What you need after umbilical hernia surgery. Umbilical hernia - postoperative period. Intimacy after hernia repair

2.1 Patient rehabilitation after umbilical hernia surgery

After the operation to remove the umbilical hernia, there comes a time that doctors call the rehabilitation of the body. The first time, the patient will have to spend in the hospital, under the strict supervision of doctors, in case complications arise. If there are no signs of complications, then the time spent in the hospital will be 1-3 days.

Immediately after the operation, the patient is put on a special bandage. Its main task is to support the belly and navel area, weakened after the operation.

In medicine, there have been cases when a patient is allowed to go home after 2-3 hours after the operation. This can happen if after the operation, the patient feels well, and the body has recovered normally after general anesthesia.

It is very important, after the operation, to go to the doctor regularly for a check-up. also have regular check-ups with your doctor. If you do not adhere to this rule, then there will be a chance of a hernia recurrence in the same place.

The probability of recurrence of umbilical hernia largely depends on the method of surgery. Some methods have a minimum percentage of recurrence of the disease, for example: surgery using mesh materials.

After umbilical hernia removal

Rehabilitation after removal of an umbilical hernia takes place in several stages. The correct mode of the day after the operation will speed up the recovery of the body.

The first two or three days after the operation, the patient should spend in bed, lying only on his back, so as not to cause complications. Since the body, after the operation, is not yet strong, unnecessary physical activity can contribute to the divergence of the seams.

On the third or fourth day, the person may begin to roll over in bed and get up. It is important to understand that excessive physical activity or overwork of the body can also cause complications. Therefore, it is best to maintain bed rest, with little physical activity (for example, go to the toilet and back).

After the operation, the patient will have to visit the hospital for dressings within 7-10 days. After this period, the patient can do the dressing himself, this can be taught by a nurse.

For faster healing of the operated site, the patient is prescribed painkillers, antibiotics and physiotherapy sessions.

In older people, after surgery, respiratory failure with tachycardia may occur. This is a very bad sign, which is better to tell the doctor.

Nutrition during rehabilitation

After any operation, it is important to remember about proper nutrition. No matter how easy the operation is, it should be remembered that this is an intervention in the human body and a violation of the integrity of the skin. This suggests that the body and internal organs need a calm regimen in order to cope with stress and return to their usual state.

During recovery, the usual diet will have to change. Spicy foods should be completely eliminated from your diet. Useful, natural healthy foods, light cereals, soups will be used. All this will soften the stool so that the feces can easily leave the body. In no case should constipation be allowed!

The first two days after surgery, the patient can only eat liquid food. Gradually, new and new foods can be added to the diet so that the stomach gets used to normal food.

Complications:

1. infringement of an umbilical hernia is a sudden compression of the hernial contents in the hernial orifice;

2. inflammation of the hernia - caused by inflammation in the organ located in the hernial sac;

3. coprostasis - stagnation of feces in the large intestine.

A hernia is well treated with surgery. In the absence of treatment, the prognosis is unfavorable - the formation of an irreducible hernia.

After elective and emergency operations for hernias, it is recommended to avoid physical exertion. Therefore, patients who are engaged in heavy physical labor should be on sick leave for at least 6-8 weeks after the operation. With recurrent hernias, this period increases by another 2-3 weeks. In the future, these patients for 2 - 3 months should be transferred to work not related to weight lifting. Early discharge to work, unreasonably short-term transfer to light work can lead to recurrence of umbilical hernia.

Of great importance is the prevention of umbilical hernia, which should be carried out from the first days of life. Immediately after birth and several times during the first year of a child's life, a pediatric surgeon examines, revealing various surgical diseases, including umbilical hernia. To prevent hernias, the child should not be swaddled tightly and thrown up - this increases intra-abdominal pressure and contributes to the formation of hernias. In addition, insufficient or improper nutrition of the child, poor care of the navel, disorders of the gastrointestinal tract (constipation, diarrhea), cough and some other disorders also contribute to the occurrence of umbilical hernia.

In adolescence, the development of the muscles of the anterior abdominal wall is facilitated by physical education and sports. Useful for swimming, cycling, skiing and skating.

Of particular importance is the prevention of umbilical hernia during pregnancy and the postpartum period, which consists in wearing special prenatal and postnatal bandages. If a woman ignores this recommendation, then she may develop weakness of the abdominal muscles, which contributes to the appearance of umbilical hernias.

Treatment of umbilical hernias is always operational, so it is better to pay attention to their prevention in advance.

Prevention of umbilical hernia:

Wearing a bandage during pregnancy;

Proper nutrition;

Abdominal muscle training;

Weight normalization.

