Surgeon Yaroslav Feleshtinsky: "After the operation, it is impossible to pump the abdominal press for half a year." Tummy tuck. Results, before and after photos. Prices

A tummy tuck is a procedure that corrects the abdomen due to severe obesity, the presence of rough scars or postpartum striae, the formation of a hanging "apron" or deep folds of the skin after losing most of the weight.

This type of surgical plastic surgery allows you to remove excess adipose tissue and form a muscular corset.

Tummy tuck refers to a surgical operation, performed only after a thorough examination., involves the postoperative period, so the price of the procedure is quite high.

Before and after photos, which are given at the end of the article, demonstrate the results of this procedure, which fully cover the expensive cost.

Features of the procedure

Tummy tuck is a very specific operation, usually performed only on those who are overweight.

The peculiarity of this procedure is that the operation is performed with the movement of the navel, this is done because otherwise it will be impossible to tighten the upper abdomen.

If you need a tummy tuck - before and after photos, prices and other information, you should first ask the surgeon.

Important factors that determine the successful completion of the operation include the following:

volume of the abdominal cavity, as well as the location of fat;
the presence of pregnancy, including the past;
age;

Who is the operation for?

Corrective surgery is carried out both for ladies and for the stronger sex.

A tummy tuck is shown (before and after photos, prices are given at the end of the article) with the following factors:

empty sagging dermis formed;
the dermis sags like an "apron";
the abdominal muscles parted;
striae appeared;
the anterior wall of the peritoneum descended;
there are rough seams with deformations;
an umbilical hernia appeared.

Before you decide on an operation, you must definitely undergo treatment from all specialists: nutritionist, gastroenterologist, cardiologist.

The person who decides on the procedure must have a conclusion on the state of the body, on the basis of which the surgeon decides to perform the operation.

What are the contraindications and restrictions for tummy tuck

In the presence of the following diseases, plastic surgery is contraindicated:

Also, if the plans include pregnancy or there is a constant change in weight, then plastic surgery will be useless.

Preparation for the procedure and necessary examinations

The success of the operation lies in a thorough examination, which will help to exclude the presence of various diseases that do not allow for tummy tuck.

Before surgery, you must undergo a series of medical examinations. The very first examination should be carried out by a surgeon who will carry out plastic surgery.

The doctor evaluates the general condition, determines the amount of adipose tissue, examines the anterior abdominal wall.

After the examination, preoperative diagnostics is prescribed:

biochemical and general blood test;
blood for HIV;
electrocardiogram;
Analysis of urine;
determination of blood group and Rh factor;
blood coagulation analysis.

Before the operation, the abdomen is photographed so that after the plastic surgery you can see and compare the result. This part of the survey does not affect the price.

How is a tummy tuck performed? Main steps

Tummy tuck is not a complicated process. Usually, under an anesthetic or the action of anesthesia, the doctor makes small incisions in the abdomen and sucks out fat deposits through special tubes.

The classic correction of the abdomen takes place in several stages:

The incision is made from one thigh to the other, shaped like an arc;
The next step is an incision around the navel - this is necessary in order to free the walls from the epithelium;
Then the skin is gently released;
The specialist stitches the muscles so that there are no stretch marks and discrepancies;
Pieces of skin that are left over are stretched well;
The incision is closed with a cosmetic suture;
A drain is installed to help remove postoperative fluid.

Plastic surgery can take from 2 to 5 hours- it depends on the degree of complexity of the surgical intervention.

How is recovery after a tummy tuck?

The rehabilitation period is 1.5-2 months, but the final effect after the procedure can be assessed no earlier than after 6 months. The hospital is provided only for 3 or 7 days, only if there is an indication from the doctor.

Important to remember! In the first three days, bed rest is necessary (getting out of bed is possible only with the help of the clinic staff).

The main principle that must be observed during the rehabilitation period is to immobilize the tissues in the abdomen, but at the same time maintain the same activity as before.

It is necessary to carry out immobilization of tissues due to the gradual bending of the body, this should be done immediately after the operation. In this position, you must be the first week of recovery.

Tummy tuck (before and after photos, prices are discussed below): recovery modes:

Besides, after the operation, the following must be observed:

take painkillers prescribed by your doctor: you need to start with the maximum dose and gradually reduce it, and then completely stop using it;
take infusion drugs that improve blood properties;
drink plenty of fluids;
a light gentle massage of the abdomen should be performed, thanks to this, blood circulation can be restored;
massage the back and limbs, it should be done 4 times a day;
be outdoors as much as possible.

After surgical correction, temporary complications may occur.

Side effects include:

What not to do after tummy tuck

The recovery period takes quite a long time. so that it passes faster and with the least negative consequences, you need to know what you can not do after the correction of the abdomen.

Tummy tuck: what results to expect. Photos before and after

Over the past few years, tummy tuck surgery has been the most popular, because the effect of it is pleasantly impressive. Thanks to the procedure, a person gets rid of excess fat folds, overhanging skin, as well as stretch marks.

The result of the operation is saved forever, but only if after that there was no pregnancy and an increase in weight.

Tummy tuck is a surgical intervention with cutting and stitching the skin, so scars remain on the body, which can be seen in the before and after photos.

Basically, the scar remains not very large, and it is covered with underwear. Currently, the quality of operations reaches the ideal, the scar is hardly noticeable, but this also affects the price, which is becoming higher.

