Stages of abdominal hernia surgery. Abdominal hernia removal with mesh

Hernia of the white line of the abdomen is a “cunning” pathology. Its trick is that at first it does not manifest itself in any way. The person does not even realize that he is faced with such a problem.

Very often the problem is identified during a random diagnostic examination. This, by the way, is one of the arguments why it is important to visit a doctor from time to time for preventive purposes.

As the hernia increases in size, it may “protrude” in the upper part of the midline of the abdomen. The place of “protrusion” is accompanied by pain, which intensifies with increasing physical activity.

A person may experience nausea, vomiting, belching and heartburn.

Is a hernia of the linea alba dangerous?

Have you noticed any of the listed symptoms? Make an appointment with your doctor. Don't wait for complications to arise.

By the way, about complications. Yes, the disease is not fatal and, according to official data, occurs in less than 15% of the total population.

However, the fact is that in the area of the white line of the abdominal wall there are slit-like spaces. Blood vessels and nerves pass through them. It often happens that, increasing in size, the hernia gets into these cracks and puts pressure on the nerves and blood vessels. This has an extremely negative effect on the functioning of the nervous and circulatory systems.

A strangulated hernia is the most serious complication. If you consider that the gates are most often relatively narrow - 5-6 centimeters, then the risk increases many times over. In case of infringement, emergency surgical treatment is performed.

And, of course, one cannot fail to mention disturbances in the functioning of the gastrointestinal tract, inflammation, which are faithful companions of this problem.

Treatment is carried out through surgery and is successful if treated in a timely manner.

Surgery to remove a hernia of the linea alba

It is carried out only in a hospital setting. ON CLINIC offers modern operating rooms and wards for a comfortable stay with an automatic doctor call system. The friendly medical team at ON CLINIC will provide you with the necessary assistance at any time of the day or night.

ON CLINIC surgeons usually perform laparoscopic surgery. Such manipulation is a reliable way to get rid of the problem with minimal tissue trauma, minimal recovery period and maximum comfort during and after surgery.

Such results are achieved due to the fact that the doctor performs the procedure without incisions in the skin. He makes several small punctures on the patient’s body, through which he inserts equipment and performs the necessary manipulations.

During surgery, the surgeon, having gained access to the hernia, isolates it, places the internal organs from the hernial sac in their natural place in the peritoneal cavity and performs abdominal wall plastic surgery.

The specificity of the manipulation is the mandatory elimination of discrepancy or, scientifically speaking, diastasis of the rectus abdominis muscles.

As for plastic surgery, it can be performed either using the patient’s own tissues or using synthetic prostheses - a special mesh made of hypoallergenic materials.

The first method has limited use - only for small defect sizes and strong surrounding tissues. Otherwise, if the connective tissues are weak, which is common in older people, the chance of recurrence can be up to 40 percent. Synthetic mesh is an ideal material for closing a defect and an excellent way to reduce the risk of re-perforation to zero. Over time, as the mesh is completely implanted and becomes overgrown with body tissue, this protection becomes even more powerful.

The synthetic mesh used in ON CLINIC is hypoallergenic and safe for the human body.

How much does the operation cost?

The cost of surgery to remove a hernia of the linea alba depends on the size of the hernia and its characteristics, the presence or absence of complications, diagnostic and surgical methods, selected materials, qualifications of specialists and a number of other factors.

Most often, postoperative hernias occur after emergency surgical interventions on the abdominal organs, as well as planned operations on the intestines, liver, and pancreas. Depending on the size, the hernia can be: small, medium, extensive or even gigantic. By location, ventral postoperative hernias are divided into:

medial (located in the central part of the body),
lateral (located on the sides).

Depending on the correction method, there are:

reducible postoperative hernias (characteristic of the initial stage of the disease and small protrusion);
irreducible postoperative hernias requiring mandatory surgical intervention.

Symptoms of a hernia after abdominal surgery

The appearance of a tumor-like protrusion along the postoperative scar, which, if small in size, can be reduced independently if the patient is in a horizontal position.
Pain in the scar area during physical activity, coughing, or sudden movements.
Gastrointestinal disorders: bloating, constipation, nausea, vomiting.

If at least one of the listed symptoms appears, you should immediately consult a doctor.

Diagnosis of postoperative hernia

For diagnostics the following is carried out:

examination of the patient by a surgeon and palpation of the protrusion area;
Ultrasound of the abdominal cavity and hernial sac;
X-ray or tomography of the abdominal organs;
a series of tests to determine the patient's condition.

Treatment of postoperative suture hernia

Surgical treatment of postoperative hernias is more complex due to the fact that the intervention is performed on tissues with scarred changes. In this case, the optimal treatment method is tension-free hernioplasty. For this purpose, a mesh endoprosthesis is used, with which the hernial orifice is closed. Thus, installing an implant allows you to strengthen the abdominal wall and prevent relapse. Depending on the size and location of the hernia and the patient’s condition, the surgeon may perform open or endoscopic hernia repair. Open access intervention is performed under local or general anesthesia. Endoscopic hernioplasty - only with the use of general anesthesia. In any case, modern instruments and materials make postoperative scars practically invisible, and the postoperative period after removal of a hernia is reduced to several weeks.

