can be pinched at any time, which will lead to their death with the need for urgent excision of the affected tissue.

How is an abdominal hernia removed?

There are several hundred methods of hernia repair, but all of them can be combined into three groups:

1. Plastic surgery using your own tissues .
2. Laparoscopic plastic surgery.
3. Non-tension plastic.

Plastic surgery using the patient’s own tissues involves suturing the hernial orifice with muscles, fascia, and aponeurosis. Access to the hernia is made through a wide incision - 8-10 cm, so after the operation a cosmetic defect remains in the form of a scar. This hernia repair option has many disadvantages. Recovery after tension plasty lasts several months, and increasing the load is prohibited throughout the rehabilitation period.

The operation in 3-15% of cases ends in relapse or development of a postoperative hernia, which is also associated with a wide scar that can become a hernial orifice.

Laparoscopic hernioplasty is performed under general anesthesia with constant video monitoring. The operation is performed from inside the abdominal cavity, and access is created through small punctures (2 cm). Three incisions on the abdominal wall are needed to insert a camera and special instruments for excision of tissue, suturing it and fixing the mesh implant. Such an operation can only be performed as planned, when there are no contraindications to general anesthesia. The main advantage of the technique is the ability to simultaneously eliminate concomitant pathologies of the abdominal cavity.

The postoperative period after laparoscopic surgery is relatively short, wounds heal quickly, no wide scars remain, and the risk of relapse is almost completely eliminated.

Tension-free repair or Lichtenstein surgery is a method of closing the hernial orifice with the installation of a synthetic implant. Due to the absence of tension during the rehabilitation period, the pain syndrome is weak, the risk of relapse is lower than when suturing the defect with natural tissues. This operation can be performed either under local anesthesia or general anesthesia. Planned hernioplasty is performed on an outpatient basis, the patient returns home the very next day, and can return to physical work in a few weeks.

In the last decade, tension-free hernioplasty has gained great popularity, due to a number of advantages: rapid recovery, absence of pain, minimal risk of relapse.

Indications and contraindications

An abdominal hernia is dangerous not only to health, but also to life. Protrusion of organs under the skin in adults and children can be asymptomatic for a long time, and only a slight swelling is visible in the abdominal wall, which does not bother you at all. A hidden disease is even more dangerous, because at any moment, under the influence of high load, an injury can occur.

A hernia is an indication for elective surgery, but there are conditions that require immediate assistance from a surgeon.

Emergency surgery is performed for complications for which the following symptoms are typical:

• acute abdominal pain, hardness and tension of the abdominal wall;
• nausea with vomiting, bleeding with vomit;
• absence of bowel movements or diarrhea with blood in the stool;
• absence of cough impulse, non-reduction of protrusion;
• a sharp deterioration in health, pale skin, tachycardia;
• general malaise, severe thirst, increased sweating.

Each surgical technique has relative contraindications. When a hernia becomes complicated, the surgeon weighs the degree of danger of the condition and the potential harm of the operation, making a decision to save the patient’s life.

Planned hernia repair requires preparation:

• abstinence from alcohol a week before surgery;
• refusal of medications 2 weeks in advance;
• refusal to eat the evening before surgery;
• treatment of concomitant gastrointestinal pathologies;
• vitamin therapy 2 weeks before surgery.

Hernia repair is carried out in case of colds, infectious diseases in the acute stage, and during pregnancy. The operation can be performed 14 days after recovery, except for emergency indications.

Complications

After removal of the hernia, mild pain is present for several days. The patient experiences discomfort during movement; there are difficulties when walking, bending and squatting. Unpleasant sensations completely disappear after 7-14 days, subject to compliance with the rehabilitation regime. Residual symptoms may bother you for up to two months, which is also normal.

If after the operation there is pain for a long time, the wound becomes inflamed, the condition worsens, this indicates the addition of complications.

Possible complications after surgery and their prevention:

1. Local- inflammation, necrosis, abscess, ischemia, phlegmon, hematoma.Prevention- compliance with the rules of asepsis during the operation, routine treatment of the wound after hernia repair, and the use of antiseptics.
2. Are common- thromboembolism, pneumonia, compartment syndrome.Prevention- comprehensive examination before surgery, treatment of infectious pathologies, restorative therapy, taking antibacterial agents.

