What are the best techniques for pushing an umbilical hernia back in. How can you prevent complications from an umbilical hernia. What treatment options are available for umbilical hernias. When should you seek medical attention for an umbilical hernia.

Understanding Umbilical Hernias: Causes and Risk Factors

Umbilical hernias occur when a portion of tissue from inside the abdomen pushes through a weak spot in the abdominal wall near the navel. While once thought to be primarily caused by heavy lifting or straining, current medical understanding points to impaired collagen metabolism as the main culprit. This predisposition, combined with factors like smoking, obesity, and infection, can increase the risk of developing an umbilical hernia.

Who is most susceptible to umbilical hernias? Contrary to popular belief, these hernias can affect individuals across all fitness levels and body types. Even highly trained athletes are not immune. However, certain groups face a higher risk:

• Pregnant women
• Overweight individuals
• Smokers
• Those with a family history of hernias

Can umbilical hernias resolve on their own? Unfortunately, once a weakness in the abdominal wall develops, it will not heal without intervention. In fact, untreated hernias are likely to worsen over time.

Identifying an Umbilical Hernia: Signs and Symptoms

Recognizing an umbilical hernia early is crucial for proper management. The most common signs include:

• A visible bulge or round lump near the navel
• Tenderness in the affected area
• The bulge becomes more prominent when coughing, straining, or standing

Is it possible to have an umbilical hernia without knowing it? Yes, in some cases, hernias may be asymptomatic and only discovered during routine medical examinations. This is why regular check-ups are essential, especially if you’re in a high-risk group.

The “Reducible” Hernia

In the early stages of an umbilical hernia, you may be able to temporarily push the protruding tissue back into place. This is known as a “reducible” hernia. However, as the condition progresses, the bulge may become more persistent and difficult to reduce.

Pushing Back an Umbilical Hernia: Techniques and Precautions

While pushing back a hernia should ideally be done under medical supervision, there are some general guidelines to follow if you need to attempt it yourself:

1. Lie down on your back with your knees bent and feet flat on the floor.
2. Relax your abdominal muscles as much as possible.
3. Gently apply pressure to the hernia bulge with your fingertips.
4. Use slow, steady pressure to guide the protruding tissue back into your abdomen.
5. If you feel pain or resistance, stop immediately and seek medical help.

Is it safe to push an umbilical hernia back in at home? While it’s possible to reduce some hernias temporarily, it’s crucial to consult a healthcare professional. Improper techniques can lead to complications or mask underlying issues.

Conservative Management: Trusses and Support Devices

For those opting to delay surgery or manage mild symptoms, various support devices are available:

• Hernia trusses
• Abdominal binders
• Supportive belts

These devices aim to hold the hernia in place and provide support during daily activities. However, their effectiveness can vary, and improper use may increase the risk of complications.

How should you choose the right support device? Consult with a healthcare provider who can recommend and properly fit a device based on your specific hernia type and lifestyle needs.

Surgical Interventions: When and Why to Consider Repair

While not all umbilical hernias require immediate surgery, repair is often the most effective long-term solution. Reasons to consider surgical intervention include:

• Persistent pain or discomfort
• Increased size of the hernia
• Difficulty in reducing the hernia
• Risk of incarceration or strangulation

What are the different surgical approaches for umbilical hernia repair? The two main techniques are:

1. Traditional suture repair: Stitching together the edges of the abdominal wall defect.
2. Mesh repair: Using a synthetic patch to reinforce the weakened area, reducing tension and lowering recurrence rates.

Is hernia surgery a major procedure? While it’s one of the most common and generally safe surgeries performed, it still carries some risks. Discuss the benefits and potential complications with your surgeon to make an informed decision.

The Watchful Waiting Approach: Is It Right for You?

Recent studies have challenged the notion that all hernias require immediate surgical intervention. A notable study published in the Journal of the American Medical Association found that for men with minimally symptomatic inguinal hernias, watchful waiting can be a safe option.

What does watchful waiting entail for umbilical hernias?

• Regular monitoring of the hernia size and symptoms
• Using supportive devices as needed
• Maintaining a healthy lifestyle to prevent worsening
• Being vigilant for signs of complications

Is watchful waiting suitable for everyone? While it may be appropriate for some adults with minimal symptoms, it’s generally not recommended for infants, children, or cases where there’s a high risk of incarceration.