Plastic surgery is not a cure for obesity, but serves only as a method to combat extra pounds. Therefore, after the operation, you should keep your muscles in good shape, which will help you maintain a good figure, and then a flat stomach will please you for a long time.

What are the prices for tummy tuck?

Considering such a procedure as tummy tuck (before and after photos at the end of the article), it should be noted that the prices for the operation are different.

They fluctuate between 140-250 thousand rubles. This is because the cost depends on the qualifications of the plastic surgeon and the status of the clinic.

A tummy tuck is an operation that is performed in order to remove fat deposits and make the stomach more toned. Before doing this operation, you need to know a lot of nuances that will help to avoid undesirable consequences.

From this video you will learn what it is and why tummy tuck is needed, photos before and after the procedure and prices for it.

This video will acquaint you with the results of girls before and after tummy tuck.

An abdominal operation is often vital. The fears of patients are no longer associated with the danger of surgical intervention, but with the fact of the appearance of an ugly scar on the abdomen. Restoring forms after surgery is possible only with the use of a number of measures.

What happens to the abdomen after abdominal surgery

Abdominal surgery is a surgical intervention for the treatment of pathologies of the organs of the genitourinary system and the digestive tract. An incision is made in the abdominal wall of the cavity and muscle tissue that hides the internal organs. Depending on the purpose of the treatment, the incision can be vertical or horizontal.

After suturing, the abdomen may sag, bulge, or stick out. Such changes are due to the fact that the inner wall of the peritoneum is thick enough and it has to be sutured in layers.

Ways to restore the previous form

Restoration of physical form after abdominal operations is a long and laborious process. Most patients fail to get rid of the sagging abdomen with the help of physical exercises alone.

The approach to solving the problem should be comprehensive. A woman needs to make adjustments to the diet, do massage and beauty treatments, wear a bandage. In particularly difficult cases, plastic surgeons will help restore the previous forms.

Proper nutrition

Nutrition is an important element of figure correction. After abdominal surgery, a woman needs to completely revise her diet, following the recommendations of doctors.

On the first day after surgery, the patient is forbidden to eat, you can only drink clean still water. Gradually introduced cereals and vegetable soups. Starting from the 5th day after the operation, the woman's diet should be complete and balanced.

The basic principles of a proper diet include the use of:

Lots of fibre. Foods high in fiber contribute to the normalization of the gastrointestinal tract and intestinal motility. The use of fresh vegetables and fruits, cereals and cereals will save a woman from the likelihood of problems with bowel movements.
complex carbohydrates. They saturate the body and provide it with the necessary energy for the whole day. Cereals, legumes, and whole grain breads are preferred for breakfast.
Squirrel. A weakened organism more than ever needs an element that is involved in all metabolic processes.
vitamins. In the absence of the opportunity to diversify your diet, you can use pharmacy vitamin complexes. Their use must be agreed with the attending physician.

During the rehabilitation period after abdominal surgery, it is important to monitor compliance with the drinking regimen. You need to drink at least two liters of water per day. However, the amount of fluid needed depends on the weight and age of the patient, as well as the presence of concomitant chronic diseases.

Physical exercise

Lack of physical activity after abdominal surgery will inevitably lead to the formation of ugly folds on the abdomen and excess weight. Light loads are a mandatory step in successful recovery after surgery, a method for preventing pressure sores, muscle atrophy and the formation of adhesions on the internal organs of the small pelvis.

In the absence of contraindications to the implementation of simple physical exercises, it is necessary to start the next day after the operation. A complex of gymnastics, the number of approaches and the duration of classes should be discussed with your doctor.

In the first 2-3 days after a caesarean section or removal of the uterus, the patient can do flexion-extension, leg extension, body turns. All movements are performed lying on the bed.

A week after surgery, the intensity of physical activity can be slightly increased. It is allowed to retract the stomach as much as possible, tilt the legs bent at the knees to the sides, raise the upper part of the body, lingering in this position for several seconds.

You can start full-fledged physical activity 3-4 months after the operation. Sometimes, on the recommendation of a doctor, sports should be postponed for up to six months. After this period, a woman can bend over, squat, pump the press, do the bar and other complex exercises.

Cosmetics

In addition to proper nutrition and exercise, cosmetic procedures can help to remove the stomach after a gynecological abdominal operation. The use of such funds is allowed only after the complete healing of the external scar, in the absence of crusts and the release of ichor.

Effective ways to deal with subcutaneous fat and skin laxity:

massage of problem areas - massage manipulations help to normalize blood circulation, strengthen muscles, restore their elasticity, get rid of body fat;
wraps and creams - a warming effect that creams and mixtures for procedures have, stimulate blood flow to the problem area and contribute to the breakdown of subcutaneous fat;
contrast shower - daily use of the procedure helps to strengthen the skin, make it more elastic and effectively fights excess weight;
peeling - removal of keratinized particles with purchased or self-prepared scrubs allows you to restore skin elasticity and firmness.

The effectiveness of procedures directly depends on the regularity of their application. The first results can be seen already after 1.5-2 months of use. The effectiveness of cosmetics increases if they are used in combination with exercise and proper nutrition.

Bandage

The use of compression devices after abdominal surgery will help support the stomach and reduce pain in the suture area, preventing it from dispersing. You can start wearing a bandage a week after surgery, when the seam will tighten a little and get stronger.