Postoperative rehabilitation

In the early period after surgery (the first 2 weeks) there are a number of restrictions and rules:

• Before removing the stitches, you need to go to dressings and follow all instructions;
• it is important to take laxatives to avoid constipation;
• a strict diet and nutrition regimen is observed;
• physical activity, heavy lifting, and bending forward are excluded;
• You need to maintain weight after surgery for six months, otherwise there is a risk of sutures coming apart.

The first weeks after hernia repair are the most difficult, because there are many factors that can lead to increased intra-abdominal pressure and suture divergence. To minimize risks, it is important to exclude damage to the respiratory tract, stop smoking, and avoid inhaling dust, pollen and other irritants.

After elective surgery, bed rest is not necessary.

The patient is discharged from the hospital the next day and can move independently, take care of himself, eat and drink as usual with only minor changes. Already on the 3rd day after hernia repair, you can leave the house, take walks, and do light physical work, but only in a postoperative bandage.

Diet

The diet after surgery is selected to avoid bloating and constipation. In the early period of rehabilitation, you need to eat in small portions several times a day. Particular attention should be paid to the diet if you are overweight, because obesity is a risk factor for the development of abdominal hernia.

The goal of dietary nutrition will also be to reduce the load on the intestines, which puts more pressure on the area of ​​the operation than other organs. The main emphasis in nutrition is on boiled and steamed dishes.

Heavy foods should be excluded: fatty meat, mushrooms, legumes, cabbage. Portions should be small, but you need to eat at least 5 times a day.

After hernia repair, low-fat soups, vegetable purees, milk porridges, and vegetable salads are recommended. It is better to drink clean water from the liquid, and do this half an hour before eating. Compotes, weak green tea with honey, and jelly will be useful. Under no circumstances should you drink sweet carbonated drinks, strong coffee, or alcohol. The therapeutic diet is prescribed by a doctor, and it must be strictly followed, regardless of how you feel.

Complications after open surgery are rare. However, sometimes they do occur. This is often due to improper patient care, increased physical activity, and failure to follow doctor’s recommendations. One of the complications that develops during surgical intervention is a postoperative hernia in the abdomen. It forms at the site where the laparotomy was performed. In most cases, a hernia after surgery appears on the white line of the abdomen. However, it can develop in any area. Typical locations include cholecystectomy, removal of liver cysts, and surgery on the pelvic organs.

Postoperative hernia of the anterior abdominal wall - what is it?

Almost everyone knows that a hernia is a protrusion above the surface of the body. It has several components. These include: the gate, the hernial sac and its contents. Such protrusion can have different localizations. The most common hernias are inguinal, umbilical and femoral hernias. They can also be located in the spine. Any internal organs can be localized in the cavity. In most cases, these are intestinal loops (if the protrusion is located on the abdomen). With other types of hernia, the contents may be the spinal cord, male genital organs, liver, etc.

What are the differences between protrusions formed after surgical procedures? The main difference is the cause of occurrence, which is always surgery. Postoperative pain can be recognized by location and time of appearance. The contents of the bag may be the same as with other types of this pathology. The hernial orifice is the area where the surgical incision was made. In most cases, this is the white line of the abdomen, a scar after appendectomy, cholecystectomy. The hernial sac itself is represented by the tissues of the anterior abdominal wall - skin, muscles and fascia. Most often, the protrusion appears some time after surgery.

Types of postoperative hernias

Depending on the size of the hernial protrusion and its location on the anterior abdominal wall, several types of this pathology are distinguished. However, they all have the same reasons for their development. Regardless of the type, the protrusions develop into an abdominal hernia; in most cases, they are removed surgically. This is a diagnostic criterion for ventral (postoperative) defects. Depending on the location, the following types of hernias are distinguished:

1. Medial.
2. Lateral.

In the first case, the hernial protrusion is located in the midline of the abdomen. It can be located above, below or at the level of the umbilical ring. A lateral hernia is located on the side of the abdominal wall. In addition, there is a division into left- and right-sided protrusions.

Depending on the size, small, medium, extensive and very large hernias are distinguished. In the first case, the configuration of the abdomen is not disturbed. Medium and large hernias are visible to the naked eye. They occupy a significant part of the anterior abdominal wall. Very large protrusions may contain several internal organs (intestines, omentum) in the hernial sac. They occupy 2/3 of the area of ​​the anterior abdominal wall.

