The hernia is the protrusion of the abdominal organs and tissues in a sac formed by the peritoneum from tears, holes or weak areas in different parts of the abdominal wall and becoming prominent under the skin.

What are the most common seen hernia types?

1) Inguinal hernia

2) Umbilical hernia

3) Incisional hernia

4) Epigastric hernia

Inguinal Hernia

It is a form of the hernia that develops in the right or left inguinal region. It is the most common seen in the abdominal wall hernias. It is much more common seen in men. There are three types including indirect, direct and femoral. It mostly shows itself in the form of swelling in the inguinal region. The physical examination is usually sufficient for the diagnosis. In the small hernias that are difficult to detect on the examination, further examinations such as ultrasound or MRI can be required for the diagnosis.

Inguinal Hernia (Inguinal Hernia) Treatment

If there is no contraindication in the treatment of the inguinal hernia, our primary option is repair with the closed (laparoscopic) method.

Treatment Types

1) TEP (Total Extrapritoneal) Laparoscopic (Closed) Inguinal Hernia Repair

It is a method that we most commonly used in the treatment of the inguinal hernia. It is a hernia repair method by reaching the hernia area through the peritoneum without entering the abdomen. In this method, a 1 cm incision is made in the navel and the hernia area is accessed with the help of a special trocar. After the hernia is detected and the hernia sac is separated, a special patch (mesh) suitable for the anatomy of the region is laid on this area and fixed, and the repair is completed. The patients can easily return to their daily activities within 2-3 days.

2) TAPP (Transabdominal Preperitoneal) Laparoscopic (Closed) Inguinal Hernia Repair

Today, this method has lost its popularity partially due to the advantages of the TEP method. In this method, the hernia area is reached by entering the abdomen and the repair is performed just like in the TEP method.

3) Inguinal Hernia Repair with the Open Method

With the help of the incision made from the outside, the surgeon reaches the level of the herniation by passing the skin and subcutaneous tissue. After the necessary intervention is made to the hernia, the repair is completed by placing a surgical patch (mesh) on the area. The mesh is used in the tension-free hernia repair technique, which was first described by Lichtenstein and Shulman in 1986. This method has advantages such as being performed with the local (regional) anesthesia and being relatively cheaper. However, when compared to the laparoscopic methods, it has disadvantages such as more pain after the surgery and a longer recovery period.

Umbilical Hernia

The umbilical hernias come out of the umbilical hole and can be in the dimensions from the size of a hazelnut to the size of an orange. The opening where the hernia comes out is the place where the cord that provides blood flow between the mother and the mother enters the abdominal wall when the baby is in the womb. For this reason, the umbilical hernias are also hernias arising from a "congenital weak point". The umbilical hernias are more common seen in women and are most often noticed by the patient after the pregnancy. The umbilical pit, which is required to normally be inward, is curved outward.

Umbilical Hernia Treatment

The first option in the treatment of the umbilical hernia is the repair with the laparoscopic (closed) method if the patient will be able to receive the general anesthesia.

Treatment Types

Laparoscopic Umbilical Hernia Repair

With this method, not any incision is made from the navel in the repair. The hernia sac is pulled into the abdomen by entering 1 piece of 1 cm and 2 pieces of 0.5 cm holes called trocars into the abdomen. The hernia area in the navel is closed with the help of a special mesh called composite. In this technique, the strength of the patch is provided by the technique that is based on the use of both sutures and fastener-like stabilizer to the abdominal wall. The biggest advantage is that there is no incision in the navel, so the recovery period after the surgery is short. The cosmetic result is another important advantage.

Incisional Hernia

They are the hernias protruding from the incision in a patient who has been operated before. The incisional hernias can come out in the early period or years after the first surgery. The incision site hernias can be caused by the patient reasons or the surgical reasons. The wrong choice and wrong application of the materials or surgical technique used during the surgery are the reasons belonging to the doctor. The reasons for the patient are diabetes, anemia, chronic heart disease, chronic lung disease, malnutrition, systemic diseases such as collagen tissue disease and cancer, and the use of drugs that impair wound healing. Whatever the reason, the incisional hernias should be considered as if the previous problem is still continuing and should be repaired in the most reliable and robust way. Otherwise, they relapse easily.

Incisional Hernia Treatment

The incisional hernias can be repaired by the open or laparoscopic method, by considering their simplicity and complexity, previous surgery history, relationship with the intestines, chronic disease history of the patient, the time passed after the previous surgery, and the patient's request.

Repair with the Laparoscopic (Closed) Method

The hernia sac is pulled into the abdomen by entering the abdomen with the help of 1 piece of 1 cm and 2 pieces of 0.5 cm holes, which we call trocars, from safe areas. The hernia area is closed with the help of a special mesh called composite. In this technique, the strength of the patch is provided by the technique that is based on the use of both sutures and fastener-like stabilizers to the abdominal wall. The biggest advantage is the short recovery time after the surgery. The cosmetic result is another important advantage.

Repair with the Open Method

In this method, the hernia sac is reached by using the old incision area and the process is completed by supporting the repair with a patch. It is appropriate to use the abdominal corset for at least one month after the surgery.

Epigastric Hernia

They are the hernias that occur on the midline of the abdomen, located between the xiphoid and the navel. It is usually small and the preperitoneal adipose tissue progresses through the defect here.

Epigastric Hernia Treatment

The primary treatment option in this hernia type is the laparoscopic approach. With the laparoscopic method, the abdomen is reached and the hernia repair is completed with the help of composite mesh. The patients who cannot undergo laparoscopy can be treated with the open method, again by using the standard prolene or composite mesh.

As a result, if there is no opposite situation, the laparoscopic repair of all abdominal wall hernias will be healthier for the patient if it is done in the comfortable and experienced hands, since the probability of recurrence is lower.