Hernia in questions and answers


  • As it happens?
  • What is hernia?
  • What are the hernia?
  • How does hernia arise?
  • Can hernia disappear without surgery?
  • Where better to operate?
  • What types of operations exist to eliminate inguinal hernia?
  • What studies need to go before surgery?
  • What to take on the eve of the operation?
  • What problems are possible after surgery?
  • How to behave at first?
  • What happens to the synthetic mesh prosthesis, which is implanted by the patient?
  • And if the hernia got out again?
  • Is it possible to talk about the prevention of hernia?
  • Training of the muscles of the abdominal press will get rid of hernia from the appearance?

    As it happens?

    Everyone has known since childhood: hernia means she was relieved. But it happens and much more prosa. I went to the toilet with constipation (in the sense of constipation in the toilet), and came out of it with hernia. You can bring it from the fitness center, and never exceeds the recommended load coach. At the same time, no one will predict in advance, immediately you will get out the bag until the middle of the hip or at first, the bulge will become slow, but correct to grow.

    Most hernia must be operated immediately, otherwise they can turn into fatal danger at any second.

    What is hernia?

    Hernia in questions and answersThis is the outcome of the abdominal bodies under the skin through the weaknesses of the abdominal wall. The emerging bodies are in the junk bag formed by the peritoneous (inner lining of the abdominal wall). Danger to life represents the infringement of internal organs, as a rule, guts, in the hernial gate - place «failure» Abdominal wall.

    What are the hernia?

    Inguinal, scrotal, femoral, umbilical, white lines and some other, more rare or low. The hernias arising in the field of postoperative scars are called postoperative ventral hernias. Abdominal operations sharply increase the likelihood of their appearance. Herniations arising in the place of previously operated hernia are called recurrent (repeated). Men are more often inhabited sconewares, and in women inguinal and femur.

    How does hernia arise?

    The abdominal wall consisting of muscles and dense connective tissue (aponeurosis) performs a number of functions; One of them is to keep the internal organs in the natural situation and counteract the intra-abdominal pressure created by them. Under the action of intraperous pressure in the weakest places of the abdominal wall, a defect (hernia doors), in which hernia comes out. This may contribute to a solid physical activity, a strong cough, constipation.

    The formation of hernia may remain unnoticed, and may be accompanied by intense pain. After some time, there is a gradual increase in hernia, up to the departure in the hernia bag most of the intestines.

    Can hernia disappear without surgery?

    Unfortunately, neither independently nor under the influence of gymnastics or hernia medicine will not disappear. Over time, it only increases in size, delivering problems and increasing the risk of complications. The only way to cure is an operation.

    Wearing bandages, widely recommended before, today is not welcome. There are few benefits from them, and the harm is obvious - due to the destruction of nearby fabrics and their final relaxation in them is broken. As a result, operate the patient who worn a bandage for several months, much more difficult. In addition, bandage provokes a patient to postpone the operation «for later».

    Where better to operate?

    Hernia in questions and answersIn a specialized medical institution. There are not so many. These are ambulance. N.IN.Sklifosophical, research scientists them. BUT.IN.Vishnevsky, Russian Surgery Scientific Center, Department of Internal Affairs of Moscow, Center Endosurgery and Litotripsy (all - Moscow), clinics with.-Petersburg Medical Academy and.-Petersburg Military Medical Academy, Samara Medical University, Belgorod Regional Hospital and Tula Regional Hospital. The experience of local surgeons in the treatment of hernia will allow the entire range of modern technologies and techniques, will reduce the risk of recurrence of hernia and other complications. Yes, and the operation itself, perhaps, doctors will spend on outpatient conditions.

    What types of operations exist to eliminate inguinal hernia?

    More than 300 methods of plastic inguinal hernia are known. Plastic with own fabrics is used for a long time – From the second half of the XIX century. Its essence in the closure of the hernial gate with the patient's own tissues (muscles, fascia and aponeurosis). Frequency of recurrence of hernia after these operations - from 2% to 15%. Basic disadvantages - pain in the first days after surgery, and intensive physical work is contraindicated at least 3 months.

