The only effective way to treat an umbilical hernia in adults is surgery. Some people are afraid of a planned operation and lay it in every way. This increases the risk of hernia formation nevpravlyaemoy and its infringement.

When to operate umbilical hernia

If the umbilical ring is large, it is carried out plastic surgery Plastic surgery   at its closure. If the hernia has become nevpravlyaemoy, first surgeon dissects formed spikes that hold the viscera in the hernial sac, reduce a hernia and then sutured the umbilical ring.

The volume of surgical intervention in the umbilical hernia can increase significantly during its pinch, especially if you have already started necrosis (dying) body tissue contained in the hernial sac. Most often, such a body is the gut, which removes dead loop.

Operations that are executed when omphalocele

Classical operations, which are still used for the treatment of umbilical hernias in adults are the methods proposed in the beginning of the last century, KS Sapezhko (1900) and Mayo (1901).

By way of Mayo surgery is performed under general anesthesia. The skin incision is carried around the navel (as a rule, they capture the excess body fat, which can then be removed), at a distance of several centimeters around the circumference of the subcutaneous tissue is separated from the fascia (dense connective tissue arrangement of the midline of the abdomen), cut the hernial sac share adhesions (connective tissue bands that connect the body caught in the hernia sac, the walls of the bag) and immersed in the inside of the abdominal cavity. Hernial sac was removed and the edges sutured in its horizontal direction. The edges of the fascia surrounding the umbilical ring, and sutured in a horizontal direction. During the surgery is often necessary to remove the navel, as the patient, the surgeon must warn in advance.

Sapezhko method differs only in that the edges of the aponeurosis of the umbilical ring sutured in two layers, but not in a horizontal and vertical direction. This method is considered more physiological than the way Mayo as suturing fascia with a vertical white line of the abdomen is done already, and the rectus abdominis become more even. As a result of the restoring force and elasticity of the anterior abdominal wall. However, in patients with a large obesity and stomach vertical sections do not completely remove all the defects, so in this case, prefer to use the method Mayo.

The disadvantage of operations and methods Sapezhko Mayo is a relatively long period of tissue repair (sometimes it lasts for the whole year), during which the need to limit physical activity. When these methods are also often relapse hernia.

Developed two ways to install such implants:

• implant is placed over the aponeurosis and of the umbilical ring (that is, over the opening in the aponeurosis), just under the skin: the plastic made in the hernial ring large size;
• Mesh implant is installed under the aponeurosis, which is more reliable.

In children, surgical treatment of umbilical hernia Hernia: Types and symptoms - which are the most dangerous?   It is usually carried out after five years. Boys can wait for some time if the umbilical hernia Umbilical hernia: unpleasant, but treatable   and reduce a little. Girls still better to have surgery after five years if the hernia is not passed. This is necessary because the girls are coming pregnancy and childbirth, during which the infringement may occur hernia.

Operations at the strangulated hernia

Hernia may infringe on any value. The operation was carried out at the restrained hernia usually means Mayo or Sapezhko. After dissection of the hernia sac are visiting it disadvantaged organs removed necrotic tissue and continue the operation on the above methods.

When festering hernia sac method is used Grekov: hernia completely resected within the healthy tissue. This re-entry into the abdominal cavity of the hernial sac is removed along with its integrated body. If you have been harmed bowel loops, between its ends, formed after the removal of the colon, impose anastomosis (connection between the tubular organs) end to end. Next, the plastic abdominal wall and sutured wound.

The main thing with umbilical hernia - make the operation time by means of the planned operation, as in this case, time is working against the patient.

Galina Romanenko

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