The most common and most effective ways to protect yourself from the possibility of an umbilical hernia include:

Wearing a bandage;

Umbilical patch for newborns;

Perform massage;

Exercises to prevent education;

Adhere to a healthy lifestyle;

Sports training.

It can be seen that many of these methods are not just a precautionary measure, but also have a positive effect on life in general. Prevention of umbilical hernia is very important, so each possible method should be considered in more detail.

The bandage, as a rule, is attributed by the doctor himself. It is necessary if men are engaged in heavy physical labor. Thus, heavy lifting increases the load on the abdominal cavity, and protrusion of the internal organs through the weakest part of the abdominal wall can occur.

This can happen instantly - then a person will immediately notice a tumor-like formation in the navel. It happens that a hernia develops gradually, then the falling out will become larger with each load on the body.

It is important to adhere to this while exercising in the gym. No wonder men working with heavy weights wear special belts. It not only protects the back, but also reduces the risk of hernia.

The bandage is also prescribed for pregnant women. It is better to wear it from the first months of pregnancy, when the tummy is just starting to grow.

Also, such a belt is necessary in the postoperative period, since it reduces the risk of recurrence of hernia formation to almost a minimum.

Patch

A special patch for the navel is intended for newborns and infants. Even after the first examinations with a pediatrician, a predisposition to umbilical protrusion can be determined. In such cases, the doctor prescribes to wear such a patch.

It is attached to the skin of the baby for several days. During this period, the patch can not be removed even while swimming. It is made of a special material that does not spread under the influence of water.

Such a device is needed in order to reduce the load on the navel when the baby is pushing, crying, screaming. The bandage holds the navel and prevents a possible hernia from falling out through the opening of the umbilical ring, which is weak in babies from birth.

The first time it should be fixed by a doctor.

Massage and exercise

Massage and exercises, as the prevention of umbilical hernia, are needed in order to strengthen the abdominal muscles. Therefore, massage and special gymnastics, first of all, can help small children and newborns.

All these manipulations can be shown by an experienced doctor. Further, parents have two ways: either learn to perform massage and gymnastics on their own, or hire a children's masseur for these purposes.

First, the baby needs to be warmed up and massaged. After these manipulations, you can proceed to special exercises. They increase the tone of the child's body and make the muscles more elastic.

This is done in a certain sequence so that each subsequent muscle group is worked out in turn.

As for adults, massage and gymnastics will not bring such a clear result, but they will not be superfluous. For adults, the best prevention is to live a healthy lifestyle and exercise regularly.

Healthy lifestyle

Maintaining a healthy lifestyle is good for everyone. A person should monitor his diet, because it is known that the foods that a person eats are reflected in his health. In addition, increased body weight significantly increases the risk of umbilical hernia.

A large body weight makes the muscles less elastic and creates an additional load on the body.

You should also quit smoking. It is not only harmful to health, but also provokes a chronic cough, which increases pressure on the abdominal wall.

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How is an umbilical hernia repaired after surgery? This question, like many others, will be answered by the doctor. A hernia in the navel is one of the conditions in which internal organs (such as the intestines) protrude beyond the boundaries of the anterior abdominal wall through an opening located in the navel. The disease manifests itself in the form of a protrusion in the navel, which may increase or, conversely, become less noticeable when taking a horizontal position. Sometimes education can occupy a large area.

The surgeon treats this complex disease, and it is necessary to contact him immediately, as soon as unpleasant sensations appear. Symptoms of an umbilical hernia include the following:

pain in the abdomen when coughing or physical exertion;
the presence of nausea;
dilated umbilical ring.

An umbilical hernia can be diagnosed in several ways:

Get an examination by a specialist.
Make an x-ray of the stomach and duodenum.
Make an ultrasound.
Undergo a gastroscopy.
Make a procedure such as herniography - an x-ray method that consists in introducing a special contrast agent into the abdominal cavity, which allows you to examine the hernia.

Umbilical hernias can be of two types: congenital and acquired. Congenital can be detected immediately after the birth of a child. In the region of the navel, where the umbilical cord was, there is a spherical protrusion with a wide base, passing into the umbilical cord. If the baby cries a lot, the hernial protrusion increases. How different congenital or acquired hernias can be can be seen in the video that is shown to patients in a medical facility. How to treat an umbilical hernia? Usually, a hernia is not surgically treated before the age of five. They are trying to eliminate it with the help of massage and physiotherapy exercises. If nothing helps and the navel does not decrease, you have to resort to surgical intervention on the hernia.

hernia surgery

Removal of an umbilical hernia in adults is carried out only by the surgical method, treatment is prescribed immediately, and strictly in a hospital.
The traditional type of plasty (the Sapezhko and Mayo method) has some disadvantages:

the recovery period of the body can last quite a long time (large loads are prohibited for one year);
high risk that the formation after surgery will reappear in the same area.

