A hernia is a condition in which an internal organ protrudes or prolapses from its normal anatomical position, through a congenital or acquired opening. The vast majority of hernias affect the abdominal wall, the most common type of hernia in adults being the inguinal hernia. The abdominal wall is made up of superimposed muscles and the connective tissue sheets (fascia) that cover them. An orifice is observed in the embryonic age, corresponding to the umbilical ring. The blood vessels supplying the foetus enter through this channel. After birth, the umbilical ring closes, but it may remain open (congenital umbilical hernia) or certain factors that cause an increase in abdominal pressure or a weakening of the abdominal wall fibres may cause the umbilical ring to reopen (acquired umbilical hernia). Through this opening, the abdominal organs protrude. Hernias are surgical diseases for which solutions are determined on an individual basis. This is true for the type of approach (open or laparoscopic surgery), the size and type of mesh or, in rare cases, the omission of mesh.
Umbilical hernias can cause burning, stabbing, sharp pain, caused mainly by traction on the peritoneum and intestinal lining, which increases over time, causing aesthetic and hygiene complaints. The skin over the hernia sac may thin and die, forming a spontaneous fistula. The real danger of abdominal hernias is hernia exclusion, whereby the hernia contents that previously moved through the hernia gate become “stuck” in the hernia sac. The tissue wall becomes oedematous (watery). Initially, this oedema may disappear after the contents are reinserted. As time progresses, the venous circulation of the intestines is disturbed, and as the intestinal wall becomes more watery, the arterial circulation is damaged, and definitive intestinal necrosis may develop, releasing bacteria, toxins and free radicals, leading to local and then systemic infection, bloodstream infection and ultimately fatal outcomes.
Most likely, you will arrive at our clinic on the day of your surgery. We will carry out the necessary tests 1-2 weeks before the planned day of surgery, which may include laboratory tests, ECG, X-ray and anaesthesia if necessary.
The surgery is performed under general anaesthesia, with a skin incision of about 5 cm in the abdominal wall following the hernia hernia flap. The hernia sac is circumferentially incised. The contents of the hose are reinserted into the abdominal cavity and removed first. The abdominal wall is reconciled with stitches and an “onlay” mesh is then attached to the connective tissue skeleton. The surgical wound is closed in several layers. A suction drain (Redon) is left over the mesh.
In some cases, hernias can be repaired by a laparoscopic approach. In this case, the abdominal cavity is inflated with carbon dioxide gas from an incision 1 cm away from the hernia hose, an optical trocar is introduced here, and the abdominal cavity is reviewed. The operating and auxiliary trocars are introduced through 2 further 0.5-1 cm incisions. The hernia gate is cleared and a double-layer mesh is inserted from the abdominal cavity and secured internally.
The operation takes on average 30-40 minutes, which is extended by approximately 30-40 minutes with the preparation, anaesthesia and final steps.
Hernias are surgical diseases, so there is no real alternative therapy. Tummy tucks can reduce the pain and discomfort associated with hernias, but they do not affect the chances of exclusion. Wearing a belly bandage is recommended primarily in conjunction with surgery to support the abdominal wall in the postoperative period.
Your doctor will explain the details if this is an option for you.
Postoperative pain in the surgical area, skin and tissue damage, inflammation, scarring, wound infection, numbness around the wound, deep vein thrombosis.
After waking up, you can expect to experience some discomfort, and we will do our best to minimise this, or if it has developed, to alleviate it.
The incision may be painful after the operation and the wound will be anaesthetised as a final step in the operation. There may also be some discomfort around the incisions, which should also improve considerably with the use of painkillers.
During the operation, a suction drain (Redon) is left in the wound cavity above the mesh to drain the acid produced. Depending on the size of the wound cavity, the drain is removed on the 2nd or 3rd day after surgery. If this is not possible, it is removed with the drain. You will be discharged 2-3 days after the operation.
When can I take a bath or shower?
There will be a clean cover dressing in the wound, which will be changed by appointment from time to time. You are welcome to wash the rest of the body, but keep the dressings completely dry for the first 48 hours. Avoid bathing or swimming until the stitches are removed, soaking the wound increases the likelihood of infection. Do not allow water to be directed onto the wound while showering during this period. You can shower for 1 week after surgery, but the wound must be carefully dried afterwards.
Exercise:
You will feel more tired in the few weeks after surgery, it is recommended to gradually resume your daily activity. For the first 6-8 weeks, avoid heavy physical work, lifting weights and intense sports activities.
Work:
Most people can return to work within 1-2 weeks.Wearing a size-appropriate abdominal hernia dressing is recommended for at least 2-3 months after surgery.Please avoid wearing it in the immediate post-operative period:
