– Tell me, what is a hernia of the abdominal wall? Is this a common disease?
– Hernia of the abdominal wall is an eruption of the membrane that covers the abdominal cavity from the inside and the organs in the abdominal cavity through the gaps in the muscles and aponeurosis that are present or formed in the abdominal wall. Hernias can be in various locations – groin, thigh, navel, midline of the abdomen.
Abdominal wall hernias are a fairly common disease, according to various literature sources, the frequency can vary up to 25%. In clinical practice, we encounter them often, we perform over 350 abdominal wall hernia operations per year. Hernias can occur in people of all ages, but especially in individuals with risk factors such as obesity, chronic cough, and other family members having hernias (heredity).
RVUL photo/Doctor Gintaras Varanauskas
– Why does a hernia of the abdominal wall appear, what are the factors that provoke this disease?
– The primary cause of a hernia is a thin layer of muscle in the abdominal wall, in the places where blood vessels and nerves pass. Under internal pressure, the organs of the abdominal cavity protrude into the subcutaneous tissue through the weakest part of the abdominal wall. This can be caused by various factors: previous abdominal surgeries, lifting heavy disproportionate weights, sudden movements, coughing, difficulty urinating or defecating, etc. Some hernias appear suddenly, while others develop over a longer period of time.
In the uncomplicated form of the hernia, it is usually visible only when coughing or straining the abdominal press. At the click of a finger, it goes back inside. If this continues for a long time, the peritoneum is traumatized, when inflammation occurs, the hernia grows to the abdominal wall and may no longer return to the abdominal cavity.
– What are the symptoms of abdominal wall hernia?
– When a hernia of the abdominal wall occurs, a person can feel a “bump”, feel pain, a feeling of pressure, discomfort when walking, see an unaesthetic image, etc.
– Does the hernia need to be operated on in all cases – maybe in the absence of obvious symptoms it is possible to live with a hernia?
– An uncomplicated hernia of the abdominal wall usually does not cause major problems, apart from an “ugly” abdomen or swimming, so the patient has a choice – to undergo surgery or continue to live with the hernia. However, the choice disappears when the hernia becomes complicated – in this case, the intestines or other organs of the abdominal cavity get stuck in its cavity, inflammation begins, intestinal obstruction, gangrene may develop.
Such a situation becomes dangerous, the person needs urgent help – an operation which, if not performed in time, can result in the death of the patient. In the event of a complication, a few hours are decisive for the successful outcome of the operation and recovery.
When talking to patients, I always emphasize that a person can choose when to perform the operation, but it is very important to know that planned abdominal wall hernia surgery is easier, not to mention convenient planning of the time of the operation, better physical and emotional preparation and mood. This leads to better results of the operation and recovery after it.
So, to the question of whether and when it is necessary to operate on a hernia of the abdominal wall, my answer is simple – this disease does not disappear by itself, so I see no point in living with it and waiting for fate’s grace or punishment.
– How is abdominal wall hernia surgery performed, is it a complicated procedure?
– RVUL Surgery Departments perform both planned operations, when patients are first consulted in the Consultation Department and the operation time is coordinated, as well as urgent operations, when patients arrive through the Emergency Department and need to treat complicated forms of the disease.
Abdominal wall hernia is treated with open or laparoscopic surgery. Planned hernia operations in our hospital are usually performed laparoscopically, that is, in a minimally invasive way, using special tools through incisions of a few mm. During the operation, the abdominal wall is reinforced with a special mesh.
After such an operation, patients recover much faster – we discharge them from the hospital on the same or the next day, and a person can return to the normal rhythm of life after 3-4 weeks. It is not necessary to follow special diets after surgery, it is enough to avoid physical exertion on the abdominal wall.
In certain situations, open abdominal wall hernia operations are also performed, during which the abdominal wall is also reinforced with a special mesh.
When the hernia is complicated and operated on an emergency basis, it is often necessary to remove a part of the intestines at the same time, because of the existing inflammation, it is not always possible to use a mesh to reinforce the wall, which increases the risk of repeated surgery in the future.
– Is there a prevention of abdominal wall hernia – what should be done to reduce the risk of hernia or prevent it completely?
– It is possible to strengthen the abdominal muscles, avoid lifting heavy objects or do it safely with the help of assistive devices. It is also important to avoid being overweight and treat a chronic cough. After major abdominal wall surgery, it is recommended to wear a protective abdominal belt. These measures will reduce the likelihood of hernias. But, as I have already mentioned, if you still suspect a hernia of the abdominal wall – do not delay and contact a medical institution.
