What are the causes of hernia and what should we know about the symptoms and the correct treatment? Dr. Stefan Tucă's advice: laparoscopy and high-performance materials are the solution for solving hernias
According to statistics, hernia is one of the most common health problems that requires surgery: according to the medical publication "Lancet", over 18 million people make various types of hernias every year.
They affect approximately 27 percent of men and 3 percent of women and can be of several types: inguinal, umbilical, epigastric, femoral or incisional. The most common hernias are the groin, which involves the exit of an organ from the abdominal cavity, through a weak spot at the level of the abdominal wall in the groin region.
"Groin hernias are more common in men, because they have testicles that descend from the abdominal cavity through an opening in the abdominal wall. Femoral hernias are more common in women. In people with obesity, they are more frequent and more difficult because the abdominal pressure is higher precisely because of the excess weight in the abdomen. In athletes, they are also more frequent because they make physical effort in which they contract the abdominal muscles. There are also pregnant hernias. So all the things that increase the abdominal pressure predispose to the appearance of hernias ”, says the primary surgeon Stefan Tucă, the one who frequently operates hernia patients.
Hernias can also occur in people who are physically at work, but also in those with weaker connective tissue. This type of tissue predisposes to hernias, hemorrhoids and varicose veins. In addition, incisional hernias (occurrences) may also appear after an intervention from the sphere of the colon, which required a large incision. In any case, the visit to the doctor as soon as possible means a quick, low-risk solution.
"In principle, the hernias do not have a resolution of their own, they will grow in size all the time, they will become more and more bulky, more and more of the contents of the abdomen will tend to come out of the abdominal wall. and, given that this exit is made through a relatively narrow hole, they will be loaded, that is, they will make some adhesions between the hernia sac and the herniated organ, and from imprisonment to strangulation there is very little, ”explains Dr. Stefan Tuca.
The strangulation of a hernia can be complicated even with intestinal occlusion, which represents a medical emergency that threatens the life of the patients. Therefore, the advice of doctors for those who find the first signs of a hernia is to contact the specialist in general surgery as soon as possible.
“If patients come later, this makes treatment difficult because the hernias are larger. Basically, it should come when they have the first signs, when they notice the appearance of swelling in the abdominal wall, in the groin, umbilical, epigastric, femoral region. The doctor performs a clinical examination, some maneuvers are made by which the patient increases his abdominal pressure by coughing or contracting the abdominal wall, so that the hernia comes out easier. Eventually, a soft ultrasound can be done to confirm the existence of this hernia, after which the surgery should be performed. It is easier for the patient as a recovery, and for the surgeon as a procedure if the surgery is done earlier, ”adds the surgeon Stefan Tuca.
At present, hernias are successfully resolved due to laparoscopic surgery. These have many advantages for patients over conventional surgery.
"Laparoscopic interventions involve the realization of what is called pneumoperitoneum, that is, in the patient's abdominal cavity, a working room, by carbon dioxide insufflation, after which a laborious dissection is performed, so that the contents of the hernia are restored. abdominal cavity. Then, all the adhesions that these organs have made over time with the sac are dissected, the hernia sac is resected, the hernia sac is closed, simply laparoscopically sutured, and a mesh is required, because the risk of recurrence without a net is very high, 50%. So most hernia repair procedures involve the use of a mesh ”, describes the intervention of the doctor Tuctefan Tucă, a surgeon who has performed many successful interventions for hernias.
At present, the nets used to cure hernias are made of high-performance materials, are easily integrated by the body and allow the hernia to be solved forever.
“I and my fellow surgeons use approved materials, tested before being marketed. The nets have evolved, now they are much more flexible, thinner, they have wider mesh, they are practically nets that are not adherent at all to the intestines. In general, they are relatively thin, relatively flexible: after the intervention, they are covered by a layer of peritoneum, the body encloses them and they become part of the patient's abdominal wall. It would be ideal for patients to opt for the highest quality nets ”, adds the surgeon.
After laparoscopic hernia surgery, patients recover quickly. They remain hospitalized for 24 hours and can leave home the next day. The only drawback is a slight embarrassment in the abdominal wall, similar to muscle fever. Patients are advised to avoid intense physical activity for a month and a half. After this period, they can usually resume their normal movement schedule.