Hernia occurs when an internal organ (e.g. a fragment of the intestine, an ovary, a fragment of bladder) are moved beyond the abdominal cavity and are located in the so-called hernial sac. In newborns, the most common is umbilical hernia – resulting from the abnormal fusion of the opening at the base of the umbilical cord. In older children it can develop due to e.g. rapid growth, physical activity or weakness / insufficiency of abdominal muscles. This type of hernia also occurs in adults – including definitely more often in women (about 10 times more often than in men.

Treatment of any form of hernia involves surgery under anesthesia: general or local. There are 2 types of the so-called hernia supply – voltage free, in which special nets (e.g. polypropylene) of various shapes are used and the tension mesh – in which the patient’s own tissues are used. Operated inguinal hernia is the so-called gold standard, i.e. the Lichtenstein method with using flat polypropylene mesh. The next steps during the procedure are:

• preparation of the hernial sac,
• draining it into the abdominal cavity,
• reinforcement of the back wall of the inguinal canal with synthetic material.

Post-operative convalescence is quick – the patient is already a few hours after the operation, when the pain is over, he may begin to walk, and after about 2 weeks it returns to normal functioning.

Umbilical hernia is operated under general anesthesia. The procedure is performed using the voltage-free method, consisting in the use of plastic nets to strengthen the weakened structures:

• after uncovering the hernial sac and dissecting it, the surgeon enters the gate hernias,
• after inspection of the hernial sac, it discharges its contents into the cavity peritoneum,
• in the next stage, after previous bowel removal, the hernial sac is cut off,
• the surgeon then sutures the appropriately prepared fascial flaps and begins suturing parietal peritoneum with rectus abdominis sheaths.

This disease very often affects, among others obese people, pregnant women, men having problems with urinating (e.g. due to an enlarged prostate), people doing heavy physical work. The biggest risk of the appearance of an abdominal hernia increases in the elderly, as well as in women who have undergone several childbirths. It also occurs in asthmatics and patients who struggle with intense attacks of coughing. The operation consists in:

• direct suturing of the fascia and tissues aimed at eliminating the hernia gates; this the type of surgery is usually performed in the case of small hernias,
• if the separation of tissues (hernia gates) is very wide, the so-called voltage-free methods , which are designed to supply the hernia without suturing the tissues under tension.

In the case of most tension-free methods, a special mesh is implanted and inserted in the abdominal wall and then attached to the surrounding tissues with sutures. This technique allows to reduce the frequency of recurrences of abdominal hernias, especially in the case of large hernias.

Diagnosis and qualification for appropriate treatment take place at the Medical Surgical Clinic Podhale during consultations with a surgeon, based on a thorough examination and thorough physical examination.

The physical examination is performed in two positions – standing and lying. It should be remembered that each case of a hernia must be consulted with a specialist doctor, because leaving it there is a danger of gradual enlargement and is just life-threatening case!

This is a situation where, for example, a piece of the intestine gets stuck in the so-called hernial sac – in effect there is severe abdominal pain, fainting, vomiting, abdominal distension and generally worsens overall condition of the child. There is a gradual impairment of blood supply to a given organ, which may consequently lead to its obstruction and necrosis.

The blockade requires quick consultation with a specialist and surgery. Surgical procedures are performed on an outpatient basis using traditional methods or laparoscopy, within the so-called one-day surgery.

Before the procedure, the patient should perform the following tests:

• blood count,
• the level of electrolytes (sodium, potassium),
• concentration of urea and creatinine,
• basic parameters of the coagulation system (prothrombin time, INR, APTT, fibrinogen),
• general urine test,
• blood group,
• HBS and HCV levels,
• ECG,
• chest X-ray.