Postoperative ventral hernia is a defect of the abdominal wall with displacement of organs, which forms in the places of the postoperative scar. It occurs as a result of an inflammatory reaction, the formation of weak connective tissue, or an excessive increase in intra-abdominal pressure.
The lack of adequate treatment for ventral hernia leads to infringement of internal organs and the development of acute peritonitis, which threatens the patient’s life and requires urgent surgical care.
Reasons for the formation of incisional abdominal hernias
A ventral hernia of the abdomen can form due to various factors:
Poor healing and wound suppuration in the postoperative period. The inflammatory process significantly slows down the time of scar formation and tissue regeneration.
Allergic reaction of the patient’s body to suture material.
Violation of the postoperative regimen with an increase in physical activity with an unformed scar, refusal to use a bandage and unbalanced nutrition, causing constipation, flatulence, as a result of which the structure and strength of the connective tissue of the scar deteriorate.
Concomitant diseases that prevent dense scarring:
bronchitis and bronchial asthma, accompanied by cough;
excess body fat;
chronic renal failure with prostate adenoma;
bowel disorders with difficult emptying.
The lowered level of microflora and carbohydrate metabolism in diabetes mellitus also interferes with durable scar healing.
Hereditary pathological processes in the form of weakness of connective tissues in Marfan syndrome, expressed in changes in the musculoskeletal system and a deficiency of adipose tissue. People with this diagnosis are prone to incisional hernia formation.
Diagnosis of ventral hernias
If a bulge appears at the time of tension or an increase in physical activity, a feeling of discomfort in the area of the scar, pain that intensifies during movement, you should consult a doctor. The diagnosis is confirmed on the basis of a visual examination by the surgeon, ultrasound examination helps to determine the size and shape of the hernial sac and hernial orifice. In some cases, CT of the abdomen or MRI of the abdomen may be needed.
When a hernia is infringed, the symptoms are expressed in acute pain, deterioration of the general condition with manifestations of fever, nausea, vomiting, which does not bring relief.
Treatment of incisional ventral hernia
Surgical intervention is the only effective method for eliminating any type of hernia. Surgery to remove a postoperative abdominal hernia can be performed using several methods:
In cases of a small defect and a good condition of the aponeurosis of the anterior abdominal wall, plastic is performed using the patient’s own tissues. Local anesthesia is used to numb small areas; complex cases require general anesthesia.
The use of additional non-biological materials – mesh synthetic prostheses for hernioplasty of a ventral hernia – that close the defect of the anterior abdominal wall. It is performed under conditions of endotracheal anesthesia with muscle relaxation.
Preparation for an operation to remove a ventral hernia includes a number of laboratory and instrumental examinations: general blood tests, urine tests, ECG, FG of the chest organs, and a therapeutic examination. After the operation, the patient is in the hospital for 1 to 3 days, then is observed on an outpatient basis until complete recovery.
To reduce the risk of developing a hernia after surgery, you should carefully follow the recommendations of your doctor:
wearing a bandage of the appropriate size;
with overweight, weight loss is desirable;
limitation of loads after abdominal operations for a period established by the doctor;
compliance with the rules of asepsis to prevent infection from entering the wound;
balanced nutrition, preventing the occurrence of flatulence and constipation.
A visit to a medical institution after discharge and an appeal to the attending physician in case of the appearance of inflammatory processes.