The duration of the bandage is about two months. Do not overtighten the belts of the device in order to avoid squeezing the internal organs, which will lead to disturbances in their work. It is necessary to remove the bandage at night and during the day every 3-4 hours.

Plastic surgery

Abdominoplasty is a cardinal method of dealing with excess weight and figure imperfections. Most often, plastic surgeons are contacted when the stomach sticks out after abdominal surgery, and other methods of dealing with the problem do not bring the expected results.

There are several options for the operation:

endoscopic - performed to remove a small fat layer in the event that the patient's skin has not lost its elasticity and elasticity, does not require a tightening;
standard - in the process of surgical intervention, subcutaneous adipose tissue is excised and muscle tissue is corrected;
mini surgery - a minor surgical intervention, during which fat deposits are removed from the lower abdomen.

You can resort to the help of plastic surgery no earlier than six months after the abdominal operation.

Recovery time

How long the body will recover after abdominal surgery depends on the volume of surgical intervention, the age of the patient, physique, emotional state and the presence of concomitant diseases. On average, the seam heals within one and a half months.

Abdominal surgery is a complex process, after which patients face the problems of scarring and sagging abdomen. Following the recommendations of the attending physician, proper nutrition, exercise and cosmetics will help restore the previous forms without harm to health.

After the removal of the uterus and appendages, a woman may experience a number of side effects. For example, a girl may begin to gain weight.

The first to increase in size is her belly. Why do women get better and what else can they face after such operations?

Operation specifics

Removal of the uterus is the kind of operation that girls of different ages can do. The medical name for this operation is a hysterectomy. Why is it being carried out?

postpartum infection.
Myoma or fibrosis of the uterus.
Endometriosis.
Uterine bleeding.

The need for an urgent hysterectomy arises in the latter case, when during childbirth the girl experiences heavy bleeding, which doctors cannot stop.

A woman who is being prepared for such an operation is concerned about the possible complications that it can lead to. Also relevant for them is the issue of changing their lives after surgery.

Does the belly really grow after a hysterectomy?

Yes, a girl after such an operation can really gain weight. The main reason for this phenomenon is malnutrition in the first month after the removal of the uterus.

As for the physiological tendency to be overweight after hysterectomy, it is absent. A girl who underwent such an operation has a growing belly in the first days after surgery.

This is explained by a banal edema. There is no reason to panic in this case.

As for malnutrition, many of the fair sex do not follow a diet in the postoperative period. In this regard, many gain weight. In girls, not only the stomach grows, but also other parts of the body, arms, hips, legs, etc.

What does dietary nutrition include? First, it must be measured. Secondly, you can not eat a large amount of food at a time. One serving should be divided into several doses.

A woman should remember the need to prevent constipation and other intestinal abnormalities, since their occurrence in the postoperative period will lead to a deterioration in her condition.

Well, the third rule: the food that the girl consumes after the removal of the uterus should be rich in carbohydrates, proteins and vitamins.

Postoperative period

This period can be called the recovery period. The girl restores her physical and psychological strength, her health improves.

There are 2 types of postoperative period: early and late. The early period is characterized by the close observation of doctors for a woman who has undergone such an operation. She is in the hospital.

How long does it take for a patient to fully recover? There is no exact answer to this question. It all depends on the method of operation, as well as on the condition of the patient after removal of the uterus.

If a girl had a vaginal hysterectomy, then she will stay in the hospital for 8 to 12 days. Her recovery period will begin after the stitches are removed.

And if the patient had a laparoscopic hysterectomy, then she will most likely be discharged on the 5th day. Of course, if after the removal of the uterus and appendages, the doctors notice any complications, the patient will stay in the hospital.

Consequences of a hysterectomy

The most significant changes in a woman's body occur already on the first day after the removal of the uterus.

Pronounced pain syndrome. The girl has a severe stomach ache and this is explained by his recent incision. To relieve pain, the patient is almost always injected with painkillers. If the pain is very strong and the usual remedies for its removal do not help, the woman is injected with narcotic substances.
Pain in the abdomen does not go away even in the second week of the recovery period. Its occurrence depends on the physical activity of the patient, as well as on diet.
In the first days after the removal of the uterus, a woman will find spotting in herself. This is a normal phenomenon, which is associated with the process of healing internal wounds.

The patient should be alert if these discharges have an unpleasant odor, and also if their consistency has changed over time.

This may indicate an infection that should be treated immediately.

The psychological consequences of hysterectomy should also be noted. The uterus is the main female organ responsible for procreation.

When it is removed, the girl may become depressed. This is especially true for young patients who have not yet had time to give birth.

What is it connected with? A woman loses hope for maternal realization.

She realizes that she will never again be able to identify with the social role of mother. It is this awareness that is the cause of possible depression.

Therefore, it is important that during the recovery period a woman is surrounded by care and attention. Then psychological rehabilitation after removal of the uterus will come faster.

Important Rules

A patient who has undergone a hysterectomy must adhere to a number of rules on which her recovery depends.

The woman's legs must be bandaged with elastic bandages. Alternatively, compression stockings can be used.
The patient should remember the need for moderate physical activity. From this, first of all, depends on her speedy recovery and recovery. Due to motor activity, blood circulation in her body improves, bowel function is activated, and the likelihood of adhesions is reduced.
On the first day after a hysterectomy, a woman should follow a liquid diet. Only in this case, on the first day after the operation, she will have the opportunity to empty her intestines on her own. This is a very important rule, which must be observed, because if this is not done, there is a risk of constipation.
If a woman in the recovery period encounters any disruption of the intestines, this will lead to a deterioration in her condition.
You can switch to regular food only after a bowel movement.