    Laparoscopic method of plastics is performed under the control of the device, allowing the minividemaker to eliminate hernia from the abdominal cavity without cutting the skin over the hernia. Most often, the abdominal wall defect closes from the inside of the abdominal cavity with a synthetic mesh prosthesis. Risk of reappear with hernia - 2-5%. The pain after the operation is small, and the period of rehabilitation is short enough - up to month.

    Serious disadvantages - the need for general anesthesia, technical complexity and high cost of equipment. Such an operation is not suitable for pulp and cores. Since this intervention is very difficult in execution, it is usually resorted to it when two operations are carried out at once - for example, if the calculous cholecystitis is eliminated or the thick intestine. It happens that the surgeon shifts the nerve fibers and then it is necessary to either conduct a re-operation, or the patient will have to live with pain for several months, while the nerve is not atrophied. There is also a risk of damageing the bladder or seed rope.

    Methods plastic «without tension» Of the traditional access differ from the plastic with their own fabrics by the fact that to close the hernial gate are used «Patch» from synthetic materials, the same as during laparoscopy. The greatest prevalence due to its reliability and simplicity was obtained by the technique I.L.Lichtenstein. It applies with any form and size of inguinal hernia.

    Last 10-15 years plastic «without tension» Of the traditional access, it is gaining increasing popularity, which has become possible due to the creation of perfect synthetic materials and the development of new methods for the closure of the hernial gate, practically guaranteeing the patient – The hernia will not happen again. Pain after surgery. Intense physical work is possible a month after surgery.

    Operations without tension from traditional access can be carried out in an outpatient basis - but only in specialized clinics. For operation, sufficiently local or spinal anesthesia, which is especially important for elderly patients and patients with heart and lung diseases.

    What studies need to go before surgery?

    Mandatory: Definition of blood group and rear factor, general and biochemical blood tests (including sugar and protuberbin), blood clotting samples, hepatitis, syphilis and HIV infection, ECG.

    Desivers: abdominal ultrasound, general urine analysis, x-ray (or fluorography) of the chest.

    What to take on the eve of the operation?

    On the eve of the evening you need to make a cleansing enema or take the drug «Fortrans». In the morning on the day of operation, you need to shake the place of the alleged cut and around it. On the day of operation you can not eat and drink. If there is varicose veins of the lower extremities or if the patient is over 50 years old, then you need to have elastic bindings for the legs.

    What problems are possible after surgery?

    After the plastle of giant inhabric and scrotal hernias during the month, the scrotum remains enlarged, its skin is edema. It is not a complication and does not create discomfort. Such is the natural tissue reaction to remove a large hernial bag. No additional treatment required.

    How to behave at first?

    Hernia in questions and answersYou can walk almost immediately after the operation, but if the spinal anesthesia was used, it is necessary to wait 3-4 hours. With plastic without tension, the patient may leave the hospital 2-3 hours after the operation, including driving his car. Within two weeks, you should not raise more than 5 kg, then the load can be gradually increased. With plastic using synthetic mesh prostheses (laparoscopic or «without tension») During the week after surgery, anti-inflammatory drugs must be taken. If necessary, and in coordination with the doctor you can take painkillers.

    Language is needed the day after surgery. With a favorable current, it will be the only one until the filming of the seams (after 7 days).

    What happens to the synthetic mesh prosthesis, which is implanted by the patient?

    A month after the operation, the synthetic mesh prosthesis, which is most often made of polypropylene, germinates the fibers of the connective tissue. Over time, a dense reservoir is formed to 1.5 mm thick, which is based on the net prosthesis. Thanks to him, the formed connecting tissue remains plastic, but not stretched - it will protect against the new hernia.

    And if the hernia got out again?

    We will have to be operated on again. Such operations are technically more complicated, require high qualifications of the surgeon. With plastic with own tissues, physical load is limited for 6 months.

    Is it possible to talk about the prevention of hernia?

    Hardly ever. Is that to reduce it to the prevention of constipation. And if you have to raise gravity, it is better to use the belt of weightlifters or simply tie the belly with a wide towel. Well and «belt» on hips, groin or scrotum has not yet invented…

    Training of the muscles of the abdominal press will get rid of hernia from the appearance?

    No, because the abdominal wall is not amenable to workout. Oddly enough, this may seem like the stronger the muscles of the abdominal press and weaker, a defective abdominal wall, the higher the risk of hernia. Especially often it happens when weakness in the area of ​​the umbilical ring.

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