Author
Osadchuk Elena Vitalievna
Senior doctor
Surgeon
until December 31
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Hernioplasty
is the surgical treatment of a hernia (from the Latin Hernia - hernia).
Previously, surgical treatment of a hernia was more often called hernia repair
or
surgery to remove a hernia
, but this name does not correspond to the essence of the operation - after all, the hernia is reduced, not excised. Currently, hernia treatment is carried out, whenever possible, laparoscopically - that is, using instruments inserted through small holes in the abdominal wall, without a wide incision in the abdominal cavity.
A hernia is a protrusion of organs from the cavity they should occupy. Such protrusion occurs through normally existing or pathological openings. The most common type is abdominal hernia.
More details about hernia>>>
Planned surgery
The operation to remove an umbilical hernia is performed under local anesthesia. Only in cases of extremely advanced hernia is general anesthesia required.
The Zdorovye network of surgical clinics in Moscow uses minimally invasive methods for umbilical hernia surgery, including hernioplasty. Such operations involve minimal surgical intervention, practically invisible traces of the operation and a short rehabilitation period. On the first day after the operation you will need to wear a bandage; within a week after the operation you can return to your normal lifestyle, with the exception of physical activity. Sports activities are allowed two months after surgery.
In our clinics, specialists use the technology of plastic surgery of the anterior abdominal wall “without tissue tension” and “with tissue tension”, depending on the age of the patients and the size of the defect. How long the operation lasts depends on the degree of development of the hernia. On average, the procedure takes from half an hour to two hours. The cost of the service also depends on the degree of development of the pathology. For an initial consultation, make an appointment with the “Health” surgeons.
Tension and non-tension hernioplasty
The only way to eliminate a hernia is surgical treatment. Modern medical technologies make it possible to perform hernia repair using mesh implants, which significantly reduces the risk of hernia re-formation. Previously, a hernia was treated like this: the organ was set in its proper place, after which the area of the hernial orifice (the hole through which the protrusion occurred) was strengthened with the body’s own tissues. As a result, the soft tissues (muscles and tendons) at the operation site were stretched. Under these conditions, the probability of cutting through the sutures and recurrence of the hernia was quite high - up to 25%.
Laparoscopic hernioplasty
The use of polymer mesh allows you to avoid fabric tension. The mesh strengthens the area of the hernial orifice. Within a month, the mesh grows into the tissue. Such a frame securely holds the organs in place. With tension-free hernioplasty, the risk of hernia re-formation on average does not exceed 1%.
Symptoms and signs
The main sign of the presence of an umbilical hernia in adults is protrusion of the navel of varying degrees of severity. Essentially, a hernia looks like a lump on your stomach. You can detect a protrusion on your own by placing your fingers on the navel and straining your stomach or coughing. At the same time, a push will be felt under your fingers.
A small hernia can be easily reduced. But it will probably come out again. A large hernia is often accompanied by umbilical adhesions and cannot be simply repaired. In addition, with an advanced hernia, the patient is often bothered by nausea and vomiting, and problems with stool. If organs adjacent to the navel are “pulled” into the hernia, this can be accompanied by many unpleasant symptoms. For example, problems with urination.
The hernia itself does not hurt. But when overexerted, pain appears. Pinched organs can also be painful. If the hernia is not treated in time, it can involve most of the peritoneal organs.
How is recovery after umbilical hernia surgery?
The duration of the rehabilitation period depends on the patient’s condition before surgery, the method of intervention and the patient’s compliance with all doctor’s instructions. If there are no complications, a few days are enough for recovery. After 7-10 days, the sutures are removed if they were not made with self-absorbable threads.
In the first few months, physical activity with lifting weights of more than 3 kg is prohibited. In some cases, a bandage is prescribed, the duration of which is determined individually. You can return to your previous rhythm of life in just six months.
Causes of umbilical hernia
With the exception of pregnancy, the causes of hernia formation in men and women are the same
:
- Abdominal injuries
- Obesity and, conversely, too sudden weight loss
- Congenital pathology of the umbilical ring, in which it does not heal completely
- Low physical activity, as a result of which the abs weaken and the risk of hernia increases
- Physical overexertion increases intra-abdominal pressure, which increases the risk of hernia formation.