It is very important that the patient remembers the need for physical activity during the recovery period.

Physical activity will help not only speed up its recovery, but also improve well-being, partially relieving discomfort.

Complications

If a woman follows the above rules, the risk of complications after hysterectomy is minimal. However, the following complications may occur:

Divergence of seams. This can happen in two cases: the patient was operated on by an inexperienced surgeon or she did not comply with bed rest on the first postoperative day.
Infection or inflammation of the suture. This complication is always accompanied by swelling, redness and suppuration. Also, infection of the suture is accompanied by an increase in body temperature. How to help the patient? Firstly, the inflamed sutures are carefully treated, and secondly, a course of antibiotic treatment is prescribed.
Painful urination. The girl is having difficulty with this process, because her urethral mucosa was injured during the operation.
External or internal bleeding. This problem occurs in the case of poor homeostasis. Possible bleeding with clots. Blood can have a different color, from light red to black.
The occurrence of hematomas in the suture area.
Blockage of blood vessels in the lungs. This is a very dangerous complication that occurs with improper therapy. What is it fraught with? Pulmonary blockage of blood vessels can lead to pneumonia, hypertension, or even death.
Inflammation of the abdominal cavity (peritonitis). Such a complication extends to other organs, causing their suppuration. The risk of peritonitis appears in the event that an emergency surgical intervention occurs.

The main signs of peritonitis are the deterioration of the patient's well-being, irritation of the abdomen and fever.

To eliminate this problem, the girl is prescribed a course of antibiotics and oxygen solutions are given to her. If it was not possible to remove the inflammation of the abdominal cavity by these methods, the patient's stomach is washed with antiseptics.

After the removal of the uterus, a woman needs to restore her strength and return to working capacity as soon as possible. To do this, she needs to improve her health.

You can do this using these methods:

Wearing a corset. What is it for? The corset will help the patient support the weakened muscles of the abdominal region. Especially wearing a corset helps tai women who have given birth to children. This method is also recommended for patients who are over 40 years old. It is important that the corset covers the postoperative scar, so you need to make sure that its width is sufficient.
Sports ban. It was said above about the need for physical activity, but this does not mean that the girl should run cross-country after removal of the uterus. In the first 2 months of the recovery period, the patient should not engage in any sport.
The ban on sex. The girl should not have sexual intercourse during the recovery period, as this can lead to rupture of the seams.
Kegel exercises. These exercises will help restore the muscle tone of the pelvis and vagina. Since there is a high risk of vaginal wall prolapse during the recovery period, it becomes necessary to prevent it using the Kegel technique.
It also helps prevent urinary incontinence. To achieve positive results, you need to perform at least 300 Kegel exercises a day.
Yoga. Restoring their physical strength, patients without a uterus can practice yoga. Such exercises will not only help to improve the well-being of the girl, but will also have a positive effect on toning the muscles of her body.
The ban on going to the bath. After the patient was left without a uterus, in the first few months she should not go to baths and saunas. You should also remember about the prohibition of vaginal steam compresses.
The ban on the use of tampons. During the discharge period, the girl can only use pads. Under no circumstances should tampons be used.
Abundant drink. It is especially important for girls without a uterus to maintain the water-salt balance in the body. During the recovery period, they should drink as much fluid as possible. It is advisable to drink mineral water. It is important that the water that a woman drinks is non-carbonated. If she often drinks water with gas, then there will be a risk of constipation. Constipation, like any other deviation in the work of the gastrointestinal tract, will negatively affect the improvement of the patient's condition.
Proper nutrition. A girl without a uterus should remember the need for proper nutrition during the recovery period. It is important not to eat foods that are difficult for the stomach to digest, such as, for example, corn or smoked chicken.

What's next?

Left without a uterus, the girl can regain her early performance 30-50 days after the operation. This period depends, first of all, on the presence of any postoperative complications.

If they are not there, and the woman is clearly on the mend, then she will be able to join her usual rhythm of life after the second month.

Is a woman without a uterus given a disability? No, since the absence of the uterus does not affect its performance. However, there are cases when chemotherapy was applied during the operation.

This significantly affects the health of the patient. In this case, a woman can count on receiving the status of a disabled person, in all other cases - no.

It is worth noting that hysterectomy is fraught with the onset of early menopause. As a result, the girl shows symptoms of menopause. Main symptoms of menopause:

Increased sweating.
Sudden change of mood.
Increased excitability, emotionality.
Depression.
Urinary incontinence.
Stress, etc.

If during the operation the patient's ovaries were not removed, then menopause will occur at 45-55 years. Do not think that without a uterus, life for a woman will lose its meaning. Such a life has a number of advantages.

Firstly, she does not need to worry about using contraceptives, because without this organ, the risk of pregnancy is zero.

Secondly, the girl does not risk getting cancer of the reproductive organ. She should not be afraid of endometriosis and other dangerous diseases.

If she follows the recommendations given in the article, the operation will not lead to any complications. The recovery process will come quickly, and the girl will forget about her problem associated with uterine disease.

There is an opinion that a hysterectomy affects a woman's life expectancy. It is said that girls who survived such an operation live about 10 years less.

This is one of the most common myths associated with uterine removal. In fact, such an operation does not affect life expectancy in any way.