Hernia removal is practiced using mesh implants, which can be installed in several ways. Advantages of the operation:

recovery can take no more than one month, the operated patient can engage in physical activity and even sports;
a small percentage of recurrence of the disease - 1%;
the operation can be performed under any type of anesthesia that has a long effect, not necessarily general.

The laparoscopic method for removing a hernia of the abdomen is one of the most sparing forms of operations, since it can proceed without incisions on the body, a few punctures are enough. Rehabilitation is easy and fast, but this method has contraindications. These include:

immunodeficiency states, including HIV,
liver disorders,
the time of menstruation in women.

Often, the operation is performed in combination with the setting of a mesh implant. Operations to remove an umbilical hernia in adults are carried out according to the following scheme. First, the patient is placed in a hospital for examination and preparation for surgery. If the patient is admitted in an emergency, preparation for adult umbilical hernia surgery is minimized.

Then the patient is given anesthesia (local or conduction; general anesthesia, as a more complex one, is used for repeated manifestations). If the formation is small, the operation on the umbilical hernia is reduced to the fact that the umbilical ring is sutured. If the formation is larger, it has to be closed surgically. The resulting adhesions are dissected, which allows the internal organs to remain in the hernial sac. You can also engage in the prevention of hernias. Usually, doctors recommend following some simple rules:

training the abdominal muscles (this will keep them in good shape);
proper nutrition that will help control body weight;
during pregnancy, it is necessary to wear an umbilical bandage;
avoid strenuous exercise.

Why does an umbilical hernia appear? In babies, the cause of the appearance may be delayed fusion of the umbilical ring. The adult population is more likely to develop an umbilical hernia after 40 years. This is especially true for pregnant women.

Predisposing factors include:

connective tissue weakness;
slow fusion of the umbilical ring;
obesity;
postoperative scars.

Risk factors that can lead to increased intra-abdominal pressure:

frequent crying and screaming in babies;
overstrain in the physical plane;
constipation;
period of pregnancy;
ascites;
prolonged severe cough.

What are the contraindications?

Children's age up to five years. There is a certain probability that the hernia will be removed on its own along with the growth of the body. If it does not cause severe discomfort and does not create any complications, the operation is postponed for several years. After the age of five, boys are also not always recommended to have surgery right away. But the girls need to remove the hernia. This is due to the growth of the reproductive system.

Do not perform surgery with active infections in the body because the operation is a certain risk, complications are possible.

Diseases that cannot be cured. Since a hernial tumor is not a dangerous disease, especially when it is in its early stages, terminally ill patients are not exposed to the risks associated with surgery.

second half of pregnancy. Any operation is stressful for the body and, accordingly, a risk for both mother and baby. Therefore, it is better not to allow such situations during pregnancy. If the mass does not carry certain risks, surgery is postponed until breastfeeding is stopped.

A contraindication is a stroke or heart attack. In such cases, anesthesia is difficult for patients to tolerate, because of this they are not exposed to such a risk.

Disturbances in cardiovascular and pulmonary activity are also an obstacle to surgery.

Large formations in people who are over the age of seventy are rarely removed. Surgical intervention is poorly tolerated by such patients.

An operation to remove an umbilical hernia is contraindicated in patients with diabetes, as well as in severe renal failure, cirrhosis of the liver with complications, and varicose veins of the esophagus.

An operation for an umbilical hernia is a mandatory measure, and it is assigned to everyone without exception. Removal is performed by the method of tension or non-tension hernioplasty, and in each case there will be specific features of the rehabilitation period. After surgery to remove an umbilical hernia, there is a risk of complications and recurrence of the disease, so patients are prescribed a special regimen to minimize risks.

Excision of an umbilical hernia in adults is performed as planned. Before the operation, the body is sanitized, contraindications are excluded. In children under 6 years of age, attempts are still being made to reduce the navel without surgery, but in this case, there is a high risk of a hernia in adulthood against the background of high physical activity and pathologies of the gastrointestinal tract.

Rehabilitation after removal of an umbilical hernia includes such basic measures as wearing a bandage, physical therapy, prevention of gastrointestinal pathologies, and exclusion of high physical activity.

Complications after umbilical hernia surgery occur mainly in patients who ignore the rules of rehabilitation. But even more often, the consequences of hernia repair relate to the mistakes of the surgeon during the preparation for the intervention and its implementation.