- Having undergone abdominal surgery if the doctor’s recommendations are not followed can also provoke an umbilical hernia in men and women
- Pathologies accompanied by increased intra-abdominal pressure
Pregnancy and childbirth
This reason is worth highlighting separately. During pregnancy, a woman's belly stretches and the edges of the navel increase in diameter. Pregnancy often causes constipation, which in turn causes increased intra-abdominal pressure.
Pregnancy implies a whole range of reasons for the occurrence of umbilical hernia in women
:
- Multiple pregnancy
- Excess amniotic fluid
- Difficult birth
- Large fruit size
How is the operation to remove an umbilical hernia performed in adults and children?
Before prescribing an operation, the doctor must interview and examine the patient and prescribe tests. These include:
- General blood and urine analysis.
- ECG.
- Determination of blood clotting parameters.
- Fluorography.
- Blood test for HIV, hepatitis, syphilis.
If contraindications are detected, the doctor decides to temporarily postpone the surgical intervention or cancel it completely. In the latter case, conservative treatment is used. Bandage, massage and therapeutic exercises are prescribed.
Preoperative preparation begins with a special low-calorie diet with the complete exclusion of heavy foods. If the patient is taking blood thinners, he should stop taking them 10 days before the planned surgery. On the eve of the intervention, it is necessary to do a cleansing enema.
Endoscopic intervention is performed under general anesthesia. During the procedure, the surgeon makes 3 punctures with a diameter of 5 to 15 mm, into which instruments and a laparoscope with a video camera are inserted. The abdominal cavity is filled with carbon dioxide to expand the space needed for manipulation.
Next, the surgeon dissects the hernial sac and sets the prolapsed organ in place. To strengthen the hernial orifice, a special implant is often used - a mesh-shaped endoprosthesis. After completing all the manipulations, the doctor sews up the punctures, forming neat seams. The duration of the operation ranges from 30 minutes to 2 hours.
Diagnostics
A surgeon diagnoses an umbilical hernia. To determine the presence of a hernia, the doctor only needs to conduct an examination. An umbilical hernia itself is not dangerous. However, it is important to distinguish a hernia from a neoplasm or metastases of an oncological process in time, and also to prevent the development of the process of “pulling” organs into the hernia.
In addition to digital examination, the following methods are used to diagnose an umbilical hernia:
:
- X-ray of the stomach
- Esophagogastroduodenoscopy
- Ultrasound examination of the abdominal cavity
- Herniography
Preparing for surgery
As noted earlier, most surgeries for umbilical hernia are performed before the age of 5 years. Before the actual operation, the child is sent to preoperative preparation, which includes:
— consultations with a pediatrician and surgeon;
- general blood analysis;
— determination of the Rh factor;
- general urine analysis;
— biochemical analysis;
— ECG.
After the child undergoes preoperative preparation, an anesthesiologist consults with the baby’s parents. The operation is performed under general anesthesia.
Physical therapy exercises
A physical therapy complex aimed at speedy recovery of the body after surgery may include basic gymnastic exercises that relax and strengthen the muscles of the abdomen, back and hips. All ab exercises are prohibited.
It is necessary to do similar gymnastics daily, dividing the entire complex into several approaches, each of which lasts 15-20 minutes.
Examples of various exercises are below, but it is better to discuss any exercises with your doctor:
The specific exercises included in the physical therapy complex are selected by the attending physician, and then the patient himself can adjust them to his feelings and capabilities.
If, while performing one or another exercise from the complex prescribed by a specialist, the patient feels discomfort or pain, then this should definitely be reported to the attending physician. Such negative sensations may be a sign of postoperative complications.
Carrying out the operation
At the First Children's Medical Center, it is possible to perform an operation using open access (through an incision in the abdominal wall).
During the operation, the surgeon excises the hernia and pushes the contents into the abdominal cavity. Then manipulations are carried out with the tissues of the umbilical ring (strengthening the tissues to prevent relapse). After this, the navel is given an aesthetic appearance. As a rule, this type of operation lasts no more than half an hour.
TREATMENT OF DIAPHRAGMAL HERNIA
Who needs surgical treatment for hiatal hernia? Elimination of a hiatal hernia is necessary for patients with a paraesophageal (paraesophageal) hernia due to the risk of strangulation, regardless of the severity of existing symptoms, as well as for patients with a sliding hiatal hernia, which has pronounced clinical manifestations in the form of heartburn, regurgitation (regurgitation) of food and requiring constant drug treatment.
