Types of hernias operated at the Surgery Clinic

*inguinal/femoral hernia

*abdominal hernia

*hernia of the linea alba

*umbilical hernia

*recurrent or postoperative hernia

*hiatal hernia

The above-mentioned surgeries are performed using the classical or laparoscopic method . During the consultation qualifying for the procedure, after an imaging test and an interview with the patient, the doctor agrees on the method of performing the surgery.

Hernia - symptoms

Symptoms of a hernia, regardless of its location

at the site of the hernia, a soft lump or bulge appears

burning, pulling sensation

pain – occurs when tensing muscles, lifting, coughing, defecating, may radiate to other parts of the body

The soft lump in the initial phase can be retracted into the abdominal cavity and is easy to move. Symptoms even in the initial phase should prompt the patient to see a specialist; in addition to pain, an untreated hernia can lead to the so-called incarceration of the hernia . In the case of incarceration, an emergency surgical procedure is necessary, usually performed during an emergency surgical call. As a result, the process of passage of intestinal contents and its blood supply may be disturbed, which may result in intestinal necrosis. The risk of complications after such a procedure is higher than after a procedure performed in a planned mode, after appropriate preparation of the patient. There is no conservative treatment for hernias. Only certain methods can be used to prevent the occurrence of complications. 

Surgical procedure

Hernia surgery is not an extensive procedure, and the patient can leave the Clinic the day after the procedure. Pain may occur in the first few days. The sutures are checked and removed about 7-10 days after the procedure. The convalescence period for each patient is individual, it is assumed that after 14 days from the procedure, work can be resumed. It is recommended to avoid driving for 7-10 days in the postoperative period, and to avoid intensive physical exertion for up to 3 months 

Abdominal hernia

An abdominal hernia is a bulge of the peritoneum (the membrane lining the abdominal cavity). It is formed when internal organs move outside the abdominal cavity. This bulge is a hard and tense lump that cannot be moved back. This lump usually grows during coughing, straining or after defecation. An accompanying symptom may be pain, which may intensify with coughing or straining. As the hernia develops, bloating, nausea and vomiting may also occur. Most often, a hernia is caused by high pressure in the abdominal cavity as a result of physical exertion 

Inguinal/femoral hernia

We distinguish between oblique inguinal hernia, direct inguinal hernia or femoral hernia. In the case of an inguinal hernia, a fragment of the abdominal cavity becomes visible. It can occur as a result of persistent coughing, heavy physical work, childbirth, chronic constipation, prostate enlargement, injuries, obesity. The size of the bulge can reach even several centimeters. This is the most common type of abdominal hernia 

Umbilical/paraumbilical hernia

It is a displacement of abdominal elements under the skin, manifested by a bulge in the area of ​​the umbilicus. The cause of the appearance of an umbilical hernia is a weakening of the structural structure of the transverse fascia, previous pregnancies, obesity, ascites, abdominal tumors. Umbilical hernias are divided into congenital and acquired. Congenital occurs in newborns, acquired in people of adulthood 

Hernia of the linea alba

The white line, also known as the white line, is the place where the right and left abdominal muscles join, runs in the middle of the abdominal cavity, between the sternum and the pubic symphysis. As a result of weakening or damage (surgical procedures) of abdominal muscle fibers, a hernia occurs. In the initial phase, the hernia does not show any symptoms, in the later stages of hernia development, pain, discomfort appear in the epigastric and navel area. There is a bulge, a lump that can be felt under the skin 

Recurrent/postoperative hernia

Recurrent or postoperative hernia may occur as a result of previous surgical treatment of hernias. During surgery using classical methods, the risk of hernia recurrence increases, depending on the size of the postoperative wound. Overweight people are at greater risk of hernia recurrence. Symptoms of recurrent hernias depend largely on the type of primary hernia. In the treatment of recurrent hernias, synthetic meshes are most often used to close the defect in the integuments

Hiatal hernia

It is a digestive tract disorder that leads to the displacement of part of the stomach into the chest, i.e. improper functioning of the diaphragm. It most often affects obese people, smokers, the elderly, women during pregnancy and childbirth. Lifting heavy objects, long-term constipation, vomiting, and even long-term stress can be a factor contributing to the development of the disease 

Symptoms of a Hiatal Hernia

Symptoms most often appear about one hour after a meal or when lying down, and are related to gastroesophageal reflux: 

*pain in the upper abdomen and under the heart - a symptom similar to the symptoms of ischemic heart disease or myocardial infarction

*heartburn

*feeling of stomach contents flowing back into the esophagus

*hoarseness, dry mouth, shortness of breath

*In some cases, a hernia may be asymptomatic 

Course of treatment

During the consultation, the doctor will interview the patient, perform an ultrasound scan and, if necessary, order additional tests, such as X-ray or gastroscopy. In the first phase of the disease, pharmacological treatments are introduced, but when there is no improvement and the symptoms become more severe, the only solution is surgical intervention. The surgery involves fixing the stomach in the abdominal cavity or strengthening the ring surrounding the esophageal hiatus of the diaphragm. The treatment is primarily aimed at relieving the symptoms and preventing possible complications. The ailments should not be underestimated, an untreated hiatal hernia can lead to ulceration or inflammation of the esophageal mucosa, which in turn can even lead to cancer 

Gastroesophageal reflux

Gastroesophageal reflux disease is a pathological reflux of acidic gastric or non-acidic duodenal contents into the esophagus, causing symptoms and/or inflammatory changes in the esophagus. The cause of the disease is too frequent, temporary reduction of the lower esophageal sphincter tone. In some patients, a sliding hiatal hernia coexists with gastroesophageal reflux disease. The regurgitation of gastric and/or duodenal contents may be caused by an inappropriate diet, hormones, certain medications, anatomical abnormalities or in various post-operative conditions. The most common symptoms are heartburn, regurgitation, frequent belching, difficulty swallowing. Surgical treatment is used in patients in whom pharmacological treatment is ineffective, symptoms from the lungs and larynx occur, or there is a high risk of developing serious complications. The basic assumption of anti-reflux surgery is to improve the function and restore the efficiency of the lower esophageal sphincter. The operations consist of creating a cuff from the fundus of the stomach around the abdominal part of the esophagus (fundoplication) and stabilizing the connection of the esophagus with the stomach below the diaphragm. The operations are performed laparoscopically. Untreated reflux disease causes inflammation of the esophagus, the consequences of which are bleeding, ulceration, narrowing and shortening of the esophagus. Despite systematic medication, symptoms may worsen. Pharmacological therapy is not a causal treatment, but only a symptomatic one. Forgoing surgery carries the risk of developing glandular cancer in the diseased esophagus.

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