What is the difference between a postoperative hernia of the white line of the abdomen?

A postoperative hernia often occupies a medial position on the anterior abdominal wall. In this case, it is located in the area of ​​the white line of the abdomen. This location of the hernial protrusion occurs after massive surgical interventions. In some cases, a midline incision is made to diagnose surgical pathologies that cannot be detected by other methods.

A medial postoperative hernia in the abdomen occurs due to weakness of the anterior abdominal wall. The rectus muscles are located in this area. When performing surgical interventions along the white line, an incision is made into the skin and fatty tissue. The rectus abdominis muscles are pulled apart in different directions. Therefore, healing after laparotomy takes quite a long time. It is necessary to achieve not only the formation of a formed scar, but also the restoration (closing) of the rectus muscles.

Causes of a hernia on the abdomen after surgery

Normally, after surgical procedures, no hernial protrusions should form. Their appearance indicates non-compliance with the surgical technique and poor lifestyle after the intervention (heavy lifting, excessive physical activity). In addition, a ventral hernia can appear on its own. This is usually facilitated by various diseases, in which wounds heal more slowly than in healthy people. A postoperative hernia in the abdomen may appear due to the following reasons:

1. Prolonged abdominal tamponade. It is used during complex surgical interventions, as well as if complications arise. Among the operations after which ventral hernias develop, one can highlight: removal of the appendix and gall bladder. Also, long-term tissue healing is observed due to interventions on the stomach (bleeding, ulcer perforation) and intestines (obstruction), pelvic organs, and kidneys.
2. History of diabetes mellitus. Patients suffering from this disease often have vascular complications. As a result, any wound surfaces heal much longer and more difficult, in contrast to healthy people.
3. Violation of surgical technique. A hernia can occur due to poor-quality application, strong tension of the thread, or lack of preparation for surgery.
4. Wound infection. Occurs when a bacterial infection occurs due to non-compliance with hygiene rules and lack of proper treatment of the seam with antiseptics.
5. The patient is overweight.
6. Refusal to wear a bandage after surgery.

A ventral hernia can form at different times. For some, it appears a few days after surgery. In other cases, it develops over months.

Clinical picture of postoperative hernia

A postoperative hernia in the abdomen often does not bother patients, as it does not affect the general condition. However, if it appears, you should seek medical help. After all, regardless of the type and location of the hernia, serious complications can develop. The most common and dangerous of them is the infringement of internal organs. The main symptoms of an uncomplicated hernia are:

1. The appearance of a protrusion (tubercle) rising above the surface of the anterior abdominal wall. It can have different sizes and shapes (usually round, oval). The consistency of the hernia is usually soft.
2. Self-reduction of protrusion. If the hernia is small, it disappears when you change your body position or press on it with your finger.
3. The appearance of protrusion when the abdominal muscles are tense, coughing.
4. Pain when rubbing against clothing.
5. In some cases - nausea and vomiting.
6. Intestinal dysfunction (constipation or diarrhea).

When a hernial protrusion is strangulated, the clinical picture of an “acute abdomen” develops. This is due to compression of the intestinal loops and ischemia. In severe cases, the strangulated organs undergo necrosis. This is accompanied by severe pain, increased body temperature, and intoxication.

Diagnosis of abdominal hernia

Diagnosis of ventral hernias is based on examination and questioning of the patient. It is necessary to find out how long ago the surgical intervention was performed and how long it took the scar to heal. If the patient complains of a painful formation that reduces on its own, a diagnosis can be made: a postoperative hernia in the abdomen. Photos of similar protrusions can be found in the medical literature. In appearance, hernias can resemble various neoplasms. Therefore, if any protrusion appears, you should consult a surgeon. Only he will be able to correctly carry out differential diagnosis.

Treatment of postoperative hernias at home

Removal of a postoperative hernia on the abdomen can only be performed by a qualified specialist. However, in some cases, surgery can be avoided. Conservative treatment of hernia is carried out at home. This includes: following a diet, fighting constipation, limiting physical activity and wearing a special bandage or shapewear.