An abdominal hernia (abdominal or ventral) is a dangerous disease that causes severe complications. With pathology, tissue fibers diverge or break. Through the resulting defect, a fatty layer protrudes with a hernial sac, which has pulled in the internal organs.

Minor discomfort at the beginning of the disease gradually progresses and ultimately causes strangulation of the hernia, tissue necrosis and peritonitis. Doctors insist that surgery to eliminate a hernia should take place in the initial stages, when the size of the protrusion is small. Whereas later, the consequences can be unpredictable.

Causes

The formed abdominal muscles reliably fix the organs located in the abdominal cavity and prevent them from falling out.

The white line is a vulnerable part of the abdominal wall. It is formed by connective tissue structures. Muscle tissue does not participate in the formation of the white line. The lack of muscle makes the linea alba the most vulnerable part of the abdomen.

In normal condition, the width of the line is 1-3 cm. As the connective tissue structures become thinner, they stretch. This leads to divergence of the muscles, allowing the formation of a hernial orifice. The wider the gate, the more severe the disease.

There are other weak spots in the anterior wall of the abdomen. Hernial protrusions, having pushed apart a thin layer of connective tissue and muscle fibers, emerge under the skin.

Increased intracavitary pressure pushes the hernial sac through weakened muscle walls. Factors that create high intra-abdominal pressure include:

prolonged inadequate physical activity;
large fetus in pregnant women;
systematic constipation;
debilitating cough caused by asthma, bronchitis, pneumonia;
obesity;
full stomach with constant overeating;
weakening of muscle tone and aging of tendon tissue in old age.

The appearance of hernia formations is influenced by damage to the abdominal cavity. Hernias also occur after abdominal surgery. Their formation is provoked by surgical interventions performed on the genitals, stomach, intestines, and gall bladder.

Types of abdominal hernia

Based on location, ventral hernias are divided into:

umbilical (supra-, sub- and peri-umbilical);
inguinal;
femoral;
postoperative;
protrusion of the linea alba.

According to etiology they distinguish:

Congenital protrusions. Usually the baby is immediately born with a pathology. Sometimes it occurs in a newborn after some time.
Acquired education. A bulge occurs when tissues lose their elasticity. Muscle elasticity decreases with age and when the body is exhausted.

According to the type of course, abdominal hernias are divided into:

Full. The filled sac penetrates through the gap in the hernial orifice.
Incomplete. The formations remain in the abdominal cavity. This phenomenon is observed in early pathologies.

Other hernias include:

Reducible hernia formations. The prolapse moves and changes location through the opening of the hernial sac. It either comes out under the skin or goes back into the abdominal cavity.
Irreversible protrusions. The hernia cannot be repaired. Organs pulled into the bag cannot be returned to their original anatomical position.

The classification of hernias of the white line depends on the severity of the pathology:

I degree. The width of the white line is 3-5 cm.
II degree. The white line expands by more than 7 cm;
III degree. Organs fall out, the stomach drops.

Symptoms

In the early stages, the main symptom is a periodically disappearing protrusion. During this period, the hernia causes almost no discomfort to the patient. He is occasionally bothered by transient pain of a dull nature. As the pathology develops, acute, sharp pain occurs.

In addition, the patient is worried about belching, constipation, nausea and vomiting syndrome, and poor health.

Complications

Neglected hernias cause dangerous complications. Pinching of the hernial sac is life-threatening. When pinched, the digestive organs are compressed. In clamped organs, there is a complete or partial blocking of blood vessels transporting nutrients. Due to lack of nutrition, tissue necrosis begins, which leads to gangrene of the intestines.

The walls of the peritoneum become inflamed. The outbreak of purulent processes leads to peritonitis - a dangerous complication that can be fatal.

The strangulation causes intestinal obstruction. The intestines become clogged with feces. Toxins accumulated in the body in incredible quantities cause intoxication. The body's excretory system cannot cope with neutralizing poisons. The patient experiences renal failure.

The first signs of an abdominal hernia are a serious cause for concern and a visit to the hospital for medical help. Removal of a hernia in the initial stages guarantees a favorable outcome of the disease.

Removal methods

Sometimes patients naively believe that diets, bandages and physical therapy can help eliminate hernia formation. This is a dangerous misconception. Such methods do not treat abdominal hernias; surgery is the only salvation from an abdominal defect and a chance for recovery.

Exercise increases the risk of strangulation of the hernia formation and subcutaneous fat layer. Diet provides temporary relief, possibly through weight loss. At the slightest load on the abdominal area or awkward movement of the body, the hernial sac falls out again.

The bandage is not capable of permanently holding a loop of intestine inside the abdominal cavity. It is impossible to replace the surgical removal of a hernial protrusion by wearing a bandage, no matter how much time it takes. With prolonged wear, on the contrary, adhesions appear in the hernial sac, and the hernia becomes irreducible. Unjustified long-term wearing of the device has the opposite effect. Mechanical loads from the abdominal muscles are transferred to the bandage, which leads to weakening of the muscles, stretching of connective tissue structures and the growth of hernia formation.

It is advisable to wear a bandage for people whose surgery has been postponed for a short period of time. In these cases, a bandage is worn to prevent the progression of the pathology.

Abdominal hernia corrects itself only in children under 5 years of age, including through exclusively traditional methods of treatment.

But sometimes babies also need surgery. The indications for it are the size of the hernial formation. Large defects in a child are eliminated until the tissue loses its elasticity.

How the operation is performed

Operations are divided into planned and emergency. Planned intervention is indicated for patients who feel discomfort at the site of the formation, without strangulation of the hernial sac.

The following signs indicate infringement:

unbearable pain in the abdomen;
the formation is not reduced;
nausea and vomiting syndrome;
disappearance of bowel movements;
blood inclusions in stool;
accumulation of gases in the intestines.

Preoperative preparation

Patient preparing for surgery:

refuses to drink alcoholic beverages 3 days before the surgical procedure;
does not use drugs with acetylsalicylic acid 14 days before surgery (they reduce blood clotting);
eats rationally and takes vitamins 14 days before treatment.
The last time he eats is before 20-00 the previous day.

Surgery is postponed for patients who have had infectious diseases. The interval between the end of treatment for infections and surgery is 14 days (except in emergency situations).

The patient is sent for a medical examination. The study includes:

blood analysis;
tests for sugar, group and rhesus, prothrombin index (PTI);
testing for infections (syphilis, hepatitis, HIV);
electrocardiogram.

Operating methods

Surgery is performed under local anesthesia or general anesthesia. It is preferable to remove non-strangulated hernia formations using local anesthesia. Local anesthetics do not have a negative effect on the cardiovascular system. After them, the person does not require long-term observation. The patient does not feel sick and can eat food without fear.

If there is no strangulation, surgery for abdominal hernia with mesh is performed quickly, without complications.

Classic operations are performed by tensioning weakened layers. A positive outcome of the operation is noted in 60-80% of patients. Relapses occur in 20-40% of patients. Repeated loss occurs due to the enormous stress on the scars. With strong tension in the abdominal cavity, the threads cut through the weakened tissue, opening the exit to the hernial sac.

Hernioplasty with mesh graft

The best way to excise a hernia is considered to be a surgical procedure with the introduction of a mesh endoprosthesis. The entire resulting load falls on the sewn-in implant. The mesh is implanted without complications and is overgrown with connective tissue.

The defect, closed with a mesh prosthesis, turns into a homogeneous structure that is resistant to stretching and tearing. The newly formed wall prevents the repeated protrusion of the internal organs.

Laparoscopy with surgical mesh implantation

Small formations are removed by laparoscopy. Thanks to a fiberoptic probe, which displays an image of the abdominal organs on the monitor, the doctor assesses the situation and performs precise manipulations.

The procedure does not require extensive abdominal dissection. Only small punctures are made through which a probe, instruments and a mesh implant are inserted. There is no heavy bleeding during the operation. Minor tissue damage heals quickly.

The method is not suitable for people who have suffered from abdominal diseases. Laparoscopy is not performed for large hernial protrusions and strangulated hernia.

Postoperative period

Patients who have undergone removal of a strangulated hernia, in which tissue necrosis and peritonitis have occurred, require a long rehabilitation period. In this situation, the surgeon removes dead tissue and sanitizes the abdominal cavity. After the operation, the patient is prescribed drug therapy. He takes anesthetics and antibiotics.

If an unstrangulated hernia was operated on, the postoperative period ends quickly. The patient is discharged from the clinic one day after surgery. He is able to:

move around the house (walking promotes healing);
eat regular foods;
leave the house on the 3rd day after surgical treatment.

Although the field surgical regimen is flexible, the patient is advised to adhere to certain rules:

do dressings in the clinic until the stitches are removed;
use laxatives (constipation during the rehabilitation period causes suture dehiscence and hernia recurrence);
refrain from bending forward;
do not do physical therapy and yoga until the excisions heal;
do not lift heavy loads for 2-3 months (after removal of stitches, lifting objects over 5 kg is prohibited);
control body weight for at least six months (excessive load can provoke divergence of fragile tissues and cause prolapse of a hernial protrusion);
try to avoid factors that contribute to the appearance of cough (when coughing, a person strains the abdominal walls, which can cause a relapse)

Compliance with prevention and careful attention to health does not allow serious complications to arise during the rehabilitation period.

An abdominal hernia must be removed surgically before complications occur. The operation in the early stages is not dangerous. Treatment of small hernias is more effective than large and strangulated ones. Following medical recommendations during the rehabilitation period prevents the recurrence of a 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:

Plastic surgery using your own tissues .
Laparoscopic plastic surgery.
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:

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.
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:

Medial.
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:

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.
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.
Violation of surgical technique. A hernia can occur due to poor-quality application, strong thread tension, or lack of preparation for surgery.
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.
The patient is overweight.
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:

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.
Self-reduction of protrusion. If the hernia is small, it disappears when you change your body position or press on it with your finger.
The appearance of protrusion when the abdominal muscles are tense, coughing.
Pain when rubbing against clothing.
In some cases - nausea and vomiting.
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.