Abdominal wall hernias/herniae

If the connective tissue weakens over the course of life, abdominal wall hernias can occur under loads that increase the pressure in the abdominal cavity significantly and temporarily. This creates a gap in the abdominal wall through which intestineor fatty tissue can protrude. Since these hernias can enlarge over time, surgical treatment should be considered. Both minimally invasive and open surgical procedures are used for this.

abdominal wall hernias

hernia

The most common form of abdominal wall hernias is the inguinal hernia. It is a congenital or acquired pouching of the peritoneum through a "weak spot" in the abdominal wall in the groin area. Due to anatomical conditions, it occurs more frequently in men . A symptom is the visible and easily palpable bulge in the groin area, which may become more pronounced, especially after physical exertion. Additionally, there may be a feeling of pressure and slight, pulling pain or burning typically occurs on the inside of the thigh and the outside of the testicle. This pain intensifies when the area is touched. A rare but possible danger of an inguinal hernia is the entrapment of parts of the intestine in the hernia portal. In this case, emergency surgery must be performed.

Therapy: Here, two different approaches are possible: minimally invasive surgery or open technique. The minimally invasive procedure (TAPP or TEP) is performed using keyhole techniques. In the open version, a small incision is made in the groin. In both methods, the abdominal wall is reinforced with a well-tolerated synthetic mesh to minimize the risk of recurrent inguinal hernia.

Umbilical hernia

This hernia occurs directly at or around the navel - a form that is also common in adults. The cause is a gap in the abdominal wall. Symptoms can include pain and discomfort in the navel area. Umbilical hernias can also lead to the entrapment of abdominal organs, causing significant pain - up to intestinal obstruction.

Therapy: Various techniques are available to repair an umbilical hernia. The choice of the "right" method depends, among other things, on the size of the hernia and the constitution of the patient. With small hernias, direct suturing of the fascia is possible, while larger hernia gaps may require the insertion of a reinforcing mesh. Here, too, both laparoscopic and open approaches are possible. However, the general rule is: Umbilical hernias should only be operated on if they cause discomfort.

Incisional hernia

Due to previous surgeries in the abdominal area, especially after open surgeries with large incisions (so-called laparotomy), an incisional hernia can develop. These incisional hernias often develop over years and occur in 20-30% of cases after a large abdominal incision. Symptoms can include a bulge, a feeling of pressure up to pain, and in the case of incarceration, also an intestinal obstruction.

Therapy: Various surgical techniques are available for closing the hernia gap. Depending on the individual needs, both minimally invasive and open procedures are used, each with mesh implantation. Increasingly, robot-assisted procedures are also being used to avoid another large incision for the hernia repair.