Surgical removal of postoperative hernia

In most cases, surgical treatment of a postoperative abdominal hernia is indicated. It is used when conservative therapy is ineffective and the protrusion is large. The indication for emergency surgery is a strangulated hernia. In this case, detoxification and symptomatic therapy, necrectomy, and hernial orifice plastic surgery are performed. In uncomplicated cases, planned surgical treatment is indicated.

Types of operations to remove abdominal hernia

The choice of surgical treatment depends on the size of the hernia. In case of slight protrusion of organs, autoplasty is performed. It involves closing the defect with the patient’s own tissues. If the hernia is large, the operation is performed under general anesthesia. In order to restore the aponeurosis of the anterior abdominal wall, special implants are used - synthetic meshes. They help strengthen the muscles and reduce the likelihood of a hernia recurring. Currently, this technique is widespread in all countries.

Prevention of postoperative hernias on the abdomen

Preventive measures should be taken not only by doctors performing surgery, but also by patients. You should not lift heavy objects or engage in physical exercise for one month after surgery. It is also recommended to avoid developing constipation. To do this, you should follow a diet and, if necessary, take laxatives. After laparotomy, it is necessary to wear a bandage. It helps restore the abdominal muscles to their previous state.

An abdominal hernia is a protrusion of internal organs outside the abdominal cavity. A hernia appears as a swelling that can be painful. A strangulated hernia, in which the blood supply to the strangulated organs is disrupted, is extremely dangerous.

When thinning or holes appear in the muscle wall, adipose tissue, intestinal loops, and other internal organs can escape through it. This leads to discomfort, intense pain and widespread complications. An abdominal hernia does not go away on its own - over time it only increases in size. Treatment for hernia is surgical only. The operation to remove a hernia is called hernia repair or hernioplasty.

The greater the development of the pathology, the higher the risk of an emergency condition. If, for example, you “start” a hernia of the white line of the abdomen, it will become irreducible. If surgery is not performed, the patient is at risk of strangulation with swelling, rapid infection and death of the tissue.

People at risk for hernias that can only be treated with surgery include:

with a chronic cough - for example, smokers have a higher risk of hernias;

frequently lifting heavy objects - during such work it is necessary to undergo regular examinations;

those who have given birth to a child - an abdominal wall hernia may develop during pregnancy;

those suffering from excess weight, allergies with frequent sneezing, difficulty defecating, etc.

The doctor issues a referral for surgery after a comprehensive examination of the patient. In addition to mandatory palpation and examination, ultrasound of the abdominal organs and laboratory tests are prescribed. You should consult a doctor when the first symptoms appear.

Symptoms and signs of the need for hernioplasty

When weakness appears and the muscles of the abdominal wall diverge, a hernial sac is formed. The process may be asymptomatic, but more often the patient feels itching and burning in the area where the hernia has formed. When a loop of intestine enters the pouch, a swelling appears - where the white line passes or in another area. Sometimes, if the patient lies on his back, the visual defect disappears.

Each hernia is individual, and its symptoms manifest themselves and the operation is performed in the same way. Pain sensations range from discomfort to a feeling of tearing. Indications for removal may be:

feeling of pressure, burning in the groin, scrotum, abdomen;

bulges and bumps in the abdomen, groin area, which become visually more noticeable when coughing;

ol for coughing, heavy lifting, etc.

In case of irreparable injuries, surgery is performed as soon as possible. Delay is fraught with vomiting, blood in the stool, intense and increasing pain in the scrotum and groin. If these symptoms occur, you should immediately call an ambulance or go to the emergency department.

How is the operation performed?

During the intervention, the hernial contents are immersed through the hernial orifice back into the abdominal cavity, after which plastic surgery of the hernial orifice is performed. During operations, the area of ​​the hernial orifice is strengthened either with the body’s own tissues or with implants (polymer meshes). Hernioplasty can be performed laparoscopically (through small incisions under visual control using special equipment).

If you are looking for where to have a hernia removed in Moscow, contact Family Doctor. The Family Doctor performs hernia repair for various abdominal hernias. If possible, preference is given to laparoscopic hernioplasty. You can find out the cost of surgical intervention for hernias of various locations below.

A hernia is a serious disease characterized by the protrusion of organs and parts from their normal location. The bulging does not violate their integrity, but a connective tissue defect is formed. If you look visually, the hernia resembles a tumor in appearance.