Rehabilitation after hernia removal

After a week, the stitches are removed, and after the scar has completely healed, various restorative procedures are prescribed. Young children and adults in the late period of rehabilitation are shown massage, therapeutic exercises, drugs for pain relief and physiotherapy as prescribed. After the suture is removed, a postoperative bandage is prescribed, in which you need to walk for several hours a day until the damaged muscle tissue is restored. It usually takes about two months, but this process is individual for each person.

To reduce the rehabilitation period allows compliance with all doctor's prescriptions, which include diet, reduction of physical activity, proper rest and limitation of stressful situations.

An umbilical hernia also occurs after surgery, which is facilitated by poor healing of the scar, non-compliance with preventive measures and congenital anomalies of the connective tissue. The recurrence of the disease is more often observed in patients who early refuse to wear a bandage, do not follow a therapeutic diet and give high physical activity to the muscles of the anterior abdominal wall.

In the early postoperative period, it is extremely important to eat right. The diet is based on preventing intestinal pressure on the operated area. This can be achieved by excluding fixing and gas-forming products from the diet.

The postoperative bandage is not put on the patient immediately, but only after the wound has healed, but in rare cases exceptions are made, which will depend on the choice of the attending physician.

In the early period after the operation of the umbilical hernia, the patient can move independently, but do this only in a supporting corset.

The patient is discharged 2-3 days after laparoscopic surgery and 3-7 days after open hernioplasty.

Features of recovery in the first weeks after umbilical hernia surgery:

after removal of a hernia in men, a regular examination by a urologist is carried out, after all, after the operation, problems from the genitourinary system may be disturbing;
diet after removal of an umbilical hernia is the same for women and men, it will be strict for the first days, and in case of complications - weeks, then the food is diluted and supplemented;
after hernia repair scarcan be removed by laser only after complete healing of the wound and tissue repair;
after surgery to eliminate several pathologies of the gastrointestinal tract at the same time, the diet is selected individually, because it differs depending on the operated organ;
therapeutic measures are prescribed exclusively by the attending physician and rehabilitator, and at home, you can only follow the appointments and apply methods approved by a specialist;
physical education and physical work are acceptable after the scar has formed, but at the same time, during the year, it is necessary to limit the load, because the healing of tissues is a long process, and with incomplete recovery, there is always a risk of recurrence or the development of a postoperative hernia.

Possible complications after surgery

The divergence of the seams and the development of a ventral hernia are frequent, but not the only consequences of hernia repair. Complications after surgery arise due to the mistakes of the patient, and more often the surgeon.

What can happen after excision of an umbilical hernia:

eating out of schedule contributes to the appearance of constipation, which will become a factor in the appearance postoperative hernia or recurrence of the umbilical;
an early return to stress will lead to suture failure and relapse;
giving up the umbilical bandage may end muscle divergence and recurrence of pathology in the same place;
ignoring the need to visit a doctor for dressings and preventive examination threatens inflammation of the wound, its suppuration, which will aggravate the condition and delay the recovery of the body.

Massage and physiotherapy

In the postoperative period, massage is prescribed mainly for young children who have suffered a congenital umbilical hernia. Adults are also recommended a course of therapeutic massage to accelerate wound healing by stimulating metabolic processes. The procedure can only be performed by a professional massage therapist who is familiar with the history of the disease. At home, massage is permissible after the full recovery of the body.

Physiotherapy will not be mandatory, but a useful measure.

The patient may be prescribed drug electrophoresis, magnetotherapy, treatment with currents. Of the non-traditional methods of treatment, acupuncture, hirudotherapy, and apitherapy will be safe after surgery.

Exercise therapy and bandage

Physiotherapy exercises will be a useful measure to prevent the recurrence of pathology in all patients without exception. Gymnastics is prescribed after the healing of the scar, and when the patient gets rid of pain. A prerequisite for starting classes will be the absence of an inflammatory process of any localization.

Exercises are performed at home. The complex is selected first with the doctor, then corrected by the patient, depending on the sensations. It is permissible to do simple gymnastic exercises aimed at relaxing and strengthening the muscles of the abdomen, back, buttocks.

The movements performed should not cause pain and discomfort. If there are discomfort, you should tell your doctor about it. A change in condition for the worse may indicate the occurrence of complications.

The postoperative bandage is prescribed for several weeks. In it, you need to do everyday activities, go out, that is, put on a belt during moments of physical activity. At night and during rest, the corset is removed. You need to wear it for as long as the doctor says. If you abuse its use, in the future it will lead to muscle weakness.

The list of the most common types of hernias, in addition to inguinal, also includes: femoral, diaphragmatic, abdominal and umbilical hernia. In men, an inguinal hernia can often descend into the scrotum.