Preventing Complications: Red Flags and Emergency Situations

While many umbilical hernias can be managed conservatively, certain situations require immediate medical attention. Be alert for:

• Sudden, severe pain in the hernia area
• Nausea or vomiting
• Fever
• Redness or discoloration of the skin over the hernia
• Inability to reduce a previously reducible hernia

These symptoms could indicate a strangulated hernia, where blood supply to the trapped tissue is cut off. This is a medical emergency requiring immediate surgical intervention.

How quickly can a hernia become strangulated? While it can happen suddenly, most hernias progress gradually. Regular monitoring and prompt attention to changing symptoms can help prevent this serious complication.

Lifestyle Modifications to Support Hernia Management

Whether you’re pursuing watchful waiting or preparing for surgery, certain lifestyle changes can help manage your umbilical hernia and support overall abdominal health:

• Maintain a healthy weight to reduce pressure on the abdominal wall
• Practice proper lifting techniques, using your legs rather than straining your abdomen
• Quit smoking to improve tissue health and healing
• Manage chronic coughs or constipation to reduce abdominal strain
• Engage in low-impact exercises to strengthen core muscles, under guidance from a healthcare provider

Can dietary changes help with hernia management? While diet alone won’t cure a hernia, a balanced, fiber-rich diet can help prevent constipation and reduce straining during bowel movements, which may aggravate hernias.

The Role of Core Strengthening

Strengthening the core muscles surrounding the umbilical area can provide additional support and potentially slow the progression of a hernia. However, it’s crucial to approach exercise cautiously:

• Consult with a physical therapist or qualified fitness professional
• Avoid exercises that create excessive intra-abdominal pressure
• Focus on gentle, controlled movements that engage the deep abdominal muscles
• Listen to your body and stop if you experience pain or discomfort

Are there specific exercises to avoid with an umbilical hernia? High-impact activities, heavy weightlifting, and exercises that involve sudden, forceful movements should generally be avoided until cleared by a healthcare provider.

Recovery and Long-Term Outlook After Umbilical Hernia Repair

If you opt for surgical repair of your umbilical hernia, understanding the recovery process can help set realistic expectations:

1. Immediate post-operative period: Expect some pain and discomfort, managed with prescribed medications
2. First few weeks: Gradual return to light activities, avoiding heavy lifting
3. 1-2 months: Most patients can resume normal activities, but should continue to avoid strenuous exercise
4. 3-6 months: Full recovery, with clearance for all activities based on surgeon’s assessment

What is the recurrence rate for umbilical hernia repairs? With modern surgical techniques, particularly mesh repairs, recurrence rates are relatively low, typically less than 10%. However, factors like obesity, smoking, and certain medical conditions can increase the risk of recurrence.

Long-Term Care and Monitoring

Even after successful repair, it’s important to maintain good abdominal health:

• Attend all follow-up appointments with your surgeon
• Continue core-strengthening exercises as recommended
• Maintain a healthy weight
• Be vigilant for signs of recurrence or new hernias

How long should you continue monitoring after hernia repair? While the risk of recurrence is highest in the first few years after surgery, it’s wise to remain aware of any changes in your abdominal area indefinitely.

Special Considerations for Umbilical Hernias in Specific Populations

While the general principles of umbilical hernia management apply broadly, certain groups may require special considerations:

Infants and Children

Umbilical hernias are common in infants, often closing on their own by age 3-4. However, larger hernias or those persisting beyond this age may require surgical intervention. Key points for parents:

• Monitor the hernia size and any changes in appearance
• Be alert for signs of incarceration, which are more common in children
• Follow pediatrician recommendations for timing of surgical repair, if needed

Pregnant Women

Pregnancy can exacerbate existing umbilical hernias or lead to new ones due to increased abdominal pressure. Management during pregnancy focuses on:

• Conservative measures to reduce discomfort
• Close monitoring for complications
• Typically delaying surgical repair until after delivery, unless complications arise

Obese Individuals

Obesity significantly increases the risk of developing umbilical hernias and can complicate both conservative management and surgical repair. Considerations include:

• Weight loss as a primary management strategy, when appropriate
• Potential need for bariatric surgery in conjunction with hernia repair
• Higher risk of surgical complications and recurrence

How does obesity impact hernia surgery outcomes? Obese patients may face a higher risk of wound complications, recurrence, and longer recovery times. Some surgeons may recommend weight loss before attempting repair to improve outcomes.

