Hernia surgery

Inguinal and abdominal wall hernias are the most frequent cause of visceral surgeries. Due to predisposition, athletic stress or as a result of a previous surgery, there may be a weakness of the corresponding abdominal wall or groin area. This loosened tissue area can then diverge so far that a gap is created. Unfortunately, such a gap cannot be closed again by itself, so that surgical treatment is usually necessary. There are various options for surgical closure. The diagnosis can usually already be made through the physical examination in conjunction with an ultrasound examination. In some cases, we will arrange for further imaging. A two-day inpatient treatment with an overnight stay makes sense for both endoscopic and open surgical procedures.

 

lnguinal hernias: 

TEPP and TAPP endoscopic procedure 

With the endoscopic, minimally invasive procedures, we use camera technology to lay a mesh over the hernia gap. Here we differentiate between the so-called TAPP and the TEPP procedure.  Both are performed under general anesthesia.

  • TAPP (transabdominal preperitoneal hernia repair):

With this tissue-sparing technique, we close the hernia from the inside of the abdomen using a mesh insert.

  • TEPP (total extraperitoneal hernia repair):

In this procedure, which is also tissue-sparing, the abdominal cavity is not opened, but rather the mesh is placed in the tissue layers of the abdominal wall.

 

Shouldice and Lichtenstein open surgical procedures  

The open surgical procedures can be performed with (Lichtenstein operation) or without a mesh insert (Shouldice operation). We usually perform both under general anesthesia.

  • Shouldice surgery:

In the Shouldice surgery, the inguinal hernia is exposed via an incision in the area of the inguinal ligament and closed with a multi-layered suture. A mesh insert is not required here.

  • Lichtenstein surgery:

In the Lichtenstein surgery, the inguinal hernia is also exposed via an access above the inguinal ligament and closed with mesh reinforcement.

 

Incisional hernias: 

After surgical interventions, the soft tissue can diverge in the area of scars. A tissue gap, the so-called incisional hernia, arises. Without surgery, this gap will widen over time. The hernia should be surgically closed to prevent part of the intestine from becoming trapped in the hernia. The surgical procedure of choice depends on many factors, particularly the degree of adhesions expected and the size of the hernia. The diagnosis can usually be made through a physical examination combined with an ultrasound scan. Sometimes it makes sense to do a CT examination as well. Smaller incisional hernias can be treated on an outpatient basis. In the case of larger hernias, a hospital stay of one to two days is usually advisable. We perform the surgery under general anesthesia.

In rare cases, a pre-operative Botox treatment of the lateral abdominal muscles can facilitate the closure of the incisional hernia.

 

Umbilical hernias: 

A hernia can also develop in the area of the belly button in the course of life. As with all abdominal wall hernias, the intestine can become trapped in the hernia, so that a surgery is usually necessary here as well. The surgery is also performed under a brief general anesthetic. Smaller umbilical hernias can be closed with a tight seam. In the case of larger fracture gaps, it makes sense to insert a mesh to reinforce the fabric.

The diagnosis of the umbilical hernia can usually be made through a physical examination, supplemented by an ultrasound if necessary. In rare cases, a CT scan is required.

 

 

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