Types of inguinal hernias:

Direct hernia, passing in the groin canal, bypassing the spermatic cord, protruding through the bottom of the canal;
Oblique hernia, passing along with the spermatic cord through the canal in the groin, protruding through the inguinal ring.

A hernia of the esophageal opening of the diaphragm is a generalized concept, because pathology can have various forms of course and degree of development, depending on which the clinical picture of the disease also changes.

So it is customary to distinguish between floating and fixed hernia of the esophagus. The latter is considered a rarer, but at the same time more dangerous pathology, which is characterized by frequent complications in the form of strangulated hernia, perforations of the esophageal tube and bleeding from the gastrointestinal tract, disorders in the heart, and an increased risk of oncology of the esophagus.

A floating hernia of the esophagus (it is also called a sliding or axial hernia) is a protrusion into the chest cavity of the distal part of the esophagus and some part of the stomach. Sometimes almost the entire stomach can fall into the hole, which indicates a large hernia that compresses the chest organs (lungs, heart), causing disruption of their work and corresponding symptoms in the form of cough and heart pain.

Stretching of the diaphragmatic opening, which enters the esophagus, is controlled by the esophagophrenic ligament. With a decrease in its tone and degenerative processes, manifested in the form of thinning of dense connective tissue, the hole in the diaphragm may increase.

With increased intra-abdominal pressure, pregnancy, obesity, age-related changes, congenital defects of the diaphragmatic opening, the cardial part of the stomach can shift upward relative to the diaphragmatic opening, thereby forming a hernia.

A floating hernia of the esophagus is said when, with a change in body position and physical exertion, the stomach, together with the esophagus, can move in the opening of the diaphragm. Thus, they either protrude into the thoracic region, or return to their place in the abdominal cavity.

With a small hernia and the normal functioning of the sphincter, the sliding variant of the pathology is asymptomatic. But in violation of the tone of the lower esophageal sphincter, there is a reflux of the contents of the stomach into the esophagus (gastroesophageal reflux), which is accompanied by belching, heartburn, pain, burning sensation behind the sternum.

There is a clear connection between the emerging unpleasant symptoms with food intake (especially plentiful) and a change in body position, on which the displacement of the esophagus and stomach cardia depends. Infringement of a hernia of the esophagus of this nature is not observed.

With a fixed hernia, which is often called paraesophageal, the middle and lower parts of the stomach and even the duodenum can protrude into the chest cavity, while the position of the esophagus remains fixed.

That is, a hernia is formed not along the esophagus, but next to it, and it does not tend to change its size and position. But when the position of the body changes, the hernia can be compressed (infringed), which is fraught with overstretching of the walls of the protruding part of the stomach and their rupture.

The most characteristic symptoms for this type of pathology are pressing pain in the pit of the stomach and a feeling of heaviness that appears after a heavy meal, which causes patients to limit the amount of food, belching, regurgitation of food and vomiting.

Violation of the movement of food from the stomach to the intestines provokes the development of a peptic ulcer, which is complicated by perforation of the stomach tissues and active hemorrhages. With a sliding hernia, hemorrhages occur in the esophagus, but they are minor and do not appear outwardly.

Reflux with a fixed hernia is not observed, heartburn is rare. True, in the case of a combined hernia, the appearance of such symptoms is not excluded.

Symptoms of a hernia of the esophagus may vary depending on the degree of development of the disease, because this pathology is considered progressive, especially if it is caused by age-related changes that negatively affect the tone of the ligaments of the diaphragmatic opening and the lower esophageal sphincter.

A hernia of the esophagus of the 1st degree is the initial period of the disease, when the lower part of the esophageal tube penetrates into the hole, and the stomach remains on the other side of the diaphragmatic plate, tightly adhering to it and forming a kind of dome.

The initial degree of hernia development is detected by chance during the instrumental diagnosis of other diseases. It is impossible to detect it by palpation. But the treatment of this pathology usually comes down to following a special diet and observing the behavior of the digestive organs.

A hernia of the esophagus of the 2nd degree is characterized by penetration into the thoracic part of not only the distal esophagus, but also the lower esophageal sphincter, as well as a small part of the stomach. Symptoms of pathology begin to manifest themselves more clearly.

Patients complain of pain behind the sternum or in the epigastrium, discomfort (a feeling of squeezing or fullness), the appearance of belching and burning in the chest area. A little later, there is a feeling of a food lump, a violation of the swallowing process, heartburn (with a sliding hernia).

Treatment of the second stage of the disease, in addition to diet, involves medication: taking antispasmodics, enzyme preparations, antacids and drugs that reduce the production of hydrochloric acid.