Emerging Treatments and Future Directions in Umbilical Hernia Management

The field of hernia repair is continually evolving, with new techniques and materials being developed to improve outcomes and reduce recurrence rates. Some promising areas of research include:

• Biological mesh materials that may reduce the risk of infection and improve integration with the patient’s tissues
• Minimally invasive laparoscopic and robotic surgical techniques, potentially offering faster recovery times and smaller incisions
• Tissue engineering approaches to strengthen weakened abdominal walls
• Gene therapy targeting collagen metabolism to address underlying hernia risk factors

What advancements are on the horizon for non-surgical hernia management? Research into advanced support devices, including “smart” trusses that adapt to body movement and pressure changes, may offer improved conservative management options in the future.

The Role of Personalized Medicine

As our understanding of the genetic and molecular basis of hernia formation improves, there’s potential for more personalized approaches to prevention and treatment:

• Genetic screening to identify individuals at high risk for hernia development
• Tailored surgical techniques based on individual patient characteristics and hernia types
• Customized post-operative care plans to optimize recovery and reduce recurrence risk

How might personalized medicine change the approach to umbilical hernia management? In the future, treatment decisions may be guided by a combination of genetic, lifestyle, and clinical factors, allowing for more precise and effective interventions.

Navigating the Healthcare System with an Umbilical Hernia

Dealing with an umbilical hernia often involves interacting with various healthcare professionals and navigating treatment decisions. To ensure the best care:

• Seek a referral to a hernia specialist or experienced general surgeon
• Prepare a list of questions for each appointment
• Keep detailed records of your symptoms and any changes
• Understand your insurance coverage and potential out-of-pocket costs
• Consider seeking a second opinion for complex cases or if you’re unsure about treatment recommendations

What questions should you ask when consulting a surgeon about umbilical hernia repair? Important inquiries include:

1. What type of repair do you recommend and why?
2. What is your experience with this specific procedure?
3. What are the potential complications and how often do they occur in your practice?
4. What can I expect during recovery, and when can I return to normal activities?
5. What is the long-term recurrence rate for this type of repair?

By staying informed and actively participating in your care decisions, you can ensure the best possible outcome for your umbilical hernia management.

Don’t Let a Hernia Put a Strain on Your Life

Hernias happen. They happen to overweight, out-of-shape smokers, and they happen to highly trained athletes. They happen to people who strain too much while lifting. And they happen to those who merely sit in a chair. While they are more common in men, hernias also occur frequently in pregnant women.

A hernia happens when a small portion of tissue from inside pushes through a weak spot in the abdominal wall. In about 75 percent of cases, this occurs in the inguinal canal, the area where the abdomen meets the thigh. Men are 25 times more likely than women to develop an inguinal hernia, and the bulge sometimes protrudes into the scrotum.

Other abdominal hernias likely to affect women as well as men include femoral (also in the groin, nearer the thigh), umbilical (around the naval) and epigastria (above the stomach).

It was once believed that hernias were caused by heavy lifting, straining, coughing or sneezing. Such activities may well bring on a hernia if a weakness already exists in the abdominal tissue, but the current belief is that the weakness is usually caused by impairment in collagen metabolism. When the predisposition exists, smoking, infection and obesity–as well as straining–can increase the risk. But even fit, muscular individuals develop hernias.

If you have a hernia, you may not know it until a doctor detects it on a routine examination. When you’re asked during a physical to turn your head and cough, the goal is to feel for a hernia.

A hernia can be seen or felt as a tender bulge or round lump that becomes more prominent when you cough, strain or stand up. In the early stages, it’s possible to push the protruding tissue back in place temporarily. In medical terms, a bulge that can be pushed back in place is known as a “reducible” hernia. When the condition worsens, the lump can no longer be pushed back.

The hard part about dealing with a hernia is the uncertainty about what to do. A break in the abdominal wall will not get better on its own and is likely to get worse. Various trusses, belts and other devices to hold the hernia in have had mixed success.

