White line hernia in the stomach area – is a pathology, which is formed by protrusion through the gaps between the plexus tendon interlayer connective adipose tissue and greater omentum of the peritoneum. It is painful for the person is characteristic protrusion, formed due to the growth of the hernia SAC and partial movement authorities.
Neglected disease leads to complications associated with the infringement, and the death of part of the bowel loops. To recover from illness quickly is impossible, and only through surgery for a hernia white line of the abdomen.
Abdominal cavity the human body consists of developed muskulaturnoy framework that firmly secures the organs inside the body. The white line in the stomach area is not included in the area of fixation. This fine structure, with a minimal amount of nerve endings and large blood vessels, fibers of tendons which are weak.
In normal condition its width ranges from 1 to 3 cm, but when thinning or relaxation begin to appear separated muscles, which form gryzenia gate.
Size and width is determined by the extent of the disease:
- the size of the protrusion is 3 to 5 cm;
- the size of the protrusions is 7 cm;
- the loss of some bodies and, as a consequence, prolapse of the stomach.
There is a classification at the place of formation of a hernia: nadupanou (localization above the umbilical ring), podrocne (located below) and umbilical (either side near this area).
White line hernia occurs in people experiencing heavy load, especially when lifting weights. For example, when constant heavy physical work, pregnant, hemorrhoids, constipation.
Symptoms of this disease are:
- sharp pain under load;
- tumors, which on palpation are felt as tight and painful;
- frequent urge to vomiting, constant nausea, bouts of heartburn.
With the proliferation of hernia pain can vary from dull aching, with intermittent, to continuous.
With the deterioration of symptoms such as:
- blood clots in the feces;
- pain are constant, aching character;
- frequent urge to vomit;
- hernia it is impossible to reduce a into the abdominal cavity by pressing.
The disease occurs in 3 stages:
- education lipoma;
- the initial stage;
- finally formed a bulge.
A hernia formed at the moment when the skylight starts to penetrate the connective fat tissue, which forms a bag. Already on the second stage it moves the fragments of the loops of the intestine or greater omentum. At the final stage of clearance is gryzenia gate rounded shape. Sometimes they have a diameter of 10-12 cm for the weak structure of the white line observed the emergence of many gruzevich formations throughout its length.
Conservative methods for the treatment of hernias of the white stripe in the stomach area does not exist, such education can only be removed surgically. Such operations are planned and prescribed by the doctor after a complete examination of the patient. During the procedure, the surgeon separates the hernia SAC, using a scalpel incision it, visually determines the condition of the bodies, got inside, and places them into the cavity. Then the growth is removed. Thereafter shall be of manipulation to strengthen the white line of the abdomen, in this regard, there are several types of operations.
In this surgery after the removal of the surgeon as if pulls and stitches between the walls of the white line of the abdomen, thereby strengthening it, hence the name – stretch.
This is the easiest way, but it has several disadvantages: large incision is made and the suture remains, the risk of recurrence is high (around 20-40%), long-term rehabilitation.
Hernia repair with surgical mesh
To strengthen the white stripes in the abdomen using special surgical mesh patch implant. This procedure is still called tension-free hernioplasty. This is the most popular and common type of operations, as it is considered low-impact and low risk of recurrence of the hernia.
Laparoscopy is widely used in clinics with high-tech equipment and refers to minimally invasive surgery that aims to minimize the area of intervention and to reduce the degree of tissue injury.
Instead of a long incision, the surgeon makes 3 small puncture, through which the hernial SAC is removed and installed surgical mesh. Such an operation reduces to zero the risk of recurrence and reduce the recovery period of the patient.
For carrying out laparoscopy is contra-is a chronic disease of the lungs and heart.
Contraindications to elective surgical intervention is considered a giant ventral hernia in patients over 70 years old with heart disease or disease of the respiratory system.
To postpone surgery is necessary in pregnancy, and to withhold it is better for patients with liver cirrhosis accompanied by ascites, varicose veins of the esophagus and rectum; diabetics in the absence of the effect of insulin; patients with severe chronic renal failure.