A hernia of the esophagus of the 3rd degree is not only an unpleasant, but also a dangerous pathology, which is fraught with various complications. In this case, a significant part of the stomach, and sometimes intestinal loops, is displaced into the sternum, which leads to a violation of the digestion process.

In addition to the symptoms described above, patients complain of severe heaviness in the stomach after eating, a lump in the throat, severe pain in the chest, frequent belching of air, and sometimes spitting up food. Patients with combined hiatal hernia complain of heartburn attacks.

Diet and conservative treatment in this case are relevant only after surgical intervention (laparoscopic surgery to return the digestive organs to the abdominal cavity and suture the diaphragmatic opening, antireflux operations - fundoplication).

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Postoperative period

A hernia often develops with weakened muscles of the anterior wall of the abdomen, so experts recommend doing special exercises to strengthen this muscle group, which will help not only prevent the development of pathology, but also prevent the re-formation of a hernia after surgery.

The following exercises are suitable for people of any age and help strengthen the rectus and oblique abdominal muscles:

lie on your back, straighten your legs, put a weight of 1 kg on your stomach (you can use a bag filled with sand) and, while inhaling, raise the bag with your stomach as high as possible, while exhaling, lower it as low as possible. Over time, you can increase the weight to 2 and 3 kg.
lying on your back, first raise the left, then the right and two together to an angle of 45 o, (hands along the body). Over time, weights can be worn on the legs.
lying on your back, legs apart and slightly bent, while exhaling, raise the pelvis (support goes only to the elbows, feet and shoulders).
lying on your back, fix your legs (under the sofa or ask someone to hold them). On the exhale, sit down, then inhale and lean forward, on the exhale, return to the starting position.
sitting on a chair, lean on the back, grab the seat with your hands, while inhaling, raise the pelvis (lean on your arms and legs), relax as you exhale.

With inguinal hernias, one should not engage in heavy physical exercises (pumping the press, exercising with dumbbells, etc.).

With contraindications to surgery, exercises should be done throughout life, but a set of exercises should be selected by a specialist, taking into account the degree of the disease and the general condition of the patient.

Effective exercises for spinal hernia are exercises aimed at strengthening the deep and superficial muscles of the back, lower back (lumbar triangle) and neck.

It is believed that by strengthening the muscles and their ligaments, we provide the spinal column with reliable support in the form of the so-called muscle corset. If this “corset” has a sufficient level of development, then you don’t have to worry about the stability of the spine and its intervertebral discs.

However, in modern vertebrology (a branch of orthopedics dealing with pathologies of the spinal column), there is an opinion that by strengthening the strength of the muscular corset of the spine, compression on its supporting segments - intervertebral discs and facet (facet) joints - increases significantly.

Especially with static body positions and significant muscle tension. Some vertebrologists recommend a universal way to prevent and solve problems with intervertebral hernias - ordinary walking at a calm (walking) pace for up to two hours in a row.

In order for exercises for a hernia of the spine of the lumbar spine (like all exercises for this pathology of any localization) to be beneficial, it is imperative to coordinate them with your doctor and exercise therapy specialist. This rule should not be broken - for your own good.

A set of exercises for a hernia of the spine in the lumbar region is done mainly lying on your back. To do this, you need to put a gymnastic rug or a woolen blanket on the floor, folded three times in length.

Starting position: lying on your back, arms straightened by the sides of the body, legs straight. Straining the feet of both legs, we pull them towards the shins (towards ourselves), at the same time, straining the neck, we try to bring the chin as close to the chest as possible.

Starting position, as in the previous exercise. Without lifting your legs from the floor and without leaning on your hands, while inhaling, slowly raise your head and upper back, hold the pose for several seconds and just as slowly (on exhalation) take the starting position.

The starting position is the same, but the legs are bent at the knees. While inhaling, lift the pelvis off the floor, holding the upper body on the shoulder blades, neck and back of the head. Hold the position for a few seconds and exhale to return to the starting position. The number of repetitions is 5.

The starting position is the same, but put your hands behind your head. It is necessary to alternately bend the legs at the knees and try to bring them as close to the chest as possible. When bending the leg, inhale, when straightening, exhale. The number of repetitions is 10 (each leg).

Lie on your back, arms and legs straight. Raise the right leg and left arm (while inhaling) up at the same time, hold the pose for a few seconds and slowly lower as you exhale. Do the same movement with your left foot and right hand. The total number of repetitions is 10.

Lie on your stomach, legs straight, arms bent at the elbows are on the floor near the body. Resting your palms on the floor, while inhaling, raise your head and back from the floor, bend your back, tilting your head back. On exhalation, return to the starting position. The number of repetitions is 10.

