he surgery for lumbar herniation is one of the most common surgical procedures worldwide. Approximately 20000 interventions for correction of defects in the inguinal area are performed annually in our country. The majority of them use conventional methods – plastics with their own tissues or prosthesis with synthetic fabrics. Some of the hernial corrections are performed by laparoscopy by a team of highly qualified specialists in the field of miniinvasive techniques. The inguinal hernia not only creates preconditions for medical complications but also causes discomfort and significantly disturbs the quality of life. This determines the serious socio-economic effect of the disease on society and its consideration not only as a purely medical problem. At the same time, patients are seeking the “best” therapeutic solution.
Treatment is surgical only, but depending on the qualifications of the GP or the consulting surgeon, the recommended treatment methods are most varied.Patient information for laparoscopic inguinal hernioplasty by SAGES * 2004* SAGES – Society of American Gastrointestinal and Endoscopic SurgeonsWhat is hernia?The hernia is the passage of the contents of a body cavity, to the surface of the body or other cavity. In the case of inguinal hernia, the abdominal organs (most often the intestine or the large vein) pass through the so- inguinal canal. The inguinal groove is a normal anatomical structure, a channel of about 4-5 cm in length, which contains the seminal cord of the male and the female uterine ligament. Under certain circumstances, the walls of this channel are weakened and part of the abdominal cavity passes through it. This can result in pain and inability to return the abdominal contents – possible intestinal wall damage requiring urgent surgical intervention.The disease occurs in both sexes, the incidence is 10 times higher in men. It may be inborn or develop at some point in life.
The hernia does not undergo reversal and becomes larger over time.What Are The Symptoms Of Hernia? What are the symptoms of hernia? Hernias occur most often in the groin (inguinal) area – inguinal hernia; in the umbilical ring – umbilical or umbilical hernia; in place of previous surgical interventions – postoperative hernia (hernia after surgery). The hernia is easily recognized. Typically, the patient notices a swelling that comes in a lying position or when pressed with fingers. Other symptoms in the hernia are pain and weight in the groin area when lifting heavy objects, physical effort, coughing or standing upright.
The pain may be sudden and sharp or dull and rising towards the end of the day Severe prolonged pain, the appearance of a swelling that does not come under pressure, redness of the skin, vomiting – when these signs occur, there is a high chance that the hernia is incarcerated (herniated).What are the reasons for the hernia?The abdominal wall has natural weaknesses. Hernia may develop in these or other areas due to severe tension on the abdominal wall, aging, damage of a different nature, old incision or congenital weakness. Anyone can develop hernia at any age. Most hernias in children are congenital.
In adults, congenital weakness or physical effort to lift severe, persistent cough, difficulty in defecation or urination can cause abdominal wall weakness.What are the possible methods of hernia treatment? Using a hernia belt – does not cure the defect, it is used only when there are absolute contraindications for surgical treatment Conventional (open) hernioplasty – a 8-10 cm incision in the groin area, splitting the skin and subcutaneous tissue and reaching the level of the defect. It can only be restored with its own tissues or implanting a synthetic mesh (hernial canvas).
The operation can be performed with local, spinal or general anesthesia. Laparoscopic hernioplasty – Three small incisions (0.5 – 1 cm) of the abdominal wall are placed troaks. In the abdominal cavity a thin laparoscope (a small telescope) is inserted, connected to a camera and two working tools. The method allows viewing of the entire back surface of the abdominal wall and all areas where the hernias could potentially occur. Apply the peritoneum (the abdomen covering the abdominal cavity), treat the hernial defect and place a large 15/14 cm synthetic canvas, which is fixed with a special tool – a tiler.What are the advantages of a laparoscopic hernia operation? Cover all possible hernial holes in the corresponding half In bilateral hernias, both defects can be corrected by one laparoscopic operation In case of recurrent hernias, work is carried out in another, anatomically unchanged from an operative intervention plan