And a serious problem could occur if fatty tissue or an organ gets trapped inside the hernia (known as “incarceration”) and deprived of blood flow (“strangulation”). Because of the risk of gangrene and tissue death, strangulation is a life-threatening condition requiring emergency surgery.

Sooner or later, most persons with a hernia have it surgically repaired. This involves re-positioning the internal tissue and repairing the defect in the abdominal wall.

About a million procedures are performed each year; it’s one of the most common types of surgery and one of the safest. Complications include pain, discomfort and recurrence of the hernia.

Because of the risk of strangulation, many persons undergo surgery right away, even if the hernia is not causing pain or other symptoms. A study published in the Journal of the American Medical Association [January 18, 2006] found, however, that immediate action may not always be necessary.

More than 700 men with hernias causing only minimal symptoms were recruited over a five-year period at five academic and community hospitals and randomly assigned either to watchful waiting or traditional surgery. Over a two to three year follow-up period, researchers found that the overall rate of pain and other complications was similar in the two groups and concluded that “watchful waiting is an acceptable option for men with minimally symptomatic inguinal hernias. Delaying surgical repair until symptoms increase is safe because acute hernia incarcerations occur rarely.”

Of the men assigned to watchful waiting, 23 percent crossed over to the surgery group–primarily because their pain had gotten worse and the hernia was protruding more.

Infants and children are more likely than adults to have tissue become trapped (or incarcerated) in a hernia; as a result, they may be advised to have surgery sooner rather than later.

Adults choosing to delay surgery might need to wear a truss, belt or other device in order to handle every day activities without pain or discomfort. It’s important, however, to be instructed in the use of a truss since an improperly worn device could actually increase the risk of incarceration.

While hernia surgery is usually worry-free, recurrence has been a problem. The traditional repair involves suturing together the ends of the defect in the abdominal wall. With the resulting increased tension on the abdominal muscle tissue, another tear is eventually likely to happen.

Newer surgical approaches aim to reduce tension by stitching a mesh patch made of synthetic material into the defect. The recurrence rate has been shown to be dramatically improved over the traditional method of suturing the tissue together. Laparoscopic repair of some hernias is also an option in some patients and should be discussed with your doctor.

As far as the patient is concerned, the best procedure is usually the one with which the surgeon has had the most experience.

If you have a small hernia that doesn’t cause symptoms, there’s no need to let it worry you. When it becomes large enough to cause you pain, the surgeons at Brattleboro General Surgery will be glad to consult with you.

Thomas H. Lewis, MD, is a general surgeon and former practice partner at Brattleboro General Surgery

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Umbilical Hernia | Johns Hopkins Medicine

What is an umbilical hernia?

Unlike most hernias, which develop in adolescence or adulthood, 20 percent of babies are born with umbilical hernias. An umbilical hernia occurs at the umbilicus (belly button) when a loop of intestine pushes through the umbilical ring, a small opening in a fetus’ abdominal muscles through which the umbilical cord—which connects a fetus to its mother while in the womb—passes. Umbilical hernias occur most often in newborns, and 90 percent will naturally close by the time the child reaches 5 years of age.

Umbilical Hernia Causes

After birth, the umbilical cord is no longer necessary, and the opening in the abdominal muscles closes as the baby matures. Sometimes, these muscles do not meet completely, leaving a small hole or gap. A loop of intestine can move into and even penetrate the opening between abdominal muscles and cause a hernia.
Umbilical hernias occur most often in infants but can also occur in adults. The most common causes of umbilical hernias in adults are:

Umbilical Hernia Diagnosis

Hernias are usually diagnosed during a physical examination by a health care provider. The provider will look and feel for a bulge or swelling in the belly button area. The swelling may be more noticeable when a baby cries and may get smaller or go away when a baby relaxes or rests on its back. During the examination, the provider will determine if the hernia is reducible—if it can be pushed back into the abdominal cavity.