These exercises for a herniated disc of the spine are focused on the cervical region and should help the longus colli, longus capitis, scalene muscles and sternocleidomastoid muscle become more elastic and facilitate the work of all seven cervical vertebrae.

In a standing or sitting position (as you prefer), straighten your shoulders and smoothly turn your head alternately left-right-right, and then in reverse order, gradually increasing the amplitude of turns. Perform the exercise 10 times.

The starting position is the same, but now you should slowly and smoothly tilt your head forward, bringing your chin as close as possible to the hole between the collarbones. Then slowly raise your head (while inhaling). The number of repetitions is 10-15.

Without changing the starting position of the previous exercises, you need to gently tilt your head back while inhaling and at the same time stretch your chin up. As you exhale, slowly return to the starting position. Repeat 10 times.

Considering that the thoracic spine is less mobile, the set of exercises for spinal hernia of this localization is very modest.

You need to sit on a chair, straighten your back and, with your hands behind your head, gently bend back while inhaling, trying to firmly press the spine to the back of the chair. As you exhale, tilt your upper body forward and slowly straighten up. The number of repetitions is 5.

Starting position: lying on your back (put a soft roller under your back to raise your chest), arms straightened along the body, legs straight. While inhaling, gently bend back, while exhaling, slowly return to the starting position. The number of repetitions is 5.

Doctor of Medical Sciences Sergey Bubnovsky is the author of kinesiotherapy - a complex of therapeutic exercises for the musculoskeletal system.

Bubnovsky's exercises for spinal hernia are designed for all intervertebral discs and are designed to improve their blood supply. Some exercises repeat those already described above, so we present the following:

Starting position: standing on all fours, arms straight, emphasis on the palms. While inhaling, gently arch your back, tilting your head to your chin; on exhalation, return to the starting position; on the next breath, bend your back and raise your head; as you exhale, return to the starting position. The number of repetitions is 15-20.
The starting position is the same. While inhaling, without bending the arms at the elbow joints, lean forward, transferring the weight of the body to the upper body. As you exhale, slowly return to the starting position. Repeat at least 20 times.

To strengthen the muscular corset, many doctors recommend performing Dikul's exercises with a hernia of the spine.

Starting position: lying on your back, straight legs together, arms spread apart (down with palms).

The upper part of the body remains motionless, raise the right thigh and slowly turn to the left without separating the legs. Hold this position for 5 seconds and slowly return to the starting position. A similar movement is done with the left thigh to the right side. Repeat on each side 5 times.

The starting position is the same as in the previous exercise, and the upper body also remains motionless. Without lifting the legs from the floor, side steps are taken in both directions with a delay in the extreme right and left positions for a few seconds.

Starting position: lying on your back, feet shoulder-width apart, arms crossed on your chest. The lower part of the body remains motionless, the upper part is smoothly (sliding along the floor) tilted to the sides. Each time at the point of maximum tilt to the right and left, a pause of 3-4 seconds is made. The number of repetitions is 3 in each direction.

Yoga exercises for spinal hernia are performed lying down, which is most appropriate from an anatomical point of view.

Starting position: lying on the stomach, straight legs together, arms extended along the body. While inhaling, raise the head, shoulders and chest from the floor, after a pause (on the exhale) gently lower them. The minimum number of repetitions is 5, the maximum is 15 (in three sets).

Starting position: lying on your stomach, straight legs together, arms extended forward. At the same time, raise your legs (without bending at the knees) and arms, linger in this position for a few seconds and slowly lower your limbs. The number of repetitions is 5-10 (with pauses of 5 seconds).

Starting position: lying on your back, legs bent at the knees together. While inhaling, raise the bent legs, clasp the shins with your hands and, pressing them to the back of the thighs, at the same time press the spinal column to the floor. Stay in this position for as long as possible.

Starting position: lying on your back, straight legs together, arms extended along the body. Bend the leg at the knee and raise it to the stomach, at the same time raise the head and reach for the bent knee. Hold the pose for 15 seconds.

Causes of inguinal hernias

Postoperative complications can be prevented by following preventive measures. The first two days after the operation, you need to observe bed rest, follow a sparing diet. The entire postoperative period should be limited to physical activity, and after the healing of the sutures, special gymnastics should be carried out.

If, during the surgical intervention, the doctor did not sufficiently treat the sac with a hernia, then the activity of the intestine may be disrupted. In this case, the patient will experience pain after surgery. To avoid such a side effect, the doctor must necessarily palpate the entire sac and its walls, and only then carry out further actions.

There is a risk that the doctor will touch the bladder and damage it when they open the hernia sac. This is possible in cases where the operation is performed with the use of plastic tissue of the human body.

