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Advanced methods of treatment of incisional hernia
Advanced methods of treatment of incisional hernia
Postoperative hernia - characterized by the exit of internal organs (intestines, greater omentum) through defects in the area of the surgical scar outside the abdominal wall. A postoperative hernia is defined as a soft tumor-like protrusion in the area of the postoperative scar, accompanied by abdominal pain, with infringement - nausea, vomiting, absence of stool and discharge of gases.
Postoperative hernia symptoms
The main manifestation of a hernia is the appearance of a protrusion along the line of the postoperative scar and on its sides. In the early stages, incisional hernias are reducible and painless. Soreness and an increase in tumor-like protrusion appears with sudden movements, straining, lifting weights. In this case, in a horizontal position, the hernia is reduced or easily repositioned. Postoperative hernias can be complicated by coprostasis, entrapment, perforation, partial or complete adhesive intestinal obstruction. With the complicated development of a postoperative hernia, there is a rapid increase in abdominal pain; there is nausea and vomiting, blood in the stool, or stool and gas retention. The hernial protrusion becomes irreducible when lying on the back.
Treatment of incisional hernia
Treatment of a postoperative abdominal hernia is possible only surgically. Preparation for the operation includes a thorough examination of the patient: an examination of the abdominal organs, respiratory organs, and the cardiovascular system. In the case of giant ventral hernias, it is necessary to prepare the respiratory and cardiovascular systems for the new conditions of their functioning that will arise after the operation. Before the operation, it is imperative to wear a bandage so that all organs extending into the hernia are set inside the abdominal cavity. The operation to eliminate the postoperative ventral hernia must be performed in a hospital setting and only not using tension techniques. Currently, there are several methods of performing an operation to eliminate a postoperative ventral hernia: laparoscopic method (IPOM +); separation methods: anterior separation - Ramirez's operation and posterior separation - TAR-plastic, subaponeutic plastic of the anterior abdominal wall (sublay), retromuscular plastic (underlay), Bridge-plastic. In each case, the most appropriate method of surgery is selected for the patient individually.
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