After the expiration of 1-2 months, a woman regains her former usefulness and begins to function normally in society, therefore, one should not believe anti-scientific rumors.

Useful video

Abdominal hernia (abdominal or ventral) is a dangerous disease that gives severe complications. With pathology, tissue fibers diverge or break. Through the resulting defect, a fatty layer protrudes with a hernial sac that has drawn in the internal organs.

Insignificant discomfort at the beginning of the disease gradually progresses and eventually causes incarceration of the hernia, tissue necrosis and peritonitis. Doctors insist that a hernia repair operation should take place in the initial stages, when the size of the protrusion is small. Whereas later, the consequences can be unpredictable.

The reasons

The formed muscles of the abdominal press securely fixes the organs located in the abdominal cavity and prevents them from falling out.

The white line is the vulnerable link of the abdominal wall. It is formed by connective tissue structures. Muscle tissues are not involved in the formation of the white line. The lack of musculature makes the white line the most vulnerable part of the abdomen.

In the normal state, the line width is 1-3 cm. As the connective tissue structures become thinner, they stretch. This leads to a divergence of the muscles, allowing the formation of a hernial ring. The wider the gate, the more severe the disease.

There are other weaknesses in the anterior wall of the abdomen. Hernial protrusions, spreading a thin layer of connective tissues and muscle fibers in them, go under the skin.

Pushes the hernial sac through the weakened muscle walls increased intracavitary pressure. Factors that create high intra-abdominal pressure include:

prolonged inadequate physical activity;
large fetus in pregnant women;
systematic constipation;
debilitating cough caused by asthma, bronchitis, pneumonia;
obesity;
full stomach with constant overeating;
weakening of muscle tone and aging of tendon tissues in old age.

The appearance of hernial formations is affected by damage to the abdominal cavity. Also there are hernias after operations on the abdomen. Their formation is provoked by surgical interventions performed on the genitals, stomach, intestines, gallbladder.

Types of abdominal hernia

According to the place of localization, ventral hernias are divided into:

umbilical (above-, sub- and paraumbilical);
inguinal;
femoral;
postoperative;
protrusion of the white line of the abdomen.

According to etiology, there are:

Congenital protrusions. Usually the baby is born immediately with a pathology. Sometimes it occurs in a newborn after a while.
Acquired Education. A bulge occurs when tissues lose their elasticity. Muscle elasticity decreases with age and with exhaustion of the body.

According to the type of flow, abdominal hernias are divided into:

Full. The filled bag penetrates through the lumen in the hernial ring.
Incomplete. The formations remain in the abdominal cavity. This phenomenon is observed in early pathologies.

Among the hernias, there are:

Reducible hernial formations. Falling out moves and changes the place of localization through the opening of the hernial sac. It then goes under the skin, then descends back into the abdominal cavity.
Irreducible protrusions. The hernia cannot be corrected. Organs pulled into the bag cannot be returned to their original anatomical position.

The classification of hernias of the white line depends on the severity of the course of the pathology:

I degree. The width of the white line is 3-5 cm.
II degree. The white line expands more than 7 cm;
III degree. The organs fall out, the stomach drops.

Symptoms

In the early stages, the main symptom is a periodically disappearing protrusion. During this period, the hernia almost does not cause inconvenience to the patient. He is occasionally disturbed by transient soreness of a dull nature. As the pathology develops, sharp, sharp pains occur.

In addition, the patient is worried about belching, constipation, nausea and vomiting, and feeling unwell.

Complications

Launched hernias give dangerous complications. Pinched hernial sac is life threatening. When infringed, the digestive organs are compressed. In the clamped organs, there is a complete or partial overlap of blood vessels that transport nutrients. Due to lack of nutrition, tissue necrosis begins, which leads to gangrene of the intestines.

The walls of the peritoneum become inflamed. Erupted purulent processes lead to peritonitis - a dangerous complication that can be fatal.

Infringement causes intestinal obstruction. The intestines become clogged with feces. Toxins accumulated in the body in an incredible amount cause intoxication. The excretory system of the body can not cope with the neutralization of poisons. The patient has kidney failure.

The first signs of a hernia of the abdomen are a serious cause for concern and go to the hospital for medical help. Removal of a hernia in the initial stages is a guarantee of a favorable outcome of the disease.

Removal Methods

Sometimes patients naively believe that diets, bandage and physiotherapy exercises help eliminate hernial formation. This is a dangerous delusion. Such methods do not cure abdominal hernia, the operation is the only salvation from an abdominal defect and a chance for recovery.

Exercise increases the risk of strangulation of the hernia and subcutaneous fat. Diet food provides temporary relief, possibly through weight loss. At the slightest load on the abdomen or an awkward movement of the body, the hernial sac falls out again.

The bandage is not able to permanently keep the bowel loop inside the abdominal cavity. It is impossible to replace the surgical removal of a hernial protrusion by wearing a bandage, no matter how much time is needed for this. With prolonged wear, on the contrary, adhesions appear in the hernial sac, and the hernia becomes irreducible. Unjustified long-term wearing of the device has the opposite effect. Mechanical loads from the abdominal muscles are transferred to the bandage, which leads to weakening of the muscles, stretching of the connective tissue structures and the growth of a hernial formation.

It is advisable to wear a bandage for people who have postponed the operation for a short period of time. A bandage in these cases is worn to prevent the progression of the pathology.