The size of the formations varies from small to large, the edges are clear and smooth, the skin is not damaged, and there is no pain. However, there are situations when pinching occurs and immediate hospitalization with further surgery for a hernia in the abdomen is required.

Symptoms of an abdominal hernia and when emergency care is needed

The clinical picture does not have clear signs, but recognizing it is not difficult. The main manifestation of the pathology is unpleasant painful sensations and a feeling of fullness. And also the pain can be cramping and have varying severity and strength. The formation of a hernial sac during gestation does not pose any particular danger. The enlarged uterus will serve as a plug and will not allow it to be pinched.

Soreness most often occurs during or immediately after physical activity. After some time, the unpleasant sensations dull. Patients complain of absence of bowel movements for 3 or more days, nausea and vomiting. At the beginning of its development, the hernia is visible; it sticks out even more when sneezing or coughing, but may disappear if the patient takes a lying position.

Sometimes it happens that the hernia is strangulated and then emergency surgical treatment is necessary. Symptoms of the disease are divided into two groups: early and late. The first include paroxysmal pain, vomiting 5 times or more that does not bring relief, flatulence, decreased or absent intestinal motility, heartburn and belching.

Externally, the hernia becomes red and hot to the touch. Its density and pain increases. Late signs include purplishness of the skin and accumulation of exudate at the site of compression, severe fatigue, apathy, and high body temperature. The development of phlegmon of the hernial sac with subsequent melting of adjacent tissues may be observed.

During pinching, the size of the hernia can increase several times

Important! An umbilical hernia can be treated without surgery only in children.

Preparation for surgical treatment

Before performing a planned operation, you need to undergo some preparation.

• For at least 3 days (or better yet, more) do not drink any alcohol-containing drinks.
• Stop taking aspirin 2 weeks in advance, as it disrupts the hemostasis system, which is responsible for stopping bleeding.
• Eat right for a month, enriching your diet with foods rich in vitamins.
• Do not eat for 12–16 hours before surgery (usually from 6 pm the previous day).

No surgical interventions are performed if you have recently suffered from colds or inflammatory diseases. The interval between the end of the disease and the start of surgery should be at least 14 days.

In addition, it is necessary to undergo some medical procedures: donate blood for general and biochemical analysis, prothrombin index (PTI) and glucose, infectious diseases (HIV, hepatitis B and C, syphilis, etc.), and have an electrocardiogram of the heart. All these manipulations are not carried out if the hernia is pinched and emergency removal is necessary.

Types of operations

In surgery, there are 2 types of surgical treatment of abdominal hernia:

• Plastic surgery using one’s own tissues (tension hernioplasty).
• Surgical treatment using mesh (implant made of polymer inert material).

Tension hernioplasty is carried out using your own tissues; they are compared and stitched in the area of ​​the hernial orifice. This method has many disadvantages: tension, which results in the risk of developing improper tissue scarring, failure of sutures, a long rehabilitation period, pain after surgical treatment, a high percentage of relapses (ventral hernias).

More modern and highly effective methods include abdominal hernia operations with a mesh made of polymer inert materials. After such an operation, the repeated exit of organs from their cavities is reduced to less than 3% or less, healing occurs quickly and painlessly. Today, tension-free hernioplasty is the most popular in surgery. Depending on the access to the surgical site, open and laparoscopic methods are distinguished.

In government institutions, surgery to eliminate pathology is carried out free of charge. This includes all types of hernias: hiatus, linea alba, umbilical, inguinal and femoral.

Postoperative period

In the early postoperative period, which is the first 2 weeks, it is worth adhering to some rules and restrictions:

• Before removing the stitches, regularly visit the dressing room at least once a day and follow all the doctor’s recommendations.
• Take laxatives to prevent constipation.
• Following a strict diet and proper nutrition.
• Avoid bending forward, lifting heavy objects and strenuous physical activity.
• Stay in the same weight class for a minimum of 6 months, otherwise there is a risk of seams coming apart.

Any surgical intervention, even the most minor one, is stressful for the whole body. He needs some time to get stronger and recover.

How long does the rehabilitation period last? The first few weeks after abdominal hernia removal are considered the most difficult. There are many reasons that can cause increased pressure in the abdominal cavity, which will lead to suture divergence. To minimize them, it is necessary to eliminate the risk of inflammation of the respiratory tract. In addition, you should stop smoking, inhaling dust and pollen, as well as other irritants.

