Laparoscopic hernia repair

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What is a hernia?

A hernia is a protrusion, most often on the anterior abdominal wall, in the navel or groin. A protrusion above the navel is possible, and then we are talking about a hernia of the white line of the abdomen. Rare types of hernias: hiatal hernia, diaphragmatic false hernia. Femoral hernias are extremely rare forms of hernias. Sometimes heavy enough for recognition and for professionals. Therefore, there is no need to deepen into this problem.

Symptoms

Consider the two most common types of hernias. Both species are congenital, and are not associated with the cry of the baby or improper bandaging of the umbilical cord at birth.
Symptoms of both hernias are similar - this is a protrusion, which increases with coughing, crying, constipation, accompanied by tension of the anterior abdominal wall.
The difference lies in the location of the protrusion: with an umbilical hernia - this is the navel, with an inguinal hernia - respectively the inguinal area.
But parents may notice an umbilical hernia after the umbilical cord falls away. A inguinal hernia appears immediately at birth, before the age of 3 years or already in early school age.

Causes, risk factors and prevalence.

The navel is a weak spot on the anterior abdominal wall, therefore, with an increase in intra-abdominal pressure during crying, the cry of the loop, as a rule, of the small intestine "goes" to the navel.
In boys, the weakness of the inguinal canal is associated with the process of lowering the testicle. Normally, the inguinal canal closes before birth or immediately after it. Theoretically, non-retention of the inguinal canal causes internal organs (loops of the intestine, omentum, girls and ovary) to enter the inguinal canal and a protrusion in the inguinal region occurs. This is an inguinal hernia. For this reason and several other factors, boys are more likely to have an inguinal hernia.

Treatment.

Umbilical hernia most often does not require treatment, since it disappears on its own. If this is not your case, that is, the hernia continues to exist, then the indications for surgery occur after 3 years of age. Of course, it is necessary to consult a doctor for the correct choice of the timing and type of operation.
An inguinal hernia after detection requires a planned operation. Only in case of pain and hardening, a protrusion of an inguinal hernia requires emergency surgery.
Before the planned operation, the child must be healthy in general, i.e. 10-14 days without general weakness, fever, impaired nasal breathing and nasal discharge, cough, nausea, vomiting, diarrhea.

And also pass the necessary tests, 10 days are valid:

  1. general blood test with leukocyte formula and platelet count;
  2. coagulation time and duration of bleeding
  3. blood glucose
  4. general urine analysis
  5. blood type, Rh factor (if known, bring a document - an extract from the hospital, a child’s development card, birth certificate - to clarify)
  6. ECG.

Complications

The only and most formidable complication of hernias is their infringement. Pinching occurs rarely with umbilical hernias.
With inguinal hernias, pinching is accompanied by an increase, curing, protrusion and pain.

When to look for emergency care

The patient becomes restless due to pain. The child may also experience vomiting, since a restrained hernia is one of the types of intestinal obstruction. If this condition is suspected, an emergency consultation with a pediatric surgeon is necessary. You need to call 103 and find out about the next hospital with a pediatric surgeon at your place of residence, and turn there as soon as possible.

After the planned operation.

Today, it is possible to treat such conditions in short-term hospitals, that is, the child can be discharged under favorable conditions on the day of surgery.
Normal nutrition is restored 24 hours after surgery. On the day of the operation, eat half the volume from the usual, before the operation.
You can wash in the shower 4-5 days after surgery, after removing the bandages.
Treat wounds after removing dressings 4-5 g per day, 4-5 days.
Of course, the recommended period for limiting physical activity is 3-4 weeks. But in practice, the smaller the child, the more difficult it is to comply. And you don’t need to “tie the child to the bed.”
A preschool or school can attend if desired. But it is advisable to refrain from these visits for 5-7 days.
At the present stage, preference is given to laparoscopic treatment methods.

 

They have several advantages:

  • reduction of operational injury;
  • the ability to prevent hernia from the opposite side
  • simultaneous elimination of bilateral hernia;
  • as a rule, there is no need to remove the seams
  • quick recovery after surgery;

This is a minimally invasive method that allows you to simultaneously close the internal openings of the femoral and inguinal canal. This technique makes it possible to significantly reduce the risks of complications and relapses that occur during classic open operations ..
But possible:

  • infection of postoperative wounds - very rarely;
  • hernia recurrence or relapse, (up to 2%) more often in boys

 

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