Patients with extraesophageal symptoms of a diaphragmatic hernia (recurrences of pneumonia and bronchitis, night cough, chronic laryngitis), Barrett's metaplasia, side effects from therapy with acid-lowering drugs are also candidates for surgical treatment.
Figure - Main types of hiatal hernia
Rehabilitation period
This operation belongs to the so-called outpatient surgery. After direct surgery, the child spends 6 to 12 hours in the hospital, after which he is sent home. Before discharge, it is imperative to consult with your doctor to receive recommendations for caring for your child. It is very important to clean the wound daily and keep it clean. After a week (or 10 days), you must come to the Center to remove the stitches and observe the surgeon. It is worth noting that the rehabilitation period is quite easy, since almost all children tolerate such surgical procedures well.
Advantages of umbilical hernia treatment at the First Children's Medical Center
The first children's medical center is equipped with modern equipment. Advanced technologies are used during operations. All this, coupled with the experience of our doctors, allows us to reduce the risk of developing any complications, as well as the traumatic nature of interventions, to almost zero.
The health of your child should be entrusted to professionals. If the first symptoms occur, consult a doctor! At the First Children's Medical Center, experienced doctors will quickly recognize the signs of the disease, conduct a full examination using modern medical equipment and provide qualified medical care. We work seven days a week and are waiting for you at any time from 8.00 to 20.00.
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Postoperative ventral hernia
Dear Konstantin Viktorovich! I would like to express my immense gratitude to you and the entire team of the Swiss University Clinic for returning me to normal life - without pain, without anxiety and fear, with full confidence that now everything will be GOOD!
It so happened that I received treatment at this clinic twice. Over the past six months, I have consulted several gastroenterologists. But it didn’t get any easier: the pain somewhere in the stomach area intensified, no medications or diets helped. Finally, a diagnosis was made - cholelithiasis. They suggested trying to dissolve the stones using medications (ursosan). They warned me that I would have to drink them for a long time, several months. For almost three months, I went to the pharmacy more often than to the store for bread: a lot of medications were prescribed, I had to take handfuls of pills! But instead of relief, a severe pain attack began. The pain made it dark in my eyes, and I was ready for surgery, and for anything - if only someone would help!
Using the Internet, the sons found information about Professor K.V. Puchkov. as the best specialist in this field and immediately contacted his clinic. And despite the huge busyness that day: operations and consultations were planned, he did not refuse to see me (for which special thanks to him!). From just communicating with him, from his calm confidence, the panic immediately decreased, and I realized that this person would definitely help me. A short time later, after all the necessary examinations, I was already lying under IVs in a comfortable room under constant supervision by very attentive and sensitive doctors and nurses. As Konstantin Viktorovich explained, I had acute cholecystopancreatitis (against the background of cholelithiasis, the pancreas also became inflamed). It was impossible to operate at this moment. Three days later I was discharged home without pain for further rehabilitation.
And so on June 18, 2014, after a preliminary consultation with Konstantin Viktorovich, I underwent 2 operations at once (during the examination, an umbilical hernia was also discovered). For some reason I was very afraid of anesthesia. But anesthesiologist Ruslan Avelievich Vinogradov calculated everything in such a way that I didn’t even feel it! After the operation I came to my senses very quickly, there was no nausea, etc. There are only 4 punctures in the abdomen (the hernia was removed through a puncture in the navel, a mesh implant was inserted). I didn't expect everything to go so easily! When Konstantin Viktorovich arrived, I was already reading a book. ))) On the 3rd day I was discharged. It's only been 8 days and recovery is going very quickly.
In conclusion, I would like to once again thank Konstantin Viktorovich for everything. In addition to the fact that he has golden hands, he also has a big heart, the warmth and kindness of which is enough for all his patients without exception. Konstantin Viktorovich, I wish you health, strength, new successes and discoveries! Prosperity to your clinic, you have a wonderful professional team, excellent conditions. I will recommend you to my loved ones with full confidence in a successful outcome.
Diagnosis: Gallstone disease. Chronic calculous cholecystitis. Irreversible umbilical hernia. Operation performed: Laparoscopy, cholecystectomy. Umbilical allohernioplasty.
Larisa Drozhzhina [email protected]