The provider will also look for and complete a medical history to determine if the umbilical hernia has become incarcerated (trapped within the abdominal opening), a serious medical condition in which the protruding intestine becomes trapped and deprived of blood supply. The intestine can quickly become necrotic if not repaired, which requires surgical removal of the affected intestine. Symptoms of a strangulated umbilical hernia include:   

• Abdominal pain and tenderness

• Constipation

• Fever

• Full, round abdomen

• Red, purple, dark or discolored bulge

• Vomiting

The provider may order blood tests to look for signs of infection resulting from the strangulated intestine. They may also order a barium X-ray, ultrasound, MRI or CT to examine the intestine more closely, especially if the hernia is no longer reducible.

Umbilical Hernia Treatments

Specific umbilical hernia treatment and timing will be determined by the surgeon based on multiple factors such as the child’s age, general health, medical history and whether the hernia is reducible or strangulated. By age 1, many umbilical hernias will have closed on their own without surgery. Nearly all umbilical hernias will have closed without surgery by age 5.

In general, if the hernia becomes bigger with age, is not reducible or is still present after age 3, the child’s provider may suggest that the hernia be repaired surgically. If the hernia is strangulated and cannot gently be pushed or massaged back into its proper place within the abdomen, the surgeon will generally recommend immediate surgery.

Under general anesthesia, a small incision is made in the umbilicus (belly button). The loop of intestine is placed back into the abdominal cavity, and the incision closed. Sometimes a piece of mesh material is used to help strengthen the area where the muscles are repaired.

treatment, the cost of an operation to remove an umbilical hernia in St. Petersburg

An umbilical hernia is a surgical pathology in which the abdominal organs go beyond their physiological position through the structures of the umbilical ring.

In the hernial sac, intestinal loops, parts of the omentum or peritoneum may be found. This disease is not so common in adults, more often it occurs in childhood. However, it takes place in the structure of surgical diseases and requires careful attention.

Why does an umbilical hernia occur?

The main mechanism for the occurrence of a hernia in the navel is the weakness of the muscles of the anterior abdominal wall. Their edges can diverge, thereby freeing up space for the formation of a hernia. This process occurs under the influence of a number of provoking factors:

• Consequences of pregnancy. An increased risk is multiple pregnancies, significant fetal size, or polyhydramnios. Increased pressure on the anterior abdominal wall of a woman can provoke a hernia in the future.
• Weight gain or vice versa – rapid loss of body weight. Uneven load on the abdominal wall leads to muscle weakness.
• Increased intra-abdominal pressure, which occurs in some pathologies.
• Regular constipation.
• Features of connective tissue, impaired collagen metabolism.
• Postponed injuries of the anterior abdominal wall.
• Operative laparotomy interventions.
• Low physical activity.

In order for a certain factor to lead to the appearance of a hernia, its long-term influence or a combination of several causes is necessary. Congenital features of the muscles of the abdominal wall also play a significant role.

What are the manifestations of an umbilical hernia?

The clinic of the disease depends on the precise localization of the hernia, the size of the hernial sac, the involvement of the internal organs in the process, as well as the indicators of reducibility. In some patients, the pain symptom is expressed constantly, while in others there is only slight discomfort. If the condition worsens, the clinical picture becomes more pronounced and varied.

You can recognize an umbilical hernia by the following signs:

• Protrusion in the umbilical region. It occurs gradually and in the early stages does not bring discomfort to a person. you may not even notice it at first. In the supine position, the hernia is reduced and disappears. However, the longer the pathology proceeds, the more significant the protrusion and deformation of the anterior abdominal wall in the navel area becomes. Accordingly, a large hernia cannot be corrected.
• Change in the size of the hernia depending on the position of the body. If a person is standing, the hernia can increase, as well as change its size when coughing, exerting, exerting, eating;
• Soreness occurs when there are adhesions or strangulation has occurred. Patients with an umbilical hernia also experience discomfort and soreness after exercise;
• With a large size of the hernial sac, the skin over it becomes thin and allows you to feel the peristalsis of the intestine;
• Involvement of the digestive system leads to constipation, belching, nausea and bad taste in the mouth. These symptoms indicate the appearance of an adhesive process and aggravation of the condition.

Indications for surgery for umbilical hernia

Hernioplasty in this case is a planned operation, which is prescribed by the surgeon from the moment the pathology is detected. Conservative treatment of umbilical hernia is possible only at the age of 6 years, for which special gymnastics and exercises are prescribed. An adult has already completed the formation of the anterior abdominal wall and muscles, so it is necessary to resort to surgery.