After discharge from the hospital, patients practically do not feel any strong restrictions in movement, self-care, eating and drinking. Already on the 3rd day after the operation, short walks in the fresh air and minimal physical activity are allowed, but only in a special bandage or corset.

Contraindications to intervention

Unfortunately, surgical treatment is not always an option to cope with the disease. Sometimes there are cases when surgical procedures are contraindicated or do not make sense:

• child's age up to 5 years. In children, there is a possibility that the hernia will disappear on its own as the child’s body grows. Therefore, if the hernia does not cause discomfort, the operation is not performed or postponed to a later date. This applies only to acquired hernias;
• infectious diseases in acute form and high body temperature. Treatment is carried out only after complete recovery;
• period of gestation. In order not to expose a pregnant woman’s body to unnecessary stress, it is worth waiting until the end of lactation or, in extreme cases, childbirth;
• impairment of pulmonary or cardiovascular activity;
• giant hernias in people over 70 years of age. It is necessary to carry out extensive surgery, which is poorly tolerated in old age;
• complicated cirrhosis of the liver;
• severe form of renal failure;
• varicose veins of the esophagus;
• myocardial infarction and stroke. In this condition, patients do not tolerate anesthesia well, so they try not to perform operations;
• incurable diseases. A hernia is not considered a disease that poses a severe threat to the body, but its removal may pose a health risk. Therefore, there is no point in subjecting patients with incurable pathologies to it;
• elevated blood glucose levels despite insulin administration.

Each such case is considered by a doctor individually. Only a specialist can assess the potential effect of treatment.

Complications

Complications of abdominal hernias include strangulation, inflammation and coprostasis.

Strangulated hernia

Sudden compression of the contents of the hernia in the hernial orifice. Absolutely any organ can be strangulated while in the hernial sac. A pathological condition occurs when there is a significant contraction of the abdominal muscles as a result of heavy lifting, a debilitating cough, and during straining. During pinching, there is always a disruption in the blood circulation of the pinched area and its normal functioning.

Hernia inflammation

It can occur both from the inside and from the outside. There are several types of inflammation: serous, purulent, serous-fibrinous, putrefactive. They occur in acute form, extremely rarely in chronic form. Infection of the contents of the hernial sac can occur through skin lesions, ulcers, and irritations.

There are rare cases of inflammation of hernias after injury. The onset of the pathological process is accompanied by severe abdominal pain, fever, and vomiting. It is very difficult to make a diagnosis, because pathology is confused with infringement.

Stagnation of feces, resulting in partial or complete blockage of the intestinal lumen. The disease develops equally in both childhood and adulthood.

Complications after surgical treatment of abdominal hernia are rare. They arise for various reasons: improper care of the patient, excessive physical activity, ignoring the instructions of a specialist.

The most common post-surgical consequence is recurrence of the hernia. It forms at the site where the hernial sac was excised earlier, most often on the white line of the abdomen.

Abdominal hernias are among the most common diseases in both adults and children. And although many do not give them due importance, there is an order from the Ministry of Health on the identification and treatment of hernias in the population, and this is not accidental. is mandatory because this disease poses a great health hazard due to the possibility of developing severe complications.

What is a ventral hernia

The expression ventral hernia comes from the Latin ventros - belly, that is, this is an abdominal hernia. The internal organs contained in it are closed inside by a connective tissue membrane by the peritoneum and are protected from the outside by the abdominal wall. It consists of several layers of muscle, aponeurosis (dense fibrous tissue), subcutaneous tissue and skin.

A hernia is formed when there is a gap, defect or divergence in the muscular aponeurotic layer of the abdominal wall. This is called the hernial orifice, and through it the organs covered by the peritoneum emerge under the skin. Most often it is the omentum and intestinal loops, but with large hernias other organs can also come out.

What are the types of abdominal hernias?

The abdominal wall anatomically has several weak points, where the aponeurosis is thinner or the muscle layer is not thick enough. Hernias most often appear in these places:

• in the umbilical region;
• in the groin area;
• in the area of ​​the white line of the abdomen (a longitudinal line running down the center of the abdomen).