As with any surgical intervention, groin hernia surgery can carry the risk of developing an infectious disease. In this case, you may notice swelling at the site of the surgical intervention.

Improper care of the site of tissue damage, failure to comply with sanitary and hygienic standards can lead to infection. Also, it can be caused by a weakened immune system. Most often, this problem is caused by carelessness during the procedure.

The infection enters the body through the puncture site. Medical personnel may carelessly treat the puncture site and sew up the wound, poorly cleaning all items. This leads to the introduction of bacteria into the place where the procedure is performed.

Subsequently, the patient's body temperature rises. There is redness in the affected area. To treat this complication, you need to take a course of antibiotics. Then the bacterial infection will come to naught.

In more severe cases, the infection can develop throughout the body, and purulent formations will be noticeable at the site of suturing. The surgeon must perform another operation and eliminate the abscess until it has grown to other organs and tissues.

There are several factors that affect the appearance of this disease in men:

Predisposing factors when a man has a predisposition to the development of abdominal protrusion;
Producing factors leading to increased pressure inside the peritoneum.

Predisposing factors for the appearance of an inguinal hernia are:

Congenital weakening of the connective tissue in the walls of the peritoneum;
Atrophy of the muscles of the peritoneum due to the absence or decrease in physical activity;
Expansion of the internal and external "gates" of the inguinal canal from birth.

The producing factors are:

Excessive exercise (lifting heavy objects);
Cough in a chronic form;
Constipation in a chronic form;
Systematic excessive tension of the walls of the abdominal cavity as a result of professional activities (for loaders, trumpeters, etc.).

It has already been said about the dependence of the method of rehabilitation after excision of the inguinal hernia on the chosen anesthesia.

Basically, after four hours, patients can move independently. In this case, the appearance of aching or cutting pains with localization in the area of the incision made is possible.

The origin of the pain syndrome is different.

Its appearance may be evidence of the process of wound healing, restoration and fusion of tissues, since during the surgical incision of soft tissues, small areas of nerve fibers are damaged, which leads to an increase in the sensitivity of the operated area.
Another cause of pain after inguinal hernia surgery is tissue swelling.
The likelihood of pain is largely due to the thoroughness of the surgical intervention. Insufficient qualification of the doctor becomes the cause of incorrect manipulation of tissues, leading to their unnecessary injury.
Pain is not in all cases evidence of scar healing problems. It may be of muscular or neurological origin.
Significant loads in the postoperative period sometimes provoke a relapse of the disease, in which there are sharp pain sensations. In this case, it becomes necessary to repeat the operation.
Pain syndrome may indicate external or internal divergence of surgical sutures

strengthen the abdominal muscles with regular workouts;
avoid heavy physical exertion and abdominal trauma;
organize proper nutrition;
maintain body weight within the age norm.

To avoid recurrence of the disease, it is necessary to follow the rules of rehabilitation and follow the doctor's prescription.

After the intervention, a man may develop pain syndrome, which is a natural reaction of tissues to damage or acts as a symptom of a postoperative complication.

READ ALSO: Treatment of osteochondrosis of the shoulder and cervical spine

Unwanted changes after surgery may occur due to the actions of the surgeon. This group includes damage to the femoral joint, the ilio-splanchnic nerve, the spermatic cord. The risk of experiencing similar surgical complications is higher in patients who have already undergone hernia repair or who conceal information about comorbidities.

To exclude the re-development of pathology allows compliance with the regime of complete physical rest for 2-3 days after surgery, proper nutrition.

Over the next 6 months, a man should stop lifting weights and maintaining a sedentary lifestyle, smoking, alcohol abuse and malnutrition should be abandoned.

After inguinal hernia surgery

Postoperative period

A bit of anatomy

A prerequisite for the appearance of oblique inguinal hernias is the presence in a person of such an anatomical formation as the inguinal canal. It begins inside the abdominal cavity, on the inner surface of the anterior wall of the abdomen, then passes inwards and downwards, opening with an external opening slightly above the scrotum in men, and slightly above the labia majora in women.

The walls of the inguinal canal are formed by muscles and ligaments. Normally, this hole does not exist. It is filled with the spermatic cord in men and the round ligament of the uterus in women. But under certain conditions, it is the inguinal canal that can become the site of the exit of the hernial protrusion.

In order to understand why boys are most often affected by pathology, consider the process of intrauterine development.

When a male fetus is still in its mother's abdomen, its testicles are located in the abdomen, not far from the kidneys. Gradually, they go down, and by the time of birth they should take their usual place in the scrotum.

But, descending, the testicle carries with it a piece of peritoneum - