What is a hernia. How are hernias diagnosed. What are the common types of hernias. What causes hernias. How are hernias treated. Who should you see for hernia treatment. What are the symptoms of a hernia.

Understanding Hernias: Definition and Prevalence

A hernia is a medical condition that occurs when an internal organ or body part protrudes through the wall of muscle or tissue that normally contains it. Most hernias develop within the abdominal cavity, between the chest and the hips. This condition is relatively common, affecting people of all ages and genders.

Hernias are classified into several types based on their location and characteristics. The prevalence of different hernia types varies:

• 75-80% of all hernias are inguinal or femoral
• 2% are incisional or ventral
• 3-10% are umbilical, affecting 10-20% of newborns
• 1-3% are other types

Common Types of Hernias Explained

Understanding the various types of hernias is crucial for proper diagnosis and treatment. Here are the most common types:

Inguinal Hernia

An inguinal hernia occurs when fatty tissue or a part of the intestine protrudes into the groin at the top of the inner thigh. This type is more common in men due to the anatomy of the inguinal canal, which serves as a passageway for the spermatic cord and blood vessels leading to the testicles. In women, the inguinal canal contains the round ligament that supports the uterus.

Femoral Hernia

Femoral hernias involve fatty tissue or part of the intestine protruding into the groin at the top of the inner thigh. These are less common than inguinal hernias and primarily affect older women.

Umbilical Hernia

An umbilical hernia happens when fatty tissue or part of the intestine pushes through the abdomen near the navel. This type is common in newborns but can also affect adults.

Hiatal Hernia

In a hiatal hernia, part of the stomach pushes up into the chest cavity through an opening in the diaphragm. This type often leads to gastroesophageal reflux disease (GERD) symptoms.

Less Common Hernia Types

While less frequent, the following hernia types can also occur:

• Incisional hernia: Tissue protrudes through the site of a previous abdominal or pelvic surgery scar
• Epigastric hernia: Fatty tissue protrudes through the abdominal area between the navel and lower part of the sternum
• Spigelian hernia: The intestine pushes through the abdomen at the side of the abdominal muscle, below the navel
• Diaphragmatic hernia: Abdominal organs move into the chest through an opening in the diaphragm

Causes and Risk Factors for Hernia Development

The development of hernias can be attributed to various factors, including:

Weakened Muscles

Inguinal and femoral hernias often result from weakened muscles that may have been present since birth or are associated with aging and repeated strains on the abdominal and groin areas.

Physical Strain

Strain on the abdominal area can come from various sources, including:

• Physical exertion
• Obesity
• Pregnancy
• Frequent coughing
• Straining during bowel movements due to constipation

Age-Related Factors

As we age, our muscles naturally weaken, increasing the risk of hernia development. This is particularly true for hiatal hernias, where the cause is not fully understood, but weakening of the diaphragm with age is thought to play a role.

Recognizing Hernia Symptoms

Identifying hernia symptoms early can lead to prompt treatment and better outcomes. Common symptoms include:

• A noticeable lump or bulge in the affected area
• Pain or discomfort at the site of the bulge
• Swelling in the groin or scrotum
• Pain while lifting objects
• A dull aching sensation
• A sense of fullness or signs of bowel obstruction

For hiatal hernias, symptoms may differ and include:

• Heartburn
• Indigestion
• Difficulty swallowing
• Frequent regurgitation
• Chest pain

Diagnosis and Medical Evaluation of Hernias

How are hernias typically diagnosed? The diagnostic process for hernias usually involves:

Physical Examination

In most cases, a healthcare provider can diagnose a hernia through a physical examination. They may be able to see or feel a bulge in the affected area. For inguinal hernias in males, the doctor often performs a specific test during the physical exam.

Imaging Studies

In some instances, soft-tissue imaging techniques such as CT scans may be used to accurately diagnose the condition and assess its severity.

Medical History

Your doctor will also consider your medical history and symptoms when making a diagnosis. They may ask about any activities or conditions that could increase your risk of developing a hernia.

Treatment Options and Management Strategies

How are hernias treated? The treatment approach for hernias typically involves:

Surgical Repair

In most cases, surgery is the only way to effectively repair a hernia. The specific surgical technique will depend on the type and severity of the hernia, as well as the patient’s overall health.

Watchful Waiting

For small, asymptomatic hernias, doctors may recommend a “watch and wait” approach, monitoring the hernia for any changes or complications.

Lifestyle Modifications

While not a cure, certain lifestyle changes can help manage hernia symptoms and prevent them from worsening. These may include maintaining a healthy weight, avoiding heavy lifting, and managing conditions that cause chronic coughing or constipation.

Seeking Medical Care: When and Who to Consult

Who should you see for hernia treatment? The journey typically begins with your primary care provider. If surgical intervention is necessary, you’ll be referred to a general surgeon. Ventral hernia repairs are among the most common operations performed by U.S. general surgeons.

It’s crucial not to delay seeking medical attention if you suspect you have a hernia. Neglecting a hernia can lead to it growing larger and more painful, potentially resulting in complications and emergency surgery. Early repair is generally more successful, less risky, and offers better recovery outcomes.

The Importance of Timely Intervention

Why is early treatment important for hernias? Prompt medical attention can:

• Prevent the hernia from enlarging
• Reduce the risk of complications such as strangulation or incarceration
• Improve the chances of successful repair
• Minimize recovery time and post-operative discomfort

Remember, hernias typically do not improve on their own. While not all hernias require immediate surgery, it’s essential to have them evaluated by a healthcare professional to determine the best course of action.

Prevention Strategies and Risk Reduction

While not all hernias can be prevented, certain measures can help reduce your risk:

Maintain a Healthy Weight

Excess weight puts additional pressure on your abdominal muscles, increasing the risk of hernia development. Maintaining a healthy body mass index (BMI) can help reduce this risk.

Practice Proper Lifting Techniques

When lifting heavy objects, use your legs instead of your back and avoid sudden, jerking movements. This can help prevent strain on your abdominal muscles.

Manage Chronic Conditions

Conditions that cause chronic coughing or constipation can increase your risk of developing a hernia. Work with your healthcare provider to effectively manage these conditions.

Quit Smoking

Smoking can weaken your tissues and increase your risk of developing a hernia. Quitting can improve your overall health and reduce this risk.

Regular Exercise

Engaging in regular physical activity, particularly exercises that strengthen your core muscles, can help maintain the strength of your abdominal wall.

By understanding the types, causes, symptoms, and treatment options for hernias, you can better recognize potential issues and seek timely medical care. Remember, early intervention often leads to better outcomes and can prevent more serious complications down the line. If you suspect you may have a hernia, don’t hesitate to consult with your healthcare provider for a proper evaluation and personalized treatment plan.

Types, Treatments, Symptoms, Causes & Prevention

Overview

Common types of hernia

What is a hernia?

A hernia occurs when an internal organ or other body part protrudes through the wall of muscle or tissue that normally contains it. Most hernias occur within the abdominal cavity, between the chest and the hips.

The most common forms of hernia are:

• Inguinal hernia: In men, the inguinal canal is a passageway for the spermatic cord and blood vessels leading to the testicles. In women, the inguinal canal contains the round ligament that gives support for the womb. In an inguinal hernia, fatty tissue or a part of the intestine pokes into the groin at the top of the inner thigh. This is the most common type of hernia, and affects men more often than women.
• Femoral hernia: Fatty tissue or part of the intestine protrudes into the groin at the top of the inner thigh. Femoral hernias are much less common than inguinal hernias and mainly affect older women.
• Umbilical hernia: Fatty tissue or part of the intestine pushes through the abdomen near the navel (belly button).
• Hiatal (hiatus) hernia: Part of the stomach pushes up into the chest cavity through an opening in the diaphragm (the horizontal sheet of muscle that separates the chest from the abdomen).

Other types of hernias include:

• Incisional hernia: Tissue protrudes through the site of an abdominal scar from a remote abdominal or pelvic operation.
• Epigastric hernia: Fatty tissue protrudes through the abdominal area between the navel and lower part of the sternum (breastbone).
• Spigelian hernia: The intestine pushes through the abdomen at the side of the abdominal muscle, below the navel.
• Diaphragmatic hernia: Organs in the abdomen move into the chest through an opening in the diaphragm.

How common are hernias?

Of all hernias that occur:

• 75 to 80% are inguinal or femoral.
• 2% are incisional or ventral.
• 3 to 10% are umbilical, affecting 10 to 20% of newborns; most close by themselves by 5 years of age.
• 1 to 3% are other types.

Symptoms and Causes

What causes a hernia?

Inguinal and femoral hernias are due to weakened muscles that may have been present since birth, or are associated with aging and repeated strains on the abdominal and groin areas. Such strain may come from physical exertion, obesity, pregnancy, frequent coughing, or straining on the toilet due to constipation.

Adults may get an umbilical hernia by straining the abdominal area, being overweight, having a long-lasting heavy cough or after giving birth.

The cause of hiatal hernias is not fully understood, but a weakening of the diaphragm with age or pressure on the abdomen could play a part.

What are the symptoms of a hernia?

A hernia in the abdomen or groin can produce a noticeable lump or bulge that can be pushed back in, or that can disappear when lying down. Laughing, crying, coughing, straining during a bowel movement, or physical activity may make the lump reappear after it has been pushed in. More symptoms of a hernia include:

• Swelling or bulge in the groin or scrotum (the pouch that contains the testicles).
• Increased pain at the site of the bulge.
• Pain while lifting.
• Increase in the bulge size over time.
• A dull aching sensation.
• A sense of feeling full or signs of bowel obstruction.

In the case of hiatal hernias there are no bulges on the outside of the body. Instead, symptoms may include heartburn, indigestion, difficulty swallowing, frequent regurgitation (bringing food back up) and chest pain.

Diagnosis and Tests

How is a hernia diagnosed?

It is usually possible to see or feel a bulge in the area where a hernia has occurred by physical exam. As part of a male’s typical physical exam for inguinal hernias, the doctor feels the area around the testicles and groin while the patient is asked to cough. In some cases, soft-tissue imaging like a CT scan will accurately diagnose the condition.

Management and Treatment

What kind of doctor do you see for a hernia?

When you have a hernia, treatment will start with your primary care provider. If you need surgery to repair the hernia, you’ll be referred to a general surgeon. In fact, ventral hernia repairs are one of the most common operations U.S. general surgeons perform.

If you think you have a hernia, don’t wait to seek help. A neglected hernia can grow larger and more painful — this can lead to complications and possibly emergency surgery. Early repair is more successful, less risky and offers a better recovery and outcome.

How is a hernia treated?

Hernias usually do not get better on their own, and surgery may be the only way to repair them. However, your doctor will recommend the best therapy to address your hernia, and may refer you to a surgeon. If the surgeon thinks it is necessary to repair your hernia, then the surgeon will tailor the method of repair that best meets your needs.

In the case of an umbilical hernia in a child, surgery may be recommended if the hernia is large or if it has not healed by the age of 4 to 5 years old. By this age, a child can usually avoid surgical complications.

If an adult has an umbilical hernia, surgery is usually recommended because the condition will not likely improve on its own and the risk of complications is higher.

One of three types of hernia surgery can be performed:

• Open surgery, in which a cut is made into the body at the location of the hernia. The protruding tissue is set back in place and the weakened muscle wall is stitched back together. Sometimes a type of mesh is implanted in the area to provide extra support.
• Laparoscopic surgery involves the same type of repairs. However, instead of a cut to the outside of the abdomen or groin, tiny incisions are made to allow for the insertion of surgical tools to complete the procedure.
• Robotic hernia repair, like laparoscopic surgery, uses a laparoscope, and is performed with small incisions. With robotic surgery, the surgeon is seated at a console in the operating room, and handles the surgical instruments from the console. While robotic surgery can be used for some smaller hernias, or weak areas, it can now also be used to reconstruct the abdominal wall.

Each type of surgery has its advantages and disadvantages. The best approach will be decided by the patient’s surgeon.

What can happen if a hernia is not treated?

Other than umbilical hernias in babies, hernias will not disappear on their own. Over time, a hernia can grow larger and more painful or can develop complications.

Complications of an untreated inguinal or femoral hernia may include:

• Obstruction (incarceration): Part of the intestine becomes stuck in the inguinal canal, causing nausea, vomiting, stomach pain, and a painful lump in the groin.
• Strangulation: Part of the intestine is trapped in a way that cuts off its blood supply. In such cases, emergency surgery (within hours of occurring) is necessary to prevent tissue death.

Prevention

How can a hernia be prevented?

• Maintain ideal body weight by eating a healthy diet and exercising.
• Eat enough fruits, vegetables and whole grains to avoid constipation.
• Use correct form when lifting weights or heavy objects. Avoid lifting anything that is beyond your ability.
• See a doctor when you are ill with persistent coughs or sneezing.
• Don’t smoke, as the habit can lead to coughing that triggers a hernia.

Outlook / Prognosis

What can be expected following surgical treatment for a hernia?

After surgery, you will be given instructions. These include what diet to follow, how to care for the incision site, and how to take care to avoid physical strain. Hernias may recur regardless of the repair operations. This is sometimes caused by inherent tissue weakness or protracted healing. Smoking and obesity are also major risk factors for hernia recurrence.

How to Tell If You Have a Hernia

Wondering if the aching in your belly or groin could be a hernia? Hernias are common in both men and women, but symptoms vary. Groin hernias are much less common in women. Hernias may cause some form of discomfort and don’t go away on their own, says Gina Adrales, M.D., M.P.H., director of the Division of Minimally Invasive Surgery at Johns Hopkins Medicine.

The good news? Nearly all hernias can be surgically repaired. Adrales explains how to recognize hernia signs in men and women, the most common types, and what surgery and recovery are like.

Q: What is a hernia?

A: Your abdomen is covered in layers of muscle and strong tissue that help you move and protect internal organs. A hernia is a gap in this muscular wall that allows the contents inside the abdomen to protrude outward. There are different types of hernias, but the most common hernias occur in the belly or groin areas.

Q: What Does a Belly or Abdominal (Ventral) Hernia Feel Like?

A: If you have a ventral hernia in the belly area, you may see or feel a bulge along the outer surface of the abdomen. Typically, patients with ventral hernias describe mild pain, aching or a pressure sensation at the site of the hernia. The discomfort worsens with any activity that puts a strain on the abdomen, such as heavy lifting, running or bearing down during bowel movements. Some patients have a bulge but do not have discomfort.

Q: Who is at higher risk for a ventral hernia?

A: Anyone can develop a ventral hernia, but those who’ve had abdominal surgery have a higher risk. If you have an incision that disrupts the abdominal wall, the scar will never be as strong as the original tissue. This makes it more likely that you’ll develop a hernia, known as an incisional hernia, along the incision area. This occurs in up to 30% of patients who have open abdominal surgery.

Pregnancy is a risk factor that makes women more susceptible to developing another type of ventral hernia near the belly button, called an umbilical hernia. The umbilicus is the thinnest part of the abdominal wall. It’s a very common site to develop a hernia, whether you’re a man or a woman.

Q: How can you tell if you have an inguinal (groin) hernia?

A: First, it’s important to understand that both men and women can develop inguinal hernias. People often believe that only men get them, and for anatomical reasons, they do have a higher risk. But women can certainly have inguinal hernias, too.

Many experts agree that women are likely underdiagnosed for this condition because they tend to have different symptoms than men. Women may not have a noticeable bulge. If symptoms indicate a possible hernia but your doctor cannot confirm it by an exam, an MRI can provide definitive evidence.

Symptoms in Men

• A bulge you can see or feel
• Aching pain in the area
• A feeling of pressure
• A tugging sensation of the scrotum around the testicles
• Pain that worsens with activities that add pressure to the area, such as heavy lifting, pushing and straining

Symptoms in Women

• Aching or sharp pain
• Burning sensation
• A bulge at the hernia site, but this may not be present with a groin hernia
• Discomfort that increases with activity

Q: How are hernias treated?

A: Treatment varies depending on the type of hernia, symptoms and the patient’s sex.

Inguinal (Groin) Hernias

Inguinal hernias in women are more likely to become emergencies. Women also have a greater chance of developing complications than in men. So, we typically recommend surgical repair after diagnosis.

Men with inguinal hernias often may put off surgery if they’re not symptomatic. Studies of men with inguinal hernias indicate the risk of having an emergency, like part of the bowel getting stuck or strangled in the muscle gap, is quite low. But because hernias tend to grow larger or cause symptoms over time, most men will require surgery within 10 years of hernia diagnosis.

There are two surgical treatments for inguinal hernias. Minimally invasive surgery is often performed laparoscopically, requiring only keyhole-size incisions through which a tiny camera and instruments can be inserted to make repairs. Minimally invasive robotic surgery (similar to laparoscopy, but surgeons use a controller to move instruments) is also an option. With minimally invasive surgery, patients are back to their regular activity within two weeks. Open surgery is the other treatment option — recovery takes four to six weeks.

Abdominal Hernias

For both men and women, repair is recommended for most abdominal hernias. The exception is if you have risk factors for complications or hernia recurrence, such as obesity or poorly controlled diabetes. It’s better to get those conditions under control before surgery. Some patients do not have symptoms and may decide to delay repair after discussion of the risks and benefits with their surgeon.

Surgical options and recovery time for ventral hernias vary widely because these hernias come in all shapes and sizes. A small umbilical or incisional hernia can often be treated on an outpatient basis. However, repairing more complicated hernias may require a hospital stay of one to five days.

Q: What are the signs of a hernia emergency?

A: When most hernias start, the internal tissue that pushes through the muscle gap is usually fat. But it’s also possible for part of the bowel to protrude through the opening. The risk of this is very low, but when it happens, it needs emergency repair. Seek immediate medical attention if you have:

• A painful bulge that doesn’t reduce in size when you lay down and rest
• Worsening pain
• Nausea and/or vomiting
• Difficulty having a bowel movement
• Bloating
• Racing heart rate
• Fever

For more information about hernias and their treatment, visit the Johns Hopkins Comprehensive Hernia Center.

Hernias and Medical Emergencies | Comprehensive Hernia Center

Could I have a hernia?

The most common symptom of inguinal, incisional, umbilical and ventral hernias is a painful lump or bulge underneath the skin where the hernia occurs. This can be in the groin or in the abdomen and is caused by intestine or other soft tissue pushing through a weakness or gap in the abdominal wall. Usually, the protrusion is more pronounced when standing, especially when coughing or straining, and it may get smaller or go away when lying down or relaxing. 

Symptoms of abdominal or groin hernias include:

• A bulge or lump in your groin
• A pulling sensation in your groin, with or without a bulge

Hiatal hernias occur when the stomach pushes up into the chest through a small opening in the diaphragm—the muscle that separates the abdomen from the chest—and often do not cause any symptoms aside from mild heartburn.

Only a trained health care provider can properly evaluate your condition. If you suspect you have a hernia, contact your primary care provider or a specialist.

Is my hernia a medical emergency?

Hernias become a medical emergency if the intestine—or esophagus, in the case of hiatal hernias—becomes trapped or incarcerated, cutting off its own blood supply. When blood supply is cut off, a condition known as strangulation, tissue can quickly die or become necrotic and cause a life-threatening infection that requires immediate surgical removal of the affected intestine.

Symptoms of a hernia in need of emergency treatment include:

• Severe pain, swelling or redness at the hernia site
• Hernia bulge growing quickly
• Nausea and/or vomiting
• Constipation and/or bloating
• Fever

If you experience any of the above symptoms of a strangulated hernia, contact your primary care provider as soon as symptoms occur. If you cannot contact your primary care provider, go to the closest emergency room.

hernia | medical condition | Britannica

hernia, protrusion of an organ or tissue from its normal cavity. The protrusion may extend outside the body or between cavities within the body, as when loops of intestine escape from the abdominal cavity into the chest through a defect in the diaphragm, the muscular partition between the two cavities. The term is usually applied, however, to an external herniation of tissue through the abdominal wall.

An abdominal hernia, or rupture, may occur at any weak point in the abdominal wall. The common sites are the groin (inguinal), the upper part of the thigh (femoral), and the navel (umbilical). In inguinal hernia, the protruding tissue descends along the canal that holds the spermatic cord in the male and the round ligament in the female. If such a hernia occurs bilaterally, it is called a double hernia. A femoral hernia lies on the inner side of the large femoral blood vessels of the thigh. An umbilical hernia protrudes through the navel.

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A hernia may be present at birth as the result of defective development of the abdominal wall, or it may occur later in life as the result of an injury. An acquired hernia usually is caused by overexertion, as in lifting a heavy weight, jumping off a high wall, or violent coughing. Men develop hernias more frequently than do women because of their greater physical exertions and because the canal for the spermatic cord leading through the abdominal wall is wider than the canal for the round ligament. A special type of acquired hernia is the incisional hernia, which occurs at an incision after surgery.

The hernia may be classified as reducible, irreducible, or strangulated. A reducible hernia is one in which the contents can be pushed back into the abdomen and often may be held in place by a truss, a pad of heavy material that is placed over the herniated area. A truss is usually a temporary expedient and is seldom used as a substitute for surgical care. A reducible hernia may increase in size or may form adhesions to other organs or structures, becoming irreducible. A strangulated hernia is one in which the circulation of blood through the hernia is impeded by pinching at the narrowest part of the passage; congestion is followed by inflammation, infection, and gangrene. The tighter the constriction, the more rapidly these events take place; unrelieved strangulation may be fatal. Surgery is often necessary for the permanent relief of reducible hernia, and it is the only safe treatment for more advanced forms.

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Inguinal Hernia in Children | Causes, Symptoms & Diagnosis

Causes of Inguinal Hernia

Between 12 to 14 weeks of fetal development, the testicles or ovaries form in the abdomen near the kidneys. They gradually move down into the lower part of the abdomen as the baby continues to develop. As they move down, a portion of the peritoneum (a thin layer of tissue that lines the inside of the abdomen) that attaches to the testicle is drawn with it into the scrotum, forming a pouch or sac.

A similar process occurs in girls as the round ligament of the uterus descends into the groin at the labia. This sac is known as the processus vaginalis and normally closes shortly after birth. This eliminates any connection between the abdominal cavity and the scrotum or groin. When closure of the processus vaginalis is delayed or incomplete, it may stretch and eventually become a hernia. The stretching of the processus vaginalis creates an inguinal sac, allowing organs to extend from the abdomen and enter the sac. If fluid, rather than organs, builds up and remains in the sac, the child has a hydrocele.

Approximately 80 percent to 90 percent of inguinal hernias appear in boys. They are more common on the right side, but in about 10 percent of cases, they occur on both sides (bilaterally).

Incidence of Inguinal Hernia

An inguinal hernia can occur at any age, but one-third of hernias in children appear in the first 6 months of life.

Risk Factors for Inguinal Hernia

• In just over 10 percent of cases, other members of the family may have had a hernia at birth or in infancy
• In premature infants, the occurrence of inguinal hernia is increased by up to 30 percent.

Signs and Symptoms of Inguinal Hernia

• Swelling or a bulge in the groin or scrotum may be seen during crying or straining, and it may get smaller or go away when the baby relaxes
• A smooth mass that is usually not tender
• Localized pain in the area of the hernia

Diagnosis of Inguinal Hernia

The diagnosis is made by a thorough medical history and careful physical examination by a physician.

Incarcerated Inguinal Hernia

If the bulge can be gently pressed back into the abdomen, the hernia is termed reducible. If it cannot be pressed back into the abdomen, the hernia is known as incarcerated (irreducible).

When a hernia becomes incarcerated, infants or children will show signs of irritability and may vomit. They may also have loss of appetite, abnormal bowel patterns, and / or tenderness of the groin area and swelling of the abdomen.

With a prolonged period of incarceration, the blood supply to the intestine could be cut off, causing it to die. This is referred to as a strangulated hernia — a life-threatening situation that requires urgent surgical attention.

Treatment of Inguinal Hernia

Inguinal hernias require an operation, and to avoid the risk of abdominal organs becoming incarcerated, this is generally done as soon as possible. In premature infants, who are only several months old, surgery may be postponed for two to three months to ensure that the lungs are functioning properly.

Surgery is carried out under general anesthesia. A small incision is made in the groin. The hernia sac is identified and repaired. The incision is closed with dissolving stitches. Incision glue and / or Steri-Strips (strong tape that sticks for seven to 10 days) are used to seal the surface of the incision. During the procedure, a generous amount of long-acting numbing medicine (local anesthetic) is injected around the incision to help control pain.

Most children who undergo hernia repairs go home the same day after a short stay in recovery; however, premature infants may require an overnight stay. Most children are able to return to normal activities, even sports, with no restrictions within a few days. The length of time sports activities are restricted depends on the age of the child and the sports activity.

In cases where a large inguinal hernia extends down into the scrotum, the scrotum may swell after surgery. It may appear as though the hernia has come back. This swelling is normal and will go away on its own within several weeks to months.

Long-Term Outlook

After surgery, the risk of the hernia returning is extremely low. However, the risk is known to be higher in premature infants and in children with hydrocephalus, connective tissue disorders, chronic lung disease and chronic renal failure.

Hernia | Cedars-Sinai

Overview

If you think of your abdominal wall as an old-fashioned tire with an inner tube, a hernia would be a defect or an opening in the tough outer layer. A similar defect in the abdominal wall allows for the contents of the abdomen to spill out; usually intestines or a layer of fatty tissue called “omentum.”

Types of Hernias

There are two general types of hernias: abdominal and groin.

Abdominal hernias usually form around the navel (umbilical hernia), at the site of previous surgical incisions (incisional hernia), or in the upper abdomen at the midline (epigastric hernia).

Groin hernias are the most common types of hernias and include: indirect inguinal hernias, direct inguinal hernias, and femoral hernias.

Symptoms

Hernia symptoms often vary from patient to patient. The most common complaints are pain/discomfort and a bulge or swelling at the site of the hernia. The bulge may be persistent or may go away. It may get bigger over time.

If the hernia bulge does not flatten when you lie down, the contents of the hernia may be trapped. This is called “incarcerated hernia.” This type of hernia can cause blockage of the intestines. If the intestines are tightly trapped, the blood supply to the gut can get blocked and the intestines can die (i.e. become gangrenous). This is called “strangulated hernia.” These may be associated with symptoms of abdominal distention, nausea, vomiting, worsening pain and skin discoloration at the site of the hernia. If, while considering surgical hernia repair, you experience any of these symptoms, please seek urgent medical attention immediately.

Causes and Risk Factors for a Hernia

Although some hernias are present at birth, the majority develop later in life. Family history of hernias can predispose you to developing a hernia. In general, conditions that increase pressure within your abdomen contribute to formation of a hernia, including:

• Pregnancy
• Obesity
• History of heavy lifting
• Conditions that predispose you to chronic cough, such as smoking or asthma
• Straining during a bowel movement, such as caused by chronic constipation
• Straining to urinate, such as caused by prostate enlargement
• Fluid in the abdominal cavity

Diagnosis

Most hernias can usually be detected by a physical examination. Sometimes, very infrequently, special imaging studies may be needed to confirm or establish the diagnosis.

Treatment

A hernia will not repair itself. It is a structural defect of the abdominal wall and most hernias should be surgically repaired. The exact type of repair depends on the type of a hernia you have. Your surgeon will discuss with your the best type of repair for your individual case. The procedure may be done under a local or general anesthesia, depending on the type and location of the repair.

To strengthen the repair and decrease pain after surgery, most surgeons use special mesh materials. The mesh is made of a thin and very strong plastic material that stays in the body. It helps the surgeon do the repair without pulling on muscles and acts as a patch that effectively closes the hole. Since the muscles are not pulled together, this type of repair facilitates faster and less painful recovery.

Risks of Surgery

Although hernia surgery is one of the most commonly performed operations in the United States, as with any surgery, it is associated with risks. These include, but are not limited to, bleeding, infection, scar formation, postoperative pain, damage to the testicles or testicular function, numbness in the groin or the thigh, mesh complications, inability to urinate, bowel or bladder injuries, hernia recurrence, and anesthesia complications. Although deaths, heart attacks, and strokes have been reported at the time or following hernia surgery, these are extremely rare.

After Surgery

Most uncomplicated hernias can be repaired in an outpatient setting. This means that it is possible for you to have your hernia repaired during the day and be home in the evening. You can help make your surgical recovery faster by gently easing into your daily routine as soon as possible. Start by taking short walks as soon as you can. This helps blood circulation and prevents blood clots from forming in the veins of your legs. Reduce pain and swelling by adhering to your doctor’s advice regarding post-operative care and medication. Of course, some hernias may be too large or too complicated to qualify for same day surgery. Some patients may be too elderly or to ill to have ambulatory repair. Please, make sure you bring up these topics for discussion during your office visit.

Returning to Work

When you can return to work depends on the type of hernia, the type of repair, and a number of your personal characteristics. If for instance you have a desk job in an office and have an uncomplicated repair of a simple groin hernia, you may be able to return to work in a few days after your operation. If, on the other hand, your job requires constant heavy physical activity (e.g. warehouse worker), you will probably require several weeks to be able to resume your full work duties. Make sure you discuss these issues with your surgeon before scheduling the repair.

© 2000-2021 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional’s instructions.

Do You Need Hernia Surgery? Look For These Symptoms.

What Are the Different Types of Hernia?

Hernias are named after the different places in the body where they’re commonly found. Some of these include:

An inguinal hernia
In men, this is located in the groin area. In women, this is in the area affecting the ligament that supports the uterus. Men are more likely to have an inguinal hernia than women.

A femoral hernia
Located in your inner thigh, this hernia is made of fatty tissue or part of the intestine.

Umbilical hernia
In this case, the hernia protrudes from the belly button.

Hiatal hernia
In a hiatal hernia, the stomach pushes through the chest cavity. This means there is a hole or opening in the diaphragm. The diaphragm is a muscle that separates the abdomen from your chest.

The most common hernias are inguinal or femoral.

Surgical Techniques for Hernia Repair

During surgery, the tissue that is “leaking” out of place is set back into its proper position. Then, the muscle is stitched back together. If the muscle is weak, a mesh may also be added for support.

At Conway Medical Center, we perform hernia surgeries laparoscopically with the aid of the daVinci Surgical Robot.

This incredible piece of medical technology connects the surgeon’s hand movements to small medical instruments. As a result, he or she has an unobstructed view of the surgical area. All surgery is done through a sophisticated computer interface.

The result? The latest advancements in minimally invasive surgery. This means patients can have surgery with only a few small incisions as opposed to a longer “open” incision. The daVinci Robot is perfect for hernia repair. It’s also used for:

• Removing the gall bladder
• Conducting weight loss surgery
• Removing all or part of a kidney
• Reconstructing a kidney
• Removing all or part of the prostate.

Diseases of the spine (outpatient neurosurgery) “MedArt, Tomsk

At the heart of 80 – 90% of cases of pain in the spine are changes in the intervertebral discs.

A wide variety of diseases can cause back pain. In the last decade, special attention on the part of vertebrologists has been paid to such a complication of osteochondrosis as rupture of the intervertebral disc with the formation of a hernia.
The intervertebral disc is a fibrous-cartilaginous plate located between the vertebrae.In the center of the disc there is a nucleus of a jelly-like consistency, surrounded on the outside by a fibrous ring (tissue resembling a tendon). The disc acts as a shock absorber. During physical exertion, the intervertebral discs can collapse: The annulus fibrosus stretches or breaks and a protrusion of the disc section occurs – a herniated disc. The direction of the protrusion is important: If the hernia protrudes towards the spinal cord or its roots, the consequences can be serious. If an intervertebral hernia compresses the roots of the spinal cord, then this leads to disruption of the work of one or another organ.

Causes of rupture of the intervertebral disc and herniation.

In most cases, this disease occurs in people aged 25-45. With age, degenerative changes develop in the disc, leading to a decrease in the hydrophilicity of the nucleus pulposus, which contributes to a decrease in the incidence of disc herniation in elderly patients.
With a sudden increase in intradiscal pressure, a one-stage rupture of the annulus fibrosus may occur with the formation of a hernia. For example, a fall from a ladder or a direct blow to the back can lead to both a fracture of the vertebra and the formation of a herniated disc.
When weight is lifted from the ground, there is also a significant increase in pressure inside the disc. More often there is a rupture of the disc, altered as a result of repeated microtraumas and osteochondrosis. A very slight increase in intradiscal pressure can lead to rupture of such a modified disc. Pain in a limb with a herniated disc is due to two reasons. First, a herniated disc inside the spinal canal can compress the nerve roots and spinal cord. Secondly, the substance of the nucleus pulposus is a chemical irritant for the nervous tissue, contributes to the occurrence of a local inflammatory reaction.As a result of compression and the development of inflammation, a dysfunction of the nerve root occurs, which is manifested by pain, numbness of a part of the limb and sometimes weakness of certain muscles.

1 – normal discs
2 – spinal cord, from which nerves exit
3 – disc herniation compressed the spinal cord and the nerve exit site

Symptoms of the disease

With herniated disc in the back may be completely absent! However, quite often patients notice back pain caused by rupture of the richly innervated annulus fibrosus.The most common symptoms of a herniated disc are:

• pain that radiates to the arm or leg
• numbness of a part of the limb
• weakness of certain muscles
• decreased tendon reflexes

When various roots are involved, the above symptoms are noted in different areas.

Given the topography of these zones, the doctor can presumably determine at what level there was a rupture of the intervertebral disc with the development of a hernia.

Diagnosis

Diagnosis of a herniated disc begins with a detailed examination of the complaints, medical history and physical examination of the patient.The doctor will ask you in detail about the location and characteristics of pain, about the presence of a decrease in skin sensitivity and muscle weakness. The question will definitely be asked about the presence of disorders of urination and defecation. From additional methods of examination, an X-ray of the spine can be prescribed. In this study, only bone structures are visualized, so a disc herniation cannot be detected on an x-ray. However, taking an X-ray allows you to exclude some other diseases, the symptoms of which are similar to those of a herniated disc.

Today, the most informative research method for diagnosing a herniated disc is magnetic resonance imaging (MRI).

Treatment of the disease

The presence of a herniated disc does not mean the inevitability of surgery. In many cases, a herniated disc does not require surgery. The choice of treatment method is based on the presence of certain symptoms in the patient. With not pronounced symptoms, with positive progress, conservative therapy is effective.For many people with MRI-confirmed disc herniation, bothersome symptoms disappear completely within weeks or months.

An experienced neurosurgeon will be able to help you understand the causes of back, neck and lower back pain during consultations in our Polyclinic. Don’t delay your visit! We may be able to help you without surgical intervention.

Posture helps to keep the skeleton and joints in the correct position so that the supporting muscles and ligaments have a minimum load, thereby preventing the development of diseases of the musculoskeletal system.Posture is not only the habitual position of a person, both at rest and in motion, formed on a subconscious level, but also a sign of health, well-being, confidence and attractive appearance. In everyday life, we forget to keep our back straight and begin to slouch and hunch over. The Correct Posture Trainer will help you get the correct posture in 4 weeks!

CORRECT YOUR POSTURE IN 4 WEEKS WITH THE CORRECT POSTURE TRAINER

We recommend wearing a 900 corset instead of

00

00 985 the whole back

• Rigid fixation of the shoulders and back, muscles are isolated and relaxed
• Short-term exposure, after removal, return to the original position
• Impedes movement
• Outdated technology
• Visible under clothing

The simulator is attached in the clavicle

• The back is corrected by muscles, the muscles are actively trained
• Creation of a muscle corset that can keep the back straight at a subconscious level
• Free movements
• Fashionable gadget
• Invisible when wearing

901 20

90,000 Hernia of the white line of the abdomen: symptoms, treatment, surgery, prices

The white line of the abdomen is the interlacing of the connective fibers of the tendons of the broad abdominal muscles.This line runs in the middle of a person’s abdomen.

Small natural slit-like gaps in this area are considered normal. Vessels and nerve fibers pass through them, connecting the subcutaneous adipose tissue with the preperitoneal tissue. If conditions develop in a certain way, hernias come out precisely through these aponeurotic intervals. The most typical place of localization of this disease is the upper part of the white line (in this case, the hernia is called epigastric), on its lower part, the hernia occurs less often – paraumbilical (paraumbilical) and hypogastric.

At the beginning of the formation of a hernia of the white line, the so-called preperitoneal lipoma appears, when preperitoneal adipose tissue penetrates into the slit spaces. When squeezing this area, pain may appear, very similar to the manifestations of cholecystitis, pancreatitis, peptic ulcer and other diseases of internal organs. In the process of hernia development, the peritoneum begins to protrude through the cracks of the aponeurosis. The content of a true hernia in most cases is an omentum, but the walls of the colon (transverse colon), loops of the small intestine, fragments of the abdominal organs can protrude.

Symptoms of hernia of the white line

• A protrusion located in the midline of the abdomen (more often observed in the upper part). May be painful
• pain in the abdomen, manifested with sudden movements, physical activity and straining. They are associated with pinching of the nerves of adipose tissue;
• diastasis (muscle divergence) in the midline;
• Loss of appetite, constipation, vomiting, nausea.

If these symptoms appear, contact your doctor as soon as possible without delaying your visit.

Read more

What is a dangerous hernia of the white line?

It seems to some patients that, in addition to sufficiently strong pain when squeezing, a hernia of the white line does not pose a health hazard. It’s a delusion. The danger is squeezing of nerve fibers and infringement of internal organs located inside the hernial sac.

Modern medicine is able to effectively cope with a hernia of the white line. Only a surgeon deals with her treatment. The disease is most easily eliminated in the early stages, therefore, at the first sign of discomfort, you should consult a doctor.

Diagnosis of hernia of the white line

In some cases, a person may not show any symptoms, except for the characteristic protrusion (reducible or irreducible), which increases with tension of the abdominal muscles.Usually, the diagnosis of a hernia of the white line is not difficult. The exception is patients with a significant layer of subcutaneous fat.

Often, hernia of the white line has to be differentiated with appendicitis, pancreatitis, gastritis, cholecystitis, peptic duodenal ulcer, gastric ulcer. To exclude these diseases, an examination of the gastrointestinal tract and laboratory tests are carried out.

Methods for the diagnosis of hernia of the white line:

How does the disease develop?

Classification of varieties of white line hernias depending on the area of ​​localization:

• Epigastric or supra-umbilical hernia, located above the navel.This is the most common type of white line hernia;
• umbilical – located inside the umbilical ring;
• sub-navel – located below the navel.

Occasionally, a hernia of the white line is discovered completely by accident, and before that does not manifest itself in anything.

Stages of development of the disease:

• preperitoneal lipoma. Only fatty tissue protrudes;
• initial hernia. A hernial sac is formed;
• formed (true) hernia of the white line.The abdominal organs enter the hernial sac.

When the formation of the hernia is complete, a painful dense protruding formation, rounded or elongated hernial gates (internal organs protrude through them) are observed on the white line, the diameter of which can reach 12 centimeters. Often, not a single hernia of the white line is formed, but several protrusions located along the white line of the abdomen, one under the other.

Complications

• inability to reposition the hernia, even in the supine position when pressed;

90,090 violations of gas discharge, inability to defecate, blood in the feces;

• severe pain in the abdomen, the intensity of which increases;
• nausea, vomiting;
• infringement – a sharp and strong squeezing of the contents of the hernial sac.

If any of these symptoms appear, the patient needs urgent medical attention!

Forecast after surgery

After surgery, the prognosis is generally favorable.

The likelihood of relapse largely depends on the patient’s conscientiousness – how accurately and carefully he follows the recommendations given by the attending physician for the recovery period after surgery.

Reasons for the appearance of

The rectus abdominis muscle, which forms the white line, has several tendon bridges (3 to 6).If the connective tissues in this area are weakened (for whatever reason), the white line becomes wider and thinner, cracks appear in it (rectus muscles diverge) and hernias form.

A predisposition to the formation of a hernia of the white line occurs for the following reasons:

• abdominal injuries – bruises, lacerations and sprains of fascia and muscles, wounds, cuts;

90,090 obesity. An excess of subcutaneous fatty tissue leads to a weakening and stretching of the anterior abdominal wall.The abdominal muscles diverge, the white line expands;

• pregnancy – the navel and the anterior abdominal wall are stretched, the abdominal muscles diverge in different directions;

90,090 scars after surgical interventions on the abdominal wall – each of them is a weak link, where a hernia is formed more easily;

• heredity – if a hernia of the white line was in the next of kin, the likelihood of its occurrence increases many times over.

Causes provoking the appearance of a hernia due to an increase in intra-abdominal pressure:

• prolonged and strong crying in an infant;
• diseases localized in the abdominal cavity, accompanied by a prolonged severe cough;
• constipation, regular or chronic;
• Difficulty urinating
• prolonged difficult labor, when the fetus is very large;
• weight lifting, overexertion, unbearable physical activity.

Treatment of hernia of the white line

There are no conservative methods for getting rid of this problem. A hernia of the white line can only be cured by surgery.

Operations are prescribed by the surgeon in a planned manner: examination, diagnosis, examination, hospitalization.

Prophylaxis of hernia of the white line:

• Competent lifting technique, avoiding lifting too much weight;
• training of abdominal muscles;
• normalization of body weight;
• proper nutrition;
• bandage in the last trimester of pregnancy.

It is easier to prevent any disease than to cure later – this is an axiom proven by time!

Inguinal hernia

However, there are also reducible, appearing and disappearing, and unreducible hernias – their independent reduction is impossible. Recurrent hernias are also distinguished – those that have appeared after an operation has already been performed, with the wrong treatment tactics, multiple recurrent hernias may appear.

Signs of an inguinal hernia

The initial manifestation is a swelling in the groin that increases with exercise.In the supine position, the protrusion becomes less or disappears altogether. The disease can appear suddenly or develop gradually, over time, painful sensations join, which can be periodic or permanent. The pain can be localized in the groin or lower abdomen, give to the lower back, sacrum. With an impressive education, discomfort occurs when moving. Depending on the involvement of a particular organ in the process, patients develop various disorders, for example, constipation, pain in the intestines, bloating – when part of the intestine enters the hernial sac, urinary disorders – when the bladder is involved in the pathological process, if the contents of the hernia are the appendages, then algodismenorrhea appears, etc.e. In the presence of an inguinal-scrotal hernia on the affected side, the scrotum increases in size.

Why you need to see a doctor

With any hernia, there is always a risk of infringement, in this case, there is a deterioration, a person is worried about nausea and vomiting, pain in the groin or lower abdomen increases, gas flow stops, etc. Among the frequent complications are coprostasis, orchitis as a result of ischemia, organ necrosis as well as peritonitis; in any case, urgent help from a surgeon is needed.

Reasons for the appearance of a hernia

There are congenital and acquired hernias of this localization.

• When the testicle (ovary) descends with a defect – non-closure of the vaginal layer of the peritoneum – internal organs move beyond the anatomical boundaries – we are talking about congenital pathology.
• Acquired – arise from the weakness of structures in the area of ​​the inguinal canal. In this case, unfavorable prerequisites are age-related changes in connective tissue, diseases that lead to muscle inferiority, increased intra-abdominal pressure (when lifting weights, coughing, persistent constipation, pregnancy), etc.etc.

Diagnostics

Today, there are various methods for diagnostics, the patient, first of all, is assigned herniography, ultrasound examination of the scrotum, abdominal cavity and small pelvis. With sliding hernias, it may be necessary to conduct an irrigoscopy or cystoscopy, etc. Great importance is given to differential diagnosis to exclude varicocele, hydrocele, lymphadenitis or femoral hernia.

Treatment

Only surgical treatment is effective for hernias; during hernia repair, after returning the organs to their intended anatomical position, the defect of the abdominal wall is eliminated.Hernioplasty is possible using the body’s own tissues or using a synthetic mesh-like implant. As a rule, the operation is performed by the method of laparoscopy. The method for eliminating the defect is selected for each patient, taking into account the peculiarities of his state of health, however, today preference is given to tension-free methods using a mesh implant, which then serves as a frame that prevents the movement of organs. Moreover, with tension-free hernioplasty, the likelihood of recurrence is minimized.Conservative therapy for hernias is ineffective, wearing a special bandage and limiting physical activity only alleviates the patient’s condition, and are prescribed if the operation needs to be temporarily postponed.

Strengthening the abdominal muscles, controlling weight, normalizing digestion to eliminate constipation – all this can serve as prevention of the appearance of an inguinal hernia. If it was not possible to avoid the disease, then the main thing is timely treatment, due to which the development of complications can be prevented, in which case the recovery process will take a minimum of time, the prognosis is very favorable.

symptoms, causes, diagnosis and effective treatment of intervertebral hernia

Hernia of the spine is a disease of the musculoskeletal system that does not tolerate self-treatment. Timely referral to a neurologist is important.

What is a hernia of the spine?

A hernia of the spine is a painful disease. With it, the integrity of the outer shell of the intervertebral disc – the annulus fibrosus – is violated. Scar tissue forms instead of elastic fibers. The intervertebral discs are displaced relative to their usual position.The nucleus of the intervertebral disc begins to bulge into the spinal canal. Protrusions can be both in both directions, and only in the right or left side.

If left untreated, the annulus ruptures. Nuclear fluid enters the spinal canal and compresses the nerve endings. With advanced stages of the disease and the absence of timely assistance, a hernia leads to a complete loss of mobility.

Most often, a hernia of the spine affects the lumbosacral region.65% of all hernias are hernias in the lumbar region and sacrum. Hernia of the thoracic region is also quite common. Less often, when a hernia is detected, the lesions relate to the cervical spine and coccyx. They account for about 5-6% of all cases of spinal hernias.

Why does the disease occur?

The following reasons lead to the onset of the disease:

• Static overloads , i.e. overloads that are associated with a long stay in one position.Moreover, both sitting and standing postures are equally harmful. The greatest occupational risk is experienced by workers on the assembly line, drivers, seamstresses, shoe collectors.
• Dynamic overloads associated with heavy lifting. Movers, slingers, miners, metal cutters, stampers, pressmen and bricklayers are especially susceptible to them. The work performed by personnel in these specialties especially contributes to the protrusion of the intervertebral discs in the lumbar region.
• Genetic predisposition and individual anatomical features of the structure of the endplates on the vertebrae.In this case, most often the patient is diagnosed with a hernia between the 1st and 3rd vertebrae of the lumbar spine or the 11th and 12th thoracic vertebrae.
• Injury. Fractures, spinal contusions, subluxations of individual vertebrae. This is due to the fact that with a fracture and injury of the spine, the surrounding tissues are affected, scars and adhesions are formed, and with subluxations, the vertebrae are displaced. In addition, with subluxation, in most cases, the size of the intervertebral foramen decreases. All conditions are created for the formation of hernias in the lumbar region and neck.
• Presence of osteochondrosis . If it is left untreated, the cartilaginous tissue is rapidly depleted, the intervertebral gap decreases and the outer membrane of the intervertebral disc ruptures. Especially often, against the background of osteochondrosis, a hernia of the lumbosacral spine develops.
• Presence of scoliosis. The danger of scoliosis is that the spinal column is not just curved, it is deformed. Especially scoliosis contributes to the progression of hernias in the thoracic spine.
• Unbalanced diet . Lack of nutrients for the body is a blow to muscle, cartilage tissue and a direct cause of dystrophies.
• Excess body weight . Excessive body weight is especially dangerous for the lumbar spine. Extra pounds put excessive pressure on the lower back. It leads to deformation of the vertebrae, and an intervertebral hernia appears in the lumbar region.

Symptoms of a spinal hernia

Symptoms of a vertebral hernia are divided into two types – general (they can bother the patient if there is a hernia in any part of the spine) and local – indicating a problem in a specific area of ​​the spine: thoracic, cervical, etc.

General symptoms are pain in the spine or part of it, aggravated by physical exertion and weakening after motionless rest, a feeling of strong muscle tension and burning of the skin. Many patients also complain of creeping creeps and swelling.

Local – these are symptoms that indicate a problem in a specific area (neck, lower back, tailbone).

Symptoms of a hernia in the cervical spine

The most common symptoms of a hernia in the cervical spine are:

• Unpleasant sensations, a feeling of squeezing in the neck area, in some cases – the appearance of protrusions on the neck.
• Severe headaches, especially of a throbbing character in the temporal and occipital regions.
• Dizziness caused by compression of the vertebral artery and accompanied by tinnitus, double vision.
• Weakness and feeling of lack of oxygen. With problems of the cervical spine, oxygen is really not enough. A hernia creates obstacles in its path to the brain.
• Increased blood pressure, accompanied by head cramps.

If osteochondrosis has already been diagnosed, and a person may not go to a doctor, he may think that he has an exacerbation of osteochondrosis, but the classical treatment regimen for osteochondrosis with a hernia is ineffective.

Symptoms of a hernia in the lumbosacral region

• Numbness extending from the lower lumbar region to the thighs.
• Sharp, shooting pain in the lower back when lifting loads.
• Problems with urination (sometimes incontinence, sometimes urinary retention).
• Weakness in the legs, a feeling that “the legs do not obey”, paralysis (with neglected hernias).

Very often with a hernia in the lumbosacral region, a person says: “I tore my back.”Feelings are just like that.

Symptoms of a hernia in the thoracic region

What makes a hernia in the thoracic region different?

• Burning and pain in the chest, many patients feel that the heart hurts.
• Pain in the shoulder blades, worse during brisk walking, walking up stairs and other movements that require deep, intense breaths in and out. With them, shortness of breath also increases.
• Deterioration of the thyroid gland.
• Unpleasant sensations in the abdomen,
• Loss of sensitivity of the skin in the area of ​​the shoulder blades and below.

Symptoms of tailbone hernia

Symptoms of tailbone hernia are less pronounced compared to symptoms of hernia in other parts of the spine. Very often she did not manifest herself at all. It happens that a person is injured, he has developed a hernia, but the person does not even suspect about it, and only in certain circumstances (for example, when sitting on a hard surface) coccyx pains appear.

In women, a tailbone hernia can appear during painful sensations during pregnancy, during childbirth, in the postpartum period.

Often, the symptoms of a tailbone hernia are very close to intestinal diseases, hemorrhoids. There is pain in the anus, there are problems with stools (severe constipation or alternation of constipation and loose stools).

Any of the above symptoms requires immediate medical attention and diagnosis.

Diagnostics

When a hernia occurs, a comprehensive diagnosis is important. The earlier the diagnosis is made and treatment is started, the less the risks of complications such as the formation of fistulas and immobilization of the spine.

Diagnosis of spinal hernias is based on several stages. What is included in them?

• Medical examination. Oral questioning of the patient. For an accurate diagnosis, an accurate picture is important – when the symptoms of the disease appeared, what is the nature of the pains, are there any other concomitant diseases.
• Assessment of skin sensitivity, motor activity. The doctor probes the neck, back, chest, lower back, sacrum, coccyx.Next, the patient is asked to perform a series of movements: raise the leg in a supine position, bend over, sit down, etc.
• Magnetic resonance imaging . The doctor receives information about the structure of the tissues, sees the protrusion of the membrane of the intervertebral disc.

X-ray diagnostic method is informative for determining the position of bones, identifying the causes of hernias. It is indicated for almost all patients with symptoms of a hernia of the spine – except for pregnant women, as well as for patients with bleeding and severe pathologies.Radiography is especially important for patients with trauma-related hernias.

Many patients are interested in why both radiography and computed tomography are prescribed in the diagnosis. The fact is that these types of diagnostics complement each other well, and each of them is the most effective for solving its goals. An X-ray allows you to get the most complete picture of the state of the vertebrae and intervertebral discs, tomography – to study the state of the soft tissues of the spine (including muscles and ligaments).

X-ray computed tomography (CT) allows to combine X-ray and tomographic examination in one procedure. In Minsk, CT of the spine sections is available at the 5th Clinical Hospital. The modern equipment of the hospital allows specialists to carry out detailed post-process data processing, to obtain three-dimensional volumetric reconstructions. On their basis, doctors can accurately diagnose, predict which treatment will be most effective.

Methods of treatment

In the early stages, when there is still no rupture of the intervertebral disc, non-surgical methods of treatment help – physiotherapy, therapeutic exercises, manual therapy and medication.With a progressive form of the disease, surgical treatment is advisable.

Non-surgical methods

• Wearing special corsets (orthoses). Does not eliminate the hernia itself, but relieves pain, restores the position of the vertebrae, relieves muscle stress. Depending on the problem area, it is recommended to wear a lumbar, chest corset. The most unpleasant moment is that long-term wearing of a corset is fraught with muscle atrophy.
• Massage . This non-surgical method can provide a good result if there are no violations of the skin, blood pressure, inflammatory processes, accompanied by an increase in body temperature.The massage uses creams with anesthetic effect, essential oils. Most often, massage is prescribed for hernias in the lumbosacral spine.
• Exercise therapy. An alternation of muscle tone and relaxation exercises is recommended. Exercises can be performed only at a time when the severity of the pain syndrome is minimal. But it is important that you train regularly. The best option is to devote 15 minutes to classes every day

The main difficulty is that massage and exercise therapy should be very dosed, otherwise you can provoke a rupture of the intervertebral disc, increase spasms

Surgical treatment

If non-surgical treatment does not help, in most cases cases resort to surgical treatment.The operations can be divided into several groups:

• Traditional discectomy . Open surgery, the intervertebral disc, part of it and the vertebral processes that touch the arteries and the spinal cord are removed. For a long time it was considered the most popular way to remove hernias, but due to the large area of ​​damage and the need for general anesthesia and long-term recovery, doctors resort to traditional discectomy less and less.
• Laminectomy . An operation that removes the part of the vertebral arch that presses the nerve root.The operation is abdominal, but less traumatic than traditional discectomy. The operation is performed through a small incision (maximum incision length 10 cm). Depending on the characteristics of the specific situation, it can be performed under general and local anesthesia. Recovery after surgery is fast enough. But on one condition – no complications. And their probability is high. Moreover, it can be both blockage of blood vessels and bleeding.
• Minimally invasive endoscopic hernia surgery. Access to the problem area is provided through a thin tube. The hernia is removed not through an open cavity, but through an endoscope. A huge advantage of the technique – the patient can get up on the day of the operation, the stay in the clinic does not exceed two weeks, there is no risk of adhesion formation.

Open and endoscopic hernia operations are actively practiced in Minsk at the 5th Clinical Hospital. The head of the neurosurgical department, Alexander Baranovsky and his team, are proficient in sophisticated surgical techniques, individually approaching each patient and the severity of the patient’s neurological deficit.

Drug treatment

If, for some reason, surgical intervention is unacceptable, or a disease, at the initial stage, the treatment can be carried out with medication. What drugs are prescribed?

• Painkillers (mainly in the form of blockades – injections directly into the focus of pain on the spine itself). In particular, X-ray-controlled blockade with local anesthetics and steroid hormones proved to be good in practice.
• Muscle relaxants (muscle relaxants) for relieving muscle spasms. They provide a good result, but with an illiterate selection, they can cause side effects associated with the functioning of the central nervous system. They are selected purely individually – exclusively by a doctor, self-medication is permissible. Not suitable for people with chronic renal or hepatic impairment
• Chondroprotective agents. Their use is important for the restoration of contributing cartilage tissue.

In addition, agents to stimulate blood circulation and vitamins of group B can be prescribed. If painkillers and muscle relaxants are in the form of tablets, preparations are recommended to protect the mucous membrane of the stomach and esophagus.

Manual therapy

Another way to combat hernias is manual therapy. It is a non-invasive procedure that focuses on restoring the correct position of the vertebrae (repositioning). The procedure is directed not easily at eliminating a hernia in one of the departments, but at improving the biomechanics of the entire spine.

A huge advantage from manual therapy – not only the problem with the spine itself is solved, but also the accompanying problems caused by the appearance of a hernia are eliminated. Swelling and inflammation go away.

But with the effectiveness of the technique, manual therapy is not suitable for all patients. There are also so-called reducible and irreducible hernias. Correctable hernias with the help of manual therapy are treated for treatment in a fairly quick time. Irreducible hernias are not treated with manual therapy. This is not only ineffective, but also dangerous.

This is why manual therapy can only be performed after a detailed diagnosis and by an extremely experienced specialist. Only he will correctly assess whether it is possible to carry out manual therapy in a particular case, whether it will lead to injury to internal organs, the formation of adhesions and even an infringement of the hernia itself, which can only be eliminated with the help of operations. By the way, some of the operations in the 5th hospital are precisely operations aimed at eliminating the infringement of the hernia provoked by manual therapy in institutions with low-level specialists

Recovery

Regardless of how the hernia was removed, recovery is required.What is it built on?

• On medical and electrotherapy, aimed at reducing pain after surgery (especially important for patients who have undergone open surgery).
• Wearing special corsets. It helps to consolidate the effect, maintain the spine in the correct position, relieve the load on the vertebrae, and prevent the recurrence of the disease. If the hernia was removed surgically and the operation was voluminous, then in the first weeks it is recommended to alternate wearing a rigid and semi-rigid corsets, and then wear a semi-rigid one for about three months.If the operation is minimally invasive, then sometimes it is enough just to wear a semi-rigid corset for two months.
• In remedial gymnastics. Exercise therapy is organized strictly under the supervision of a physician. The main exercises for the patient are static movements aimed at keeping the back muscles in a contracted state for several seconds.
• On control of being in an upright position. In the first month after surgery, you can stay upright in a row for no more than 1.5 hours.

The exact recovery time after removal of a hernia depends on age, the presence of concomitant diseases, the method used to treat the hernia.

Prevention

If your loved ones have faced such a problem as a hernia of the spine, your job involves constant stay in one position, you are at risk. And prevention in this case is required. What does it include?

• Regular exercise, which includes exercises to strengthen the muscle corset and stretching the muscles of the back, and, if possible, sign up for a pool and go swimming.
• Proper nutrition. It is important that the body has enough protein and calcium. Therefore, the use of cottage cheese, kefir, chicken meat should be regular.
• Vitamin therapy. If you eat few vegetables, fruits, often catch colds, do not neglect vitamin therapy. A weakened body is a direct target for diseases of the spine.
• Use of food supplements with chondrocytes for the elasticity of the connective tissue. Especially if there are signs of osteochondrosis, arthrosis, or have recently been injured.

Weight control. Excess weight is especially dangerous for the spine. After all, it creates additional pressure and load on the vertebrae. And, in the case of the slightest injury, the appearance of a hernia in this case is a natural process. Refrain from high-calorie foods, smoked meats.

Treatment of umbilical, inguinal hernias in St. Petersburg, removal of skin neoplasms

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The general surgery specialists of the medical center are involved in the diagnosis, surgical treatment and rehabilitation of patients with various diseases, such as

1.Purulent surgical infections of the skin and soft tissues.

• Furuncle – inflammation of the hair follicle;
• Carbuncle – purulent inflammation of hair follicles;
• Panaritium – purulent inflammation of the skin, soft tissues, tendons and bones of the fingers;
• Suppurative atheroma;
• Infected open wound;
• Inflammatory process of fingers and periungual bed;
• Bursitis – inflammation of the joint capsules;
• And others

2.Benign formations of the skin and soft tissues.

• Lipoma
• Atheroma
• Fibroma
• Papilloma
• Gigroma
• Keratoma

The surgeons of the medical center are engaged in the removal of all types of benign neoplasms. More details here

3. Hernias of various types.

Office photo

Inguinal hernia

Inguinal hernia refers to hernias of the abdominal wall, but is visualized in the groin area.

There are a number of characteristics that define an inguinal hernia:

protrusion of individual parts of internal organs, or any internal organ as a whole through the inguinal canal under the skin.

On both sides of the groin, the inguinal canal passes, which is visualized as a space between the broad muscles of the abdomen. In women and men, through the inguinal canal pass: in women – the round ligament of the uterus, in men – the spermatic cord with nerves.

Disease – inguinal hernia occurs in both men and women.However, due to the anatomical features of the structure in men, it is observed much more often than in the opposite sex.

There are a number of reasons that contribute to the development of an inguinal hernia:

Allocate congenital and acquired causes.

Congenital:

• Heredity
• Age (due to muscle weakening)
• Sex (predisposition in men)
• Genetic features of the body structure

Predisposing:

• Rapid weight loss (e.g. when losing weight)
• Regular labor in women
• Atrophy of the nerves that provide innervation to the abdominal wall

Acquired:

• Difficulty urinating
• Frequent constipation
• Difficult childbirth
• Heavy physical activity
• Persistent cough

There are a number of symptoms that indicate the development or presence of an inguinal hernia:

• Groin discomfort when walking
• Disorder of urination and even digestion
• Swelling in the groin area
• In men, there is a stretching of the skin on the scrotum and its enlargement, possibly a state of deviation of the penis in the direction opposite to the location of the hernia.

The only radical and effective method for the treatment of inguinal hernia today is the operative elimination of hernia formation. It allows you to completely eliminate the hernia and eliminate possible consequences.

The operation consists in removing the hernial sac itself and then strengthening the weakened area of ​​the abdominal region with your own tissues, or, if it is impossible to use your own tissues, with a polypropylene mesh graft.

Skilled surgeons treat inguinal hernia under local or general anesthesia.The decision is made by the surgeon according to individual indications. With general anesthesia, a consultation with an anesthesiologist is mandatory.

Rehabilitation period:

After the operation, the patient can, without any anxiety and discomfort about the inguinal hernia, continue to lead a normal life.

Umbilical hernia

Umbilical hernia is visually manifested by the protrusion of the navel outward or part of it, which does not always look aesthetically pleasing.

A common cause of an umbilical hernia is the protrusion of internal organs (possibly part of the intestine) into the navel, due to the weakness of the abdominal fascia.In 70% of cases, it is a hereditary disease.

Treatment of an umbilical hernia is carried out through surgery, during which the umbilical hernia is removed. You can see the photos before and after the operation on the website. In addition to eliminating the umbilical hernia itself, the aesthetic perception of the navel is significantly improved.

Umbilical hernia before and after photos.

After surgery

Before operation

Before operation

After surgery after 7 days

Before operation

After surgery after 7 days

After surgery

Before operation

In adulthood, the causes of umbilical hernias are: obesity or overweight, postoperative scars, strenuous exercise (possibly in the gym), work associated with physical activity or lifting weights, abdominal trauma.It can also often develop during pregnancy, when the resistance of the abdominal wall of the abdomen decreases and the tissues around the umbilical ring change, and the pressure from the inside increases.

Lack of systematic exercises aimed at forming the press and maintaining the shape of the abdomen can also lead to the formation of an umbilical hernia.

In the reclining or horizontal position of the body, the protrusion can disappear or change in size. Umbilical hernias can occur in children, women, or men at any age.

A surgeon deals with the treatment of umbilical hernias in adults and children. The operation most often takes place under local anesthesia.

After the operation, the patient can go home in 3-4 hours.

The operation is characterized by low trauma and a short rehabilitation period.

Surgical treatment of umbilical hernias in St. Petersburg is carried out in a hospital clinic, where, in addition to general surgical operations, plastic, neurosurgical, phlebological and other types of operations are also performed.The operation is prescribed only after a preliminary examination by the surgeon and diagnostics of the “removal of the umbilical hernia” necessary for the operation. The cost can be found in the price section.

Ventral (incisional) hernia

Disease of the anterior abdominal wall, the external manifestation of which is the protrusion of internal organs in the abdomen.

Reasons.

Ventral hernias appear after unsuccessful surgical interventions, often associated with a violation of the operating technology.The second common reason is a violation of the postoperative regimen by the patients themselves: a violation of the prescribed diet, premature physical activity.

Treatment of hernias in the MedSwiss Medical Center is carried out by the surgical method by removal.

If 100% exclusion of recurrence is required, under certain indications, it is possible to use polypropylene mesh grafts (mesh).

Local anesthesia or general anesthesia can be used according to individual indications.

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Femoral hernia

Visually defined as a tumor-like protrusion in the femoral triangular area.

Femoral hernia is formed gradually due to the exit of intestinal loops through the femoral ring outside the abdominal cavity.

Diagnostics: consultation with a surgeon using visual examination and palpation, ultrasound diagnostics of hernial protrusion, ultrasound of the pelvis and bladder, irrigoscopy, herniography.

An operation to remove such a hernial formation is called hernioplasty.

The causes of femoral hernias, like most other hernias, are factors that lead to a weakening of the abdominal wall, both genetic and acquired over time.

If you suspect a femoral hernia or if you are sure that it already exists, you should consult a surgeon. complications of femoral hernias often occur, which is the most dangerous for the body.

Possible complications, with femoral hernias:

• Inflammation – hyperemia, swelling of the skin, pain, fever. Peritonitis is possible.
• Coprostasis – blockage of the intestine or part of the intestine with feces.
• Infringement – violation of innervation and blood supply, pain, an increase in hernia in size, gas formation, stool retention. Intestinal obstruction is possible.

Treatment of femoral hernia is performed only by surgery.

Experienced surgeons at MedSwiss Medical Center treat all types of hernias.

The operation takes place in the hospital of the medical center, which is equipped with technological equipment from European manufacturers, which allows us to provide all our patients with the highest quality result in a comfortable environment, both for the patient and the surgeon.

Benign skin lesions

The surgeons of the medical center are engaged in the removal of all types of benign neoplasms.More details here

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Doctors

Surgeon, K.MD, doctor of the highest category

Surgeon, Ph.D., doctor of the highest category

Plastic surgeon, surgeon, phlebologist

Surgeon

+ 7-905-25XXXXX 07/03/2021

Anastasia K.03/04/2020

Vladimir L. 12.12.2019

Nina Pavlovna 12.08.2015

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Hernia of the anterior abdominal wall | TS Clinic – Krasnodar

The exit of the abdominal organs through natural or acquired holes in the peritoneum is called abdominal hernia.

The main reason for the development of abdominal hernias is an imbalance between intra-abdominal pressure and the ability of the abdominal walls to resist it.General factors of hernia formation are usually divided into two groups:

• Predisposing factors. These include the features of the human constitution, formed on the basis of hereditary or acquired properties. This is, first of all, a hereditary predisposition to the formation of hernias, as well as typical, gender and age differences in the structure of the body. For example, changes in the abdominal wall associated with pregnancy, hard physical labor, malnutrition (obesity or exhaustion).
• Productive factors, , contributing to an increase in intra-abdominal pressure or its sharp fluctuations. For example, lifting a load, coughing with chronic lung diseases, prolonged constipation, difficulty urinating with prostate adenoma.

The interaction of these factors determines the localization and nature of the resulting hernia. Also, there are frequent cases of postoperative abdominal hernia.

As a rule, the hernia develops gradually.At the initial stage of the disease, the patient feels slight pulling pains in the area of ​​the forming hernia, aggravated by an increase in intra-abdominal pressure (when lifting weights, coughing, defecating, etc.). The pains gradually intensify, and after a certain period of time in the area of ​​their localization, the patient (or the doctor) discovers a small tumor-like formation of a round or oval shape that appears during physical exertion and disappears when taking a horizontal position.

Pain sensations in the initial stage of the disease , when the intact peritoneum is stretched with the formation of a hernial sac, is quite intense, but does not reach the severity characteristic of infringement.As the hernial protrusion increases, the pain becomes weaker and even disappears completely. Subsequently, with the long-term existence of the hernia and its large size, with sliding and recurrent hernias, they again become a constant symptom and the main complaint of patients. The pain syndrome occurs at the moment of hernia emergence and completely disappears after its reduction. The larger the hernial protrusion, the more significant inconvenience it causes when walking and physical work, sharply limits the ability to work and creates not only physical, but also psychological problems in everyday life.

With a formed hernia, the main symptom of the disease is the appearance of a tumor-like formation. A characteristic feature of is a change in its size. It increases in an upright position, with coughing and straining, and in a horizontal position or with manual reduction, it decreases or even completely ceases to be determined.

It is possible to eliminate the hernia and prevent possible complications only by surgery.

The most dangerous complication of a hernia, threatening the patient’s life and requiring immediate surgical intervention – infringement. Impairment is understood as a sudden or gradual compression of an abdominal organ (hernial contents) in the hernial orifice, leading to a disruption of its blood supply and ultimately to necrosis.

The various organs that make up the hernial contents can be infringed. Most often, the small intestine or a strand of the greater omentum is infringed, less often a section of the transverse colon or sigmoid colon. It is extremely rare that organs located are mesoperitoneally infringed: ascending intestine, bladder, uterus and its appendages, etc.The most dangerous infringement of the intestine, since it is fraught with its necrosis, the development of severe strangulated intestinal obstruction and peritonitis.

Main types of hernias

Umbilical hernias

Umbilical hernias in adults are usually acquired and can be significant in size. A significant predominance of the size of the hernial protrusion over the diameter of the hernial orifice is characteristic, as a result of which the prerequisites for the infringement of the internal organs are created.

Inguinal hernias

Inguinal hernias account for 75-80% of the total number of hernias. The main reason for the formation of inguinal hernias is the weakness of the posterior wall of the inguinal canal. Inguinal hernia is diagnosed mainly in men (90%). This is due to the fact that the inguinal canal in women is narrower and longer than in men, has a slit-like shape, and is better strengthened by muscle and tendon layers. The main varieties are represented by oblique and straight inguinal hernias.

An oblique inguinal hernia emerges through the external inguinal fossa, as part of the elements of the spermatic cord covered with the external spermatic fascia, the inguinal canal passes, exits through the external opening of the inguinal canal and can descend into the scrotum, stretching it.Such a hernia is called an inguinal-scrotal hernia.

Straight – passes only through the external opening of the inguinal canal. A straight hernia always lies medial to the spermatic cord, which is of normal size, is not associated with a hernia and only adjoins it. The pulsation of the inferior epigastric artery is determined outward from the hernial orifice.

Direct hernias are often sliding and contain the wall of the bladder. In addition to pain in the hernia, a feeling of discomfort when moving and a tumor-like formation, such patients may be disturbed by dysuric phenomena.

Femoral hernias

Femoral hernias exit through the femoral canal and are located below the projection of the inguinal ligament. They account for 5% of all external abdominal hernias. Femoral hernias are much more common in women, due to the peculiarities of the structure of the pelvis. Femoral hernias are more likely than inguinal hernias to be difficult to diagnose and are more likely to be impaired. In the process of its formation, a femoral hernia goes through three stages:

• initial – the hernial protrusion does not go beyond the inner femoral ring;
• channel – the hernial protrusion is located near the vascular bundle, does not go beyond the superficial fascia and does not penetrate into the subcutaneous fatty tissue of the Skarp triangle;
• full – when the hernia passes through the entire femoral canal, its internal and external openings and enters the subcutaneous tissue of the thigh; this stage of hernia is found most often.

Postoperative hernias

Postoperative hernias emerge from the abdominal cavity in the area of ​​the postoperative scar and are located more often on the anterior abdominal wall, less often in the lumbar region. Most often they occur after emergency laparotomies for inflammatory diseases of the abdominal organs and wounds.

Postoperative hernias are often extensive and gigantic in size and sometimes cause patients, including many young patients, no less physical and mental suffering than the diseases for which they were operated.Disturbed by abdominal pain, constipation, inability to engage in physical labor, aesthetic discomfort. The hernial orifice is located in the area of ​​the postoperative scar, they are formed by the dispersed, scar-altered edges of the muscles and aponeurosis. The outer covers of a postoperative hernia are represented by scar tissue, intimately fused with the hernial sac and skin. They are so thin that intestinal motility can be seen. Abdominal scars are prone to maceration and ulceration.

Treatment

Conservative treatment of hernia is not possible.Surgical treatment is called hernia repair. It includes the following stages:

• dissection of tissues over the hernial sac;
• Isolation of the hernial sac to the neck;
• opening the hernial sac and inserting the contents into the abdominal cavity;
• Sewing, ligation of the hernial sac at the neck and its cutting off;
• Plasty of the hernial orifice with local tissues or alloplastic materials

The prosthesis mesh serves as a framework for penetration of connective tissue, which is equal in strength or superior to that of the aponeurosis.The most widely used synthetic materials are polyester, polytetrafluoroethylene, polypropylene. Non-woven plates made of porous polytetrafluoroethylene are maximally inert to body tissues; they can even be placed intraperitoneally without the risk of causing an adhesion process. Closure of the hernia orifice with alloplastic material is called tension-free hernioplasty.

Routine use of one type of intervention is unacceptable for clinical practice. For example, the methods of tension-free hernia repair, which have proven themselves in terms of long-term results, are not shown to children, they are dangerous in strangulated hernias due to the possibility of mesh infection, the cost of the operation is twice as high as in traditional hernia repair.Video endoscopic surgeries require the use of general anesthesia, appropriate technical equipment, special training of the operating team, and are impossible for strangulated and recurrent hernias. The choice of the method may be limited by the age and concomitant diseases of the patient, the condition of the tissues of the abdominal wall and the size of the hernial defect. Priority should be given to the simplest and least traumatic intervention, with which you can reliably eliminate the defect of the abdominal wall.

Hernia repair for umbilical hernias

Hernia repair for umbilical hernias in Operating room No. 1, Aleksandrov

G Redhead surgery for umbilical hernias is the only method of treating this disease in adult patients. Such a disease is also diagnosed in infants, young children, but in a child, a hernia can go away on its own.

Umbilical hernia is a condition in which internal organs protrude beyond the navel to form a lump.If parts of the intestine or other internal organs appear in the form of a hernia, it is impossible to refuse the operation: it is possible infringement of the hernia, necrosis, the development of intestinal obstruction.

Causes of the appearance of an umbilical hernia

An umbilical hernia in babies develops when there is increased pressure in the peritoneum. This disease is congenital.

In adults, a hernia appears due to the weakness of the connective tissue, with excessive physical exertion, and frequent coughing. Constipation, pregnancy, excess weight, fluid accumulation in the peritoneum can lead to hernia formation.

Diagnosis of an umbilical hernia

This disease affects men, women, children. Most often occurs in infants and middle-aged patients. Symptoms of hernial protrusion of internal organs:

• increase in the size of the umbilical ring;
• The appearance of a lump or lump near the navel;
• nausea, impaired appetite;
• pain in the middle of the abdomen during exercise;
• pain when coughing.

The primary examination of the patient is carried out by a therapist who performs a visual examination of the patient in a vertical, horizontal position.The patient’s abdomen is palpated; if a pathology is suspected, additional examinations are performed.

• An ultrasound examination of the peritoneum and intestines is performed.
• Differential diagnosis may require herniography, a study with the introduction of contrast.
• If the patient is diagnosed with gastrointestinal diseases, EGD is used.

Preparation for surgery for umbilical hernia

Conservative methods of treatment in adults are ineffective, therefore, surgical intervention is used to treat a hernia.Preparation for it includes a lightweight diet. The menu is made up so as to avoid constipation. The last day before the operation, you should refuse food, but drinking water is allowed.

On the eve of the operation, you must not smoke, take alcohol, or aspirin-based medications. Taking medication is agreed with the doctor. The hair in the navel is shaved off, the patient is given a cleansing enema.

Preparation for surgery includes the following examinations:

• general analysis of blood, urine;
• ECG;
• fluorography;
• coagulogram;

90,090 tests for syphilis, hepatitis, HIV.

If the patient has contraindications to surgery, it is performed only when the hernia passes into a dangerous form.

Methods of surgical intervention for umbilical hernias

Hernia repair, or hernioplasty, is a simple operation, especially if the hernial lump is small. When the hernial sac grows, is infringed, urgent intervention is necessary.

The following methods of hernia removal are used in surgery:

• traditional – without implants;
• with the installation of an endoprosthesis.

Endoprosthesis is a mesh that strengthens the peritoneum. It stimulates the overgrowth of the cavity with new tissue. Implants are made from materials that dissolve on their own or stay in place. Installation of an endoprosthesis reduces the risk of recurrence.

Open method operation

Removing a hernia in this way is a traditional operation. It is carried out if the hernial sac is extensive, restrained, with emergency intervention. The disadvantage of the open method is an increased risk of complications, the addition of a secondary infection.The suture is an open gateway for infection to enter. The recovery period is quite long, a scar remains on the skin, which requires cosmetic removal.

With the open method of operation, the surgeon makes an incision in the peritoneum, through which he sets the internal organs that have fallen into the hernial sac. The intervention is performed under general or local anesthesia. Dead tissue is removed, the incision is sutured, mesh can be installed.

Laparoscopic umbilical hernia removal

This is the most popular and safest treatment.Small incisions are made on the peritoneum. A camera is inserted through one incision, with which the doctor controls the progress of the operation. The instrument is inserted through the remaining incisions.

A subspecies of laparoscopy is a single puncture method that reduces trauma to the abdominal tissues. The hernial orifice is closed by pulling the tissues, installing an endoprosthesis.

Benefits of laparoscopic treatment:

• is a minimally invasive method, therefore the postoperative period is short;
• low risk of adhesions;
• minimal risk of complications.

Laser method

Hernia repair with a laser knife reduces the risk of adhesions and complications. This is a modern bloodless method. It has high accuracy, is used for the treatment of small and medium-sized umbilical hernias that are not restrained, however, it is demanding on the competence of the surgeon.

Hernia repair according to the methods of Mayo, Lexer, Sapezhko

These methods of surgical intervention involve closing the hernial orifice by pulling the peritoneal tissue.

• Mayo method.The incisions are made in the form of a semicircle, adipose tissue is captured, the hernial sac is sutured horizontally.
• Sapezhko’s method implies vertical cuts. The fabrics are sewn together in layers.
• The Lexer method is used if the hernial sac is inseparable from the navel.

Advantages of the operation in the Operating room # 1

• The Surgical Center “Operating Room No. 1” in Aleksandrov performs surgical interventions for an umbilical hernia. We use modern methods of treatment, minimally invasive methods.