Hernia white line of the abdomen may be complicated by the development of the strangulation, when the hernial SAC cannot be set back into the cavity. The patient experiences a sharp pain, which is accompanied by vomiting and constipation. In this case, the delay could lead to death, and the operation will be carried out urgently.
Infringement leads to poor circulation, which causes necrosis of internal organs and the development of peritonitis.
At the opening of the hernia SAC, the surgeon carefully examines the internal organs and eliminates dead areas.
Preparing for surgery
Before carrying out the surgical procedure, the patient undergoes special training: 2 weeks before operation it is forbidden to take medicine with the contents of aspirin, you must follow a healthy diet, do not drink alcoholic beverages.
Procedure is strictly contraindicated in those who recently had a cold or inflammatory diseases, we need to wait for full recovery and then within 2 weeks to comply with above recommendation. The only exceptions are emergency indications for surgery.
The patient undergoes a full medical examination, which includes:
- 1a Fluoroscopy of the stomach with the use of contrast. Her results have been excluded such diseases as ulcers or stomach cancer due to similar symptoms and can also be seen that there is no loss in the hernial SAC of the stomach.
- 2Gastroduodenoscopy (inspection of the mucous membrane of the stomach and duodenum with the help of a gastroscope).
- 3Ultrasound examination of the abdomen.
- 4magnetic Resonance imaging of the abdomen.
- 5Gerniografii. The survey is assigned very rarely, only when the diagnosis is impossible to establish with 100% certainty.
On the basis of complex examination, the doctor obtains a complete picture of the disease is the treatment plan. Directly a few days prior to the procedure, the patient gives blood on a standard study. The last meal should be no later than 19 hours before the day of surgery, then not eat or drink anything, you need to empty the bladder and bowels.
The progress of the operation
The surgery is performed under General anesthesia. Previously, the anesthesiologist will interview the patient to determine the method of anesthesia and allergic reactions to certain substances.
- the anesthetist introduces the anesthesia;
- incision is made the desired size;
- exfoliate the abdominal cavity from the back side of the hernia;
- cut off the tumor;
- fixed mesh implant;
- overlap the seams.
The duration of depends on the type of operation, degree of pathology.
The postoperative period depends on the General condition of the human body and the selected method of surgical intervention. The most rapidly restore its own tissues occurs after laparoscopy. When other methods of rehabilitation takes a longer period.
Don’t have operated for a long period of time to be in the supine position, it is necessary the very next day to start moving, because walking speeds up the healing process. The patient should wear the abdominal bandage, the wearing time is determined by the attending physician.
In the first 2-3 months strictly forbidden exercise, then you need to start doing exercises that strengthen the abdominal muscles, recommended by a doctor for physical therapy.
If you have problems with excess weight, they need to be urgently addressed. Change bandage 2 times a week, and after 10-12 days the sutures are removed.
Nutrition in the postoperative period
You need to adhere to a composed diet and food rules of conduct. Initially, the patient can drink water and liquid broths. Set a daily drinking regime (at least 1.5 l of water), as this helps to restore the fluids after the operation and prevents constipation.
Operation for hernia white line of the abdomen
Hernia of the stomach
Food must be fractional and divided into 4-6 doses. Forbidden foods, causing constipation and excessive gas formation. In the first months of liquid porridge, soups, mashed potatoes. Products should be easily digestible. At observance of all recommendations of the doctor the risk of relapse is minimal.
Mary, 47 years: “in compliance With all recommendations of the rehabilitation process is quick, the person returns to a normal way of life. The most effective and virtually painless tolerated laparoscopy, after which it is operated are discharged home the next day. What price intervention? Hernia treatment is included in the list of free procedures, the policy of obligatory medical insurance”.
Natalia, 51: “in order to get on elective surgery, need a referral from a therapist from the clinic and current health insurance. This treatment is also carried out in private clinics, where the treatment can enter and the cost of the survey. On average, prices range from 30 to 50 thousand rubles. The indicator depends on the technical equipment of the clinic-level staff and the quality of the preparations of the implants”.