Hernias occur when organs or their surrounding connective tissue, also known as fascia, push through the walls of the cavity where they are normally contained. Most hernias occur in the abdomen and are the result of the intestines or other tissues pushing through the muscular abdominal wall. In general, the only effective treatment for an abdominal hernia is surgery.
Indications
With the exception of umbilical hernias, which usually do not need any treatment, abdominal hernias can only be treated by surgically repairing the abdominal wall. The timing of the surgery is variable, however. In general, surgery to repair an abdominal hernia is elective, which means that it can be done when it is convenient for the patient, the Merck Manual states. Some hernias, however, cause the intestines to become twisted, which is also known as incarceration or strangulation. This complication of an abdominal hernia requires immediate surgical intervention.
Types
There are two main types of surgery for an abdominal hernia, HealthCommunities.com notes. With laparoscopic surgery, a flexible camera, specialized tools and multiple small incisions are used to repair the hernia. The advantage of laparoscopic surgery is that the recovery time and the risk of complications are lessened. In situations in which laparoscopic surgery is not an option, open surgery can be performed, which uses one large incision and conventional surgical tools.
Procedure
Abdominal hernias are repaired by putting the protruding tissue back into the abdominal cavity and by strengthening the abdominal wall, the Baylor College of Medicine explains. Because abdominal hernias are caused by weak spots in the abdominal wall, a surgeon will stitch in a strong synthetic mesh to help give the muscle in the wall additional support. In the case of very large abdominal hernias, a drain may also be inserted into the abdomen to keep fluid from collecting in the abdominal cavity after the surgery.
Recovery
Because abdominal hernia surgery is done under general anesthesia, patients will first be taken to a postanesthesia care unit, HealthCommunities.com reports, until they have recovered from the effects of anesthesia. Patients can expect some pain at the surgical site and cannot leave until they have regained full sensation in their abdomen. Patients who receive laparoscopic surgery can return to normal activities in a few days; open surgery often requires a longer recovery period. Patients should avoid any activities that put strain on their abdomen or cause pain.
Risks
Some of the risks associated with abdominal hernia surgery are shared by almost all surgical procedures. There is the risk that the patient will have an adverse reaction to the anesthesia. Patients may also have problems with internal bleeding or infection of the surgical site. Risks that are unique to abdominal surgery include injury to the intestines or other abdominal organs and a recurrence of the hernia.