Abdominal hernia is self-removing only in children under 5 years of age, including, due to exclusively folk methods of treatment.

But sometimes babies need surgery. Indications for it is the size of the hernial formation. Large defects in a child are eliminated until the tissues lose their elasticity.

How is the operation done

Operations are divided into planned and emergency. A planned intervention is indicated for patients who feel discomfort at the site of the localization of the formation, without infringement of the hernial sac.

The following signs indicate abuse:

unbearable pain in the abdomen;
education is not reduced;
nausea-vomiting syndrome;
disappearance of stools;
blood inclusions in feces;
accumulation of gases in the intestines.

Preoperative preparation

Patient preparing for surgery:

refuses to drink alcoholic beverages 3 days before the surgical procedure;
does not use drugs with acetylsalicylic acid 14 days before surgery (they lower blood clotting);
rationally eats and takes vitamins 14 days before treatment.
The last time he eats until 20-00 of the previous day.

The operation is postponed for patients who have had infectious diseases. The interval between the end of the treatment of infections and surgery is 14 days (with the exception of emergency situations).

The patient is sent for a medical examination. The study includes:

blood analysis;
tests for sugar, group and Rh, prothrombin index (PTI);
examination for the presence of infections (syphilis, hepatitis, HIV);
electrocardiogram.

Operating methods

Surgery is done under local anesthesia or general anesthesia. Unincarcerated hernial formations are preferred to be removed by local anesthesia. Local anesthetics do not adversely affect the cardiovascular system. After them, a person does not need long-term observation. The patient does not feel sick, he can safely take food.

If there is no infringement, the operation for a hernia of the abdomen with a mesh is performed quickly, without complications.

Classical operations are done by tensioning weakened layers. A positive outcome of the operation is noted in 60-80% of patients. Relapse occurs in 20-40% of patients. Repeated prolapse occurs due to the huge load on the scars. With a strong tension in the abdominal cavity, the threads cut through the weakened tissues, opening the way out for the hernial sac.

Hernioplasty with mesh graft

The best way to excise a hernia is a surgical procedure with the introduction of a mesh endoprosthesis. All resulting load falls on the sewn-in implant. The mesh is implanted without complications, overgrown with connective tissue.

A defect closed with a mesh prosthesis turns into a homogeneous structure, resistant to stretching and tearing. The newly formed wall prevents the re-protrusion of the internal organs.

Laparoscopy with surgical mesh implantation

Small lesions are removed by laparoscopy. Thanks to the fiberoptic probe, which displays the image of the abdominal organs on the monitor, the doctor assesses the situation and performs precise manipulations.

The procedure does not require extensive abdominal dissection. Only small punctures are made through which the probe, instruments and mesh implant are inserted. During the operation, there is no heavy bleeding. Small tissue damage heals quickly.

The method is not suitable for people who have had abdominal diseases. Laparoscopy is not done with large hernial protrusions and strangulated hernia.

Postoperative period

Patients who have undergone the removal of a pinched hernia, in which tissue necrosis and peritonitis have occurred, need a long rehabilitation period. In this situation, the surgeon removes dead tissue, restores the abdominal cavity. After the operation, the patient is prescribed drug therapy. He takes anesthetics and antibiotics.

If an incarcerated hernia was operated on, the postoperative period ends quickly. The patient is discharged from the clinic one day after surgery. He is able to:

move around the house (walking promotes healing);
eat ordinary foods;
leave the house on the 3rd day after surgical treatment.

Although the postoperative regime is flexible, the patient is advised to adhere to certain rules:

do dressings in the clinic until the stitches are removed;
use laxatives (constipation during the rehabilitation period causes divergence of sutures and recurrence of a hernia);
refrain from bending forward;
do not do physiotherapy exercises and yoga until the excision heals;
do not lift heavy loads for 2-3 months (after removing the stitches, lifting objects over 5 kg is prohibited);
control body weight for at least six months (excessive load can provoke a divergence of fragile tissues, cause prolapse of a hernial protrusion);
try to avoid factors that contribute to the appearance of a cough (when coughing, a person strains the abdominal walls, which can cause a relapse)

Compliance with prevention and attentive attitude to health does not allow serious complications to occur during the rehabilitation period.

Abdominal hernia must be surgically removed before complications occur. The operation in the early stages is not dangerous. Treatment of small hernias is more effective than large and strangulated ones. The implementation of medical recommendations during the rehabilitation period prevents the recurrence of a hernia.

Postoperative hernia on the abdomen, or rather, in the abdominal wall, refers to a variety of traumatic effects. It manifests itself in the area of the postoperative scar, located under the skin. In relation to all variants of hernias, this type is 6–8%.

According to the statistics of complications in the postoperative period, hernias account for up to 5% of all manipulations with the opening of the abdominal cavity, and when analyzing the course of festering wounds, the figure increases to 10%. Prevention measures depend not only on the type of surgical intervention, the skill of the doctor, but also on the behavior of the patient, the implementation of recommendations during the rehabilitation period.

Localization and classification

Abdominal surgeries are performed for a variety of reasons. Each pathology requires preliminary study and the choice of optimal tactics. In order for the surgeon to be able to completely isolate the desired organ, conduct an examination, and stop bleeding, it is necessary to resolve the issue of access or a specific incision site for surface tissues and skin.

To do this, there are standard methods developed by the practice of many generations of doctors. Postoperative hernias are more often formed in the anatomical zones, where the most convenient access to the abdominal organs is provided. By localization, you can guess which operation and incision the surgeons used.