Indications for emergency surgery are aggravated conditions:

• infringement of the contents of the hernial sac;
• involvement in the inflammatory process of the peritoneum;
• occurrence of intestinal obstruction;
• bleeding.

If you delay the operation in such cases, there is a necrotic change in the soft tissues. This can lead to general complications and is life threatening.

Diagnostic program for hernia in the umbilical region

The diagnosis begins with a questioning of the patient. It is important for the surgeon to find out the circumstances of the onset of the disease, its course. An objective examination includes examination of the hernia, palpation of the abdominal wall, a detailed examination of the patient’s appearance.

Additional diagnostic methods:

• abdominal x-ray;
• ultrasound examination of hernia;
• in difficult cases (severe obesity) – computed tomography of the abdominal cavity.

If the patient’s condition is critical, laboratory diagnostic methods may be needed. They will show the state of metabolism in the body, as well as the readiness of a person for the upcoming surgical intervention.

Modern treatment of umbilical hernia

Treatment of a hernia can prevent serious complications, and also returns the patient to comfort and the usual mode of life. Many patients hope for self-reduction of the hernia, but for adult patients, only surgical treatment is indicated.

Umbilical hernia surgery

There is conventional surgery and laparoscopic hernioplasty , in both cases with the possible use of a mesh implant.

Surgical treatment with an open method is carried out according to classical techniques. For this, the umbilical ring is sutured in the extreme places of the aponeurosis. Sutures are applied in a vertical or transverse position. Such an intervention has a long recovery period, as well as a high risk of relapse.

Mesh hernioplasty has a number of advantages. The mesh implant strengthens the abdominal wall. The surgeon can place it under the aponeurosis or above it. Materials for implants do not cause reactions from soft tissues, are safe and resistant to damage. Such treatment successfully helps the patient to return to the usual mode. The operation has a shorter and more comfortable rehabilitation period, reduces the likelihood of relapse.

Laparoscopic surgery is the best treatment option for a hernia. Hernioplasty using a laparoscope is performed through several small incisions, which reduces the trauma of the intervention. Such treatment is most effective: after all, the mesh is attached from the side of the abdominal cavity, and not from the aponeurosis. The patient stays in the hospital for one to several days and, after confirmation of a satisfactory condition, is discharged home.

In the postoperative period, the main priority is the prevention of local complications. The attending physician monitors the patient’s condition for inflammation, suture failure, and bacterial complications. High-quality nutrition and compliance with hygiene standards are a prerequisite for keeping a patient in the clinic. The determining factor in the rehabilitation period is the type of surgical intervention. The laparoscopic technique significantly reduces the risk of postoperative complications.

Discomfort after surgery lasts only a few days. This is facilitated by high-quality anesthesia and minimal tissue trauma. It is necessary to consult with your doctor about returning to your usual activities, sports and work. The surgeon takes into account the age of the patient, his physical form, activities and makes recommendations. In the postoperative period, depending on the size of the hernia, the age of the patient, his constitutional status, it is recommended to wear a bandage on the anterior abdominal wall. The attending physician may prescribe repeated consultations for a preventive examination. Failure to follow these tips can lead to recurrence of the hernia and the need for a second operation. If symptoms recur, you should contact your doctor, as he knows the characteristics of the body and will qualitatively assess the situation.

Abdominal wall hernia removal free of charge under CHI

Abdominal hernia is one of the most common reasons for visiting surgeons: it occurs in 6-7% of men and 2.5% of women during their lifetime [1]. Many people put off hernia treatment, but in vain: high-tech methods allow you to recover in a matter of days after surgery. Dmitry Sergeevich Gavrukov, head of the surgical department No. 4 of the GKB named after I.I. S.S. Yudina

What is a hernia and why does it occur?

A hernia is a disease in which the contents of the abdominal cavity exit through a hole formed in the abdominal wall. A hernia consists of a hernial sac, hernial contents and hernial ring. The gate is the defect of the abdominal wall through which the contents come out into the subcutaneous fat. This content can migrate to the hernial sac and back – and so on throughout the day back and forth.

How to understand that there is a hernia of the abdominal wall?

