Hernia is the protrusion of tissue, usually the bowel and/or abdominal tissue, through a natural or formed opening in the abdominal wall. It occurs due to congenital tissue weakness or damage of the abdominal wall (surgery, injury). Hernias usually occur in the groin area, around navel or in the place of a previous surgical procedure.
Hernia cannot be healed on its own. It becomes bigger with time, which causes tingling and pain. Incarceration is the most difficult complication of hernia. This is a condition when a bowel goes through the hernia opening and cannot return to the stomach anymore, and it is followed with strong pain and vomiting. If this condition lasts for a longer period, there is a great possibility of bowel damage (gangrene) and consequent inflammation of the abdomen. Such condition is often deadly.
GROIN OR INGUINAL HERNIA
It is the most common type and it makes 75% of all abdominal hernias. It occurs more frequently with men. These hernias can be direct and indirect. They appear in the groin area and are seen as protrusions.
Indirect hernia appears in the place of opening through which testicles descend during foetal development, from the lower abdomen to the scrotum. This opening naturally closes before the birth, but it can remain a weaker wall through which a hernia develops later in life.
Direct inguinal hernia is a consequence of weakness of the bottom of the groin canal. In that place, abdominal wall is naturally thin.
Femoral canal is an opening through which a femoral artery, vein and a nerve come out of the abdominal cavity and go into the leg. Although this is a naturally very narrow opening, it sometimes increases which enables the content of the lower abdominal part to break through. Femoral hernia manifests as a bulge under the groin. It occurs more frequently in women.
It occurs in 10 to 30% of cases. It appears with newly born babies and it can occur during the adult age too. It is diagnosed at birth as a bulge of content on the navel. The cause of umbilical hernia occurrence in children is incomplete closure of abdominal wall during the foetal development. If the opening is smaller than 12 mm, it usually spontaneously closes until the age of 2. If the opening is larger, usually surgery is performed between the ages of 2 and 4. In the adult age, abdominal wall in the navel area may be weaker and may loosen which will cause the occurrence of umbilical hernia. The frequent occurrence of umbilical hernia is with women in pregnancy and during childbirth because of the increased obstruction in this area.
VENTRAL OR INCISIONAL HERNIA
It occurs as a consequence of a surgery on abdominal wall. At 2 to 10% of all abdominal surgical procedures comes to development of ventral or incisional hernia.
Risk factors for all hernia types are: old age, an increase of pressure in the abdominal cavity due to the lifting of heavy objects, stool difficulties, severe and prolonged cough, obesity, pregnancy.
CANDIDAES FOR THE PROCEDURE
Hernia can only be cured by surgery. Anyone who has a hernia is a candidate for the procedure if one’s health condition can withstand the surgery. If it comes to incarceration, an urgent operation that has more complications is required.
The procedure is preceded by an examination where hernia is precisely inspected and treatment possibilities are discussed. The patient will receive detailed information about the surgery and postoperative period.
PREPARATION FOR THE PROCEDURE
For the surgery under the general anaesthesia it is necessary to do standard blood and urine tests: complete blood count, erythrocyte sedimentation rate, coagulogram, blood glucose levels, urea and creatinine concentration, to record electrocardiogram (ECG) and, if it is necessary, do the internist examination. All these examinations can be done in the Polyclinic for aesthetic and plastic surgery Arcadia.
ADMISSION TO POLYCLINIC
Hernia surgery is conducted under the general anaesthesia. In special situations, it can be performed under the locally potentiated anaesthesia.
With hernia surgery (hernioplasty), the opening on the abdominal wall is being closed with the surrounding tissue or synthetic net. The procedure can be performed by an open method or laparoscopic technique. The open method cuts the skin above the hernia, while laparoscopy closes the hernia from the inside, from the abdomen, with the help of a camera and special instruments. During the procedure, hernia, its opening and its content are shown. The content is returned to the abdomen and the opening is closed. Scar tissue germinates through the net for 4-6 weeks and then the full strength of the hernioplasty is achieved.
You are under the surveillance of our professional staff in Polyclinic Arcadia during the first 24 hours after the surgery. After your departure, you return to your normal activities, but physical demanding activities, exercising and weight lifting should be avoided. Return to work is possible after a week or two, with the exception of patient who do physical work.
After 4 to 6 weeks, the patients may return to both physical work and sports activities. Hernia recurrence is possible in a smaller percentage of patients (4-7%), rarely in those who have used synthetic mesh.