For hernia:

the white line of the abdomen - an upper or lower median laparotomy was performed (dissection of the peritoneum along the central line), probably due to diseases of the stomach, intestines;
in the iliac region on the right - after the operation of appendectomy, on the caecum;
umbilical region - recovery from surgical interventions on the intestines may be complicated;
right hypochondrium - an undesirable outcome of the removal of the stone and gallbladder, liver resection;
hypochondrium on the left - splenectomy (removal of the spleen);
lumbar region from the side - a consequence of kidney operations, access to the ureters;
the area above the pubis - in cases of urological diseases, surgical interventions on the internal genital organs in women.

The diagnosis will be noted "left-sided lateral incisional hernia with a medium-sized defect"

Accordingly, the classification of postoperative hernias provides for the following options: median (upper and lower), lateral (right- and left-sided, upper, lower). Depending on the size of the postoperative defect:

small - do not violate the shape of the abdomen;
medium - occupy a small area in the peritoneum;
extensive - comparable to a defect in a large area of the abdominal wall;
giant - sharply deform the abdomen, located in two or more zones of the peritoneum.

Postoperative hernias differ in character - into reducible and irreducible, according to the internal structure - into single-chamber and multi-chamber. Taking into account the effectiveness of treatment, surgeons distinguish recurrent hernias, including those that recur many times. The principles of classification are important for choosing a way to eliminate negative consequences.

Why do some patients develop hernias after surgery, while others do not?

The causes of postoperative hernias are most often associated with the inability to fully prepare the patient for lack of time in cases of emergency intervention. After all, any planned operation requires preoperative therapy, bowel cleansing, removal of intoxication.

The lack of timely measures contributes to complications in the postoperative period associated with bloating, slowing down of peristalsis, impaired fecal excretion (constipation), vomiting, increased intra-abdominal pressure, congestive changes in the lungs with inflammation, cough. All this greatly worsens the conditions for the formation of a dense postoperative scar.

The erroneous choice of the access method without taking into account the anatomical and physiological features of the structure of the internal organs and peritoneum is not ruled out. As a result, the blood supply and innervation in the area of surgical intervention is disturbed, and in the future, persistent changes appear in the tissues that contribute to the eruption of the sutures.

The role of suppurative complications is significant. This type is referred to as an early manifestation. Inflammation and pus accumulate in the area of the wound, under the aponeurosis of the muscles. Congestive pneumonia and bronchitis that occur after surgery cause coughing, sharp shocks and fluctuations in intra-abdominal pressure, which predisposes to the appearance of a hernia ring.

Operating technique defects include poor-quality suture material, excessive tissue tightening, unresolved bleeding and accumulation of blood in hematomas followed by rapid suppuration, prolonged tamponade and drainage in the surgical area.

With increased pressure in the abdominal cavity, a loop of intestine is wedged into the umbilical hernial sac

Of the reasons that depend on the patient's compliance with the doctor's recommendations in the postoperative period, the most important are: early increase in physical activity, diet violations, neglect of wearing a bandage.

Hernias often occur in patients with obesity, systemic connective tissue diseases, diabetes mellitus, in which the formation of a full-fledged scar is significantly impaired. For women, the duration of pregnancy after surgery is important. The weakening of the body, vitamin deficiency, the pressure of the enlarged uterus on the abdominal wall create conditions for hernia formation.

Although theoretically any surgical intervention on the abdominal cavity can be complicated by a postoperative hernia, most often the pathology is observed after surgical treatment:

perforated stomach ulcer;
inflammation of the appendix;
calculous cholecystitis;
intestinal obstruction;
in women, removal of ovarian acid, uterus;
peritonitis;
consequences of penetrating wounds in the abdominal cavity.

As a relapse after surgery to eliminate the umbilical or hernia of the white line of the abdomen.

Symptoms

The main sign of a hernia is the detection of a protrusion in the area of the postoperative scar and around it. At the initial stage, postoperative "bumps" are adjusted by patients in the supine position on their own, they do not really interfere and do not have symptoms. Pain and growth of a tumor-like formation occur when straining, sudden movements, lifting heavy objects.

In a horizontal position, the protrusion is reduced. The deterioration of the condition is associated with the transition of pain into constant, sometimes having the character of an attack, contractions. At the same time, patients complain:

for prolonged constipation;
persistent bloating;
belching;
nausea;
difficult urine output (in case of suprapubic hernias);
irritation or inflammation of the skin on the abdomen in the area of the hernial protrusion.

The patient's condition depends on the size of the hernia, adhesions in the abdominal cavity, inside the hernial sac. Sometimes, even with large hernias, patients do not have complaints.

How is the diagnosis carried out?

During examination of the patient in a standing and lying position, the surgeon sees a protrusion in and around the area. To find out the size and shape, the patient, who is in a supine position, is asked to raise his head. This movement will cause tension in the abdominal muscles and “squeeze out” the hernial sac with the contents.

With a small size, the hernia is well palpated

At the same time, all discrepancies in the area of the rectus muscles appear, possible incipient protrusions that are not related to the main one. The patient must be assigned research methods to clarify the connection with the internal organs.

X-ray reveal the state of functioning of the gastrointestinal tract, the existing adhesive process, entry into the hernial cavity of the abdominal organs. Ultrasound allows you to examine not only the abdominal organs, but also the cavity of the hernial sac, determine the shape, true size of the hernia, changes in muscle structures, and the effect of adhesions.