The patient usually finds it himself. There is some protrusion on the abdomen or in the groin. It can independently retract into the abdominal cavity and do not disturb for some time, and then reappear. A person may notice the asymmetry of the anterior abdominal wall, experience pain. Usually it has a jerking, cramping character and is stopped by self-reduction of the hernial protrusion.

Types of hernias of the abdominal wall

Localization of hernias most often occurs in the groin (inguinal hernia), in the umbilical region (umbilical hernia), in the projection of the white line of the abdomen (hernia of the white line of the abdomen). There is also a postoperative hernia (usually in the projection of the postoperative scar).

What situations require surgery?

Hernia itself is an absolute indication for surgery. An exception is the expansion of the umbilical ring up to 1 cm, in which the contents of the abdominal cavity do not stick out – that is, this is not yet a hernia. But if the defect of the abdominal wall is more than 1 cm, this is an indication for surgical treatment.

How is the operation to remove a hernia of the abdominal wall performed?

Two options: open surgery and laparoscopic intervention.

Open operation

Open operation is the most traumatic: the incision can be 8-10 cm, depending on the size of the hernia. But there are situations when an open operation is indicated. For example, at a high risk of increased intra-abdominal pressure, in aged patients with severe concomitant diseases, in the case of previous multiple abdominal operations. The latter is a relative contraindication, since here the factor of the surgeon’s professionalism, his skills, as well as the level of equipment in the operating room are of particular importance.

Laparoscopic intervention

Laparoscopic intervention is performed without going into the abdominal cavity. We work in the retroperitoneal space. The anterior abdominal wall, like a sandwich, consists of several layers, and we need to be in the right one in order to approach the hernia from the inside. The operation uses a 10mm port to enter the abdominal cavity and two 5mm ports to expose the hernia. Total – three cuts with a total length of 2 centimeters.

The surgeon visualizes the hernial protrusion on a large high-resolution monitor, which allows you to perform a high-quality operation and eliminate the risk of complications.

Next, we isolate the hernial sac and bring its contents into the abdominal cavity. A mesh implant is installed on the hernia gate, which closes the space between the layers. We do not sew anything, we do not cross, we do not injure the layers of the anterior abdominal wall. Generally speaking, there is nothing to get sick after the operation.

How is recovery going?

After laparoscopic surgery, the patient spends up to three days in the hospital, taking into account the examination. Within two weeks it is necessary to refrain from physical activity, since excessive exercise can lead to damage to tissues that have not fused together. You can return to your usual work activity in a week if you work in an office. Of course, if the work is physically demanding (for example, if you are a loader), then it will take a month to recover.

What are the contraindications for surgery?

Contraindication is the presence of oncological diseases – in the case of planned treatment. In emergency situations, they operate even if they are available. Also, contraindications are diabetes mellitus in the stage of decompensation, the constant use of blood-thinning drugs – anicoagulants and desogregants (but with their correct cancellation, surgical treatment is possible), as well as the presence of purulent-septic disease. During pregnancy, the operation is not performed in a planned manner.

What happens if the operation is not performed?

There is a superstition that a hernia can go away on its own. This is impossible. But a number of complications are likely. The most dangerous complication is strangulation of the hernia. Against the background of increased intra-abdominal pressure – for example, when lifting weights – several intestinal loops come out into the hernial orifice. Then they close, and the contents of the hernial sac are infringed. This is an extremely dangerous condition that requires emergency hospitalization. If a person is in the operating room within the next few hours, the organ can still be saved. If not, the tissues become necrotic. Life can be saved, but part of the intestine has to be removed. This is urgent surgery with all the ensuing complications.

Is it possible to perform an operation to remove a hernia in Moscow for patients from other cities?

Our center is known as one of the leading herniological centers in the country, where patients come from all over Russia. A resident of any region can go to the site, register and describe the medical history by attaching a picture of a hernia. Then we study the documents, set the date of hospitalization. Day after day, a person arrives in Moscow, goes to the hospital – that is, you do not have to live in a hotel, waiting for the date of the operation. As a rule, the next day after hospitalization, an operation is performed, and a day or two later he goes home.

Do I need to come to Moscow again after the operation?

No, after discharge, only consulting assistance from a surgeon at the place of stay is required.