Contemporary treatment of hernia
Contemporary treatment of hernia
The surgeon Pericles S. Chrysocheris talks about the new recovery techniques.
Significant developments in the treatment of abdominal wall hernia have been made in recent years.
The new methods have many advantages for the patient, such as faster return to activities, lower rates of postoperative complications, and less hospital stay.
The anterior abdominal wall hernia is very common and is an important morbidity factor and affects quality of life.
Frequent risk factors are history of previous surgery (postoperative hernia) and obesity. Other factors are heredity (collagen diseases) and chronic fluctuations in intra-abdominal pressure due to chronic cough, constipation or prostatitis.
In women, pregnancy is a major risk factor for hernia formation. When many of the above factors coexist, the chances of developing a hernia are greatly increased.
The hernia is a separate entity from the "relaxation" of the abdominal wall, the so-called white line hernia. In this case there is no "hole" in the abdominal wall fascia but relaxation.
Relaxation is common:
1) In the case of women after multiple pregnancies
2) Generally in obese patients regardless of gender
Hernia and relaxation can coexist. The treatment options depend on the size, exact location of the hernia, age, body type of the patient.
Treatment options
Laparoscopic mesh repair offers many benefits, such as faster return to activities and shorter hospital stays. An important development in hernia surgery is the axiom to repair abdominal wall anatomy, that is, to close the hernia gap.
This results in a functional muscular abdominal wall. Scientific studies have shown fewer hernia recurrences and a better quality of life in patients who have undergone these methods.
Robotic technology
In recent years, new minimally invasive techniques have enabled the surgeon to perform such surgeries by closing the hernia gap, combined with the use of a mesh.
Robotic technology provides significant advantages in resolving intra-abdominal adhesions, reducing the likelihood of intra-abdominal injury and turning the procedure into open air. It also gives great flexibility in endoscopic preparation and adhesion of the abdominal wall to complex hernia cases.
With the help of robotic surgery many limitations of laparoscopy are overwhelmed.
It is worth noting, however, that in very large and chronic hernias where there is loss of vital intra-abdominal space, the method of choice is open surgery with new reconstructive techniques and the use of a mesh.
Special cases
At this point it is worth mentioning the case of women of childbearing age. Choosing the right treatment should take into account whether the patient intends to conceive. In this case we avoid the operating room, unless the hernia is tightened, so the operating room cannot wait.
In this category of patients, we prefer the use of state-of-the-art fully absorbable mattress technology.
In patients who have decided not to have a child again, the repair of the cervical gap may be combined with an abdominal incision, usually following the caesarean scar (if present) to correct for loosening.
The surgeon Pericles S. Chrysocheris talks about the new recovery techniques.
Significant developments in the treatment of abdominal wall hernia have been made in recent years.
The new methods have many advantages for the patient, such as faster return to activities, lower rates of postoperative complications, and less hospital stay.
The anterior abdominal wall hernia is very common and is an important morbidity factor and affects quality of life.
Frequent risk factors are history of previous surgery (postoperative hernia) and obesity. Other factors are heredity (collagen diseases) and chronic fluctuations in intra-abdominal pressure due to chronic cough, constipation or prostatitis.
In women, pregnancy is a major risk factor for hernia formation. When many of the above factors coexist, the chances of developing a hernia are greatly increased.
The hernia is a separate entity from the "relaxation" of the abdominal wall, the so-called white line hernia. In this case there is no "hole" in the abdominal wall fascia but relaxation.
Relaxation is common:
1) In the case of women after multiple pregnancies
2) Generally in obese patients regardless of gender
Hernia and relaxation can coexist. The treatment options depend on the size, exact location of the hernia, age, body type of the patient.
Treatment options
Laparoscopic mesh repair offers many benefits, such as faster return to activities and shorter hospital stays. An important development in hernia surgery is the axiom to repair abdominal wall anatomy, that is, to close the hernia gap.
This results in a functional muscular abdominal wall. Scientific studies have shown fewer hernia recurrences and a better quality of life in patients who have undergone these methods.
Robotic technology
In recent years, new minimally invasive techniques have enabled the surgeon to perform such surgeries by closing the hernia gap, combined with the use of a mesh.
Robotic technology provides significant advantages in resolving intra-abdominal adhesions, reducing the likelihood of intra-abdominal injury and turning the procedure into open air. It also gives great flexibility in endoscopic preparation and adhesion of the abdominal wall to complex hernia cases.
With the help of robotic surgery many limitations of laparoscopy are overwhelmed.
It is worth noting, however, that in very large and chronic hernias where there is loss of vital intra-abdominal space, the method of choice is open surgery with new reconstructive techniques and the use of a mesh.
Special cases
At this point it is worth mentioning the case of women of childbearing age. Choosing the right treatment should take into account whether the patient intends to conceive. In this case we avoid the operating room, unless the hernia is tightened, so the operating room cannot wait.
In this category of patients, we prefer the use of state-of-the-art fully absorbable mattress technology.
In patients who have decided not to have a child again, the repair of the cervical gap may be combined with an abdominal incision, usually following the caesarean scar (if present) to correct for loosening.
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