In addition, a hernia can develop after any operation on the abdominal organs in the area of ​​the postoperative scar, as well as anywhere in the abdominal wall where, for any reason, muscle separation has occurred.

Clinically, hernias are reducible and irreducible. The first ones are characterized by the fact that they come out in a vertical position of the body, under load, and are set back in a horizontal position. To prevent the hernia from coming out, you can wear a special bandage.

When adhesions form between the peritoneum and the abdominal wall, the hernia becomes irreducible, that is, the protrusion does not disappear. In these cases, nagging pain appears, the likelihood of pinching is high, and wearing a bandage becomes ineffective.

Advice: You should not assume that if the hernia is reducible, you can do without surgery using a bandage. It is not always effective, does not provide a 100% guarantee, and during physical activity it will not protect against injury.

Why do hernias form?

Based on the reasons for their occurrence, hernias are divided into 2 groups – congenital and acquired. Congenital hernias are, as a rule, umbilical and inguinal hernias; they occur in both boys and girls, more often in premature babies and those with other congenital anomalies.

Acquired hernias always arise from increased intra-abdominal pressure against the background of a weakened abdominal wall:

• during prolonged physical activity associated with lifting weights;
• in case of large or multiple pregnancy;
• with frequent constipation;
• with persistent cough, especially in asthmatics and people with chronic bronchitis;
• with obesity and fullness of the stomach, excess nutrition;
• with injuries to the abdominal wall.

This also includes postoperative hernias - most often after operations on the stomach, intestines, and gynecological interventions.

Why is hernia removal necessary?

A hernia is by no means just a cosmetic defect. Frequent displacement of organs leads to disruption of their function and the formation of adhesions. But the most dangerous complication is strangulated hernia. This happens when a hernial protrusion, having emerged under the skin, is compressed by spasming muscles and cannot be set back.

The most dangerous thing in this case is squeezing the blood vessels. In this case, ischemia of the exited organs and their necrosis (death) develops. If such a hernia is not operated on in the first hours, this will lead to the development of peritonitis, intestinal obstruction, and the need to remove necrotic organs. Such operations are usually lengthy, difficult and fraught with complications.

Clinically, the infringement is manifested by the appearance of sharp pain in the area of ​​the protrusion, its thickening and irreducibility, followed by nausea, vomiting, increased body temperature, and deterioration of the general condition.

Advice: When symptoms of strangulated protrusion appear, you should absolutely not try to straighten it, this can lead to dead intestinal loops getting into the stomach and the development of peritonitis. The only correct thing is to urgently call the ambulance and hospitalize in the urgent surgical department.

What methods are used to remove abdominal hernias?

Modern surgery has a large number of different methods of operations for hernias, including those using the latest technologies. All of them can be divided into 2 groups:

• open hernia repair operations performed through a large incision in the abdominal skin;
• laparoscopic operations performed using a special fiberoptic probe with instruments inserted through small skin incisions (up to 2 cm).

Large or laparotomic operations are performed less frequently today, only in complex cases when the hernia is very large, as well as in case of strangulation, when it is necessary to examine the entire abdominal cavity. In most cases, the laparoscopic method is used, when manipulations with suturing the hernial orifice are performed in a closed manner under the control of a screen, the image to which is transmitted from a miniature video camera of the laparoscope.

This is how most of them are performed today; laparoscopy is also done. This is especially important for women, when there are no large post-operative scars left on the skin of the abdomen. Laser technology is used for more precise tissue dissection and hemostasis (“sealing” blood vessels and preventing hematomas).

In addition, modern laparoscopic hernia repair technologies are minimally traumatic, practically do not lead to pain, in most cases they do not require anesthesia, and their rehabilitation period is much shorter.

To close the hernial orifice, both patient tissue and synthetic materials are used, most often plastic meshes. They are used in cases of large hernia defects, with loose tissues of the abdominal wall, in weakened and elderly people, and reliably protect against the recurrence of a hernia.

Abdominal hernias should be subject to timely surgical treatment, before complications develop, when surgery is much less dangerous and more effective. Following the diet and other doctor’s recommendations during the postoperative recovery period will prevent the recurrence of the hernia.

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Attention! The information on the site is presented by specialists, but is for informational purposes only and cannot be used for independent treatment. Be sure to consult your doctor!