The examination complex includes a contrast X-ray examination of the passage of a barium suspension through the stomach and intestines, the study of the degree of intervention of the stomach. Pictures (X-rays) and herniography (X-ray of the contents of the hernial sac) are taken.

To clarify, you may need a colonoscopy (examination of the intestine), fibrogastroduodenoscopy, magnetic resonance imaging.

What complications are possible with an untreated hernia?

The lack of therapeutic measures for postoperative hernias aggravates the patient's condition. Over time, you may see:

coprostasis (stagnation of feces and the formation of stones in the intestines) with mechanical obstruction;
infringement;
perforation;
partial or complete adhesive intestinal obstruction.

In the clinical course, there is a deterioration in the patient's condition, an increase in abdominal pain, nausea and vomiting, blood in the stool, stool retention and gas discharge. In this case, the protrusion on the abdomen ceases to be reduced.

What should people do when they find postoperative signs of a hernia?

Understandably, the reluctance to get into surgery again in patients who have found a protrusion in the scar zone. However, it is necessary to reckon with the likelihood of more significant health consequences. During the examination, the doctors will decide how to continue treatment, to prevent complications.

Sometimes consultations are needed to make a final decision.

Conservative tactics is considered a method that is acceptable only with obvious contraindications to repeated surgical intervention (decompensation of the heart, internal organs, severe stage of chronic diseases). In such cases, patients are advised to:

nutrition control;
limitation of physical activity;
elimination of constipation with the help of diet and medication;
constant use of a special bandage.

Nutrition Features

In the presence of a hernia, food products should exclude bloating, constipation, and indigestion. To do this, you will have to eat often, but in small portions. Should be excluded from the diet:

all fatty, fried, spicy dishes;
pickled and salted vegetables;
alcoholic drinks and carbonated water;
strong coffee;
various seasonings that stimulate acidity;
solid food.

Shown: cereals, boiled meat and fish dishes, baked goods, stewed vegetables, cottage cheese. To prevent constipation in the morning, it is recommended to take a tablespoon of vegetable oil, a few dried apricots or prunes. During the day, you can drink alkaline mineral water without gas ("Essentuki 4").

Features of surgical treatment

Most surgeons believe that the only way to save a patient from a postoperative hernia is by hernioplasty. So, the types of operations on the hernial ring, of a strengthening nature, are called. The most optimal approach is chosen, taking into account the size and localization of the protrusion, the information obtained during the examination about the adhesions between the hernial sac and the abdominal organs.

If the hernia is less than 5 cm in diameter and has no complications, then it is possible to suture the muscle aponeurosis with strengthening of local tissues. With medium, extensive, gigantic, long-term and complicated processes of own tissues, it is not enough to cover and strengthen the abdominal wall defect. Synthetic mesh-shaped prostheses are used.

It is important to properly install the protection system, provide for the separation of adhesions, dissection of old scars so as not to injure the internal organs and structures of the abdominal cavity. If there is an infringement of the hernial sac, then the removal of non-viable intestinal tissue (resection) and the omentum is additionally performed.

Artificial mesh prostheses are used to strengthen the hernia ring.

Standards require an incisional hernia to be operated six months to a year after the initial operation. But with rapid growth, a tendency to infringement, the indications extend to the early stages. The steps of the operation must be performed sequentially:

Providing access to the formed hernial orifice - incisions are made along the edges of the protrusion, excess skin and fatty tissue are removed.
Opening the cavity of the hernial sac, blunt separation of the organs located there from the walls (intestinal loops, omentum). In the presence of a multi-chamber hernial sac, a cicatricial conglomerate is formed in it from the omentum and loops of the intestine and omentum. Usually they are soldered to the peritoneum and scars. It is not always possible to separate it, since it takes a long time and significantly injures the intestinal wall. It is necessary to remove the deformed section of the intestine and omentum.
Removal of the hernial sac.
Economic excision of tissue along the edges of the hernial orifice.
Plastic (closure of the hole) in the anterior abdominal wall.
Wound suturing.

Plastic surgery is performed with the patient's own tissues (autoplasty), if the hernial defect is not more than 10x10 cm in area. Napalkov and Sapezhko's modifications are used with the aponeurosis of the anterior abdominal muscles. With more extensive defects, recurrent hernias, artificial materials (alloplastic) are used. To do this, nets of nylon or lavsan are placed between the layers of stitched fabrics.

The photo before and after the operation convinces of the possibilities of peritoneal plasty even with increased fat deposits on the abdomen

Forecast and prevention

The development of a postoperative hernia seriously complicates the physical and labor activity of a person, accompanied by a visible cosmetic defect. In the case of infringement in modern surgery, despite the help, a lethal outcome is observed in 8.8% of patients. Timely removal by surgery gives a satisfactory prognosis.

Prevention problems require the surgeon to:

the right choice of optimal access for any operation;
at all stages of careful observance of asepsis;
use only high-quality suture material;
if possible, preoperative preparation of the patient;
unhurried and careful management after surgery.

Patients need to clearly follow the recommendations on the regimen, nutrition, wear a bandage, monitor the regularity of the stool, and achieve weight loss. Such a postoperative complication as a hernia, when one pathology is eliminated, contributes to another. Identification and treatment allow for correction. Observation by a doctor after surgery contributes to early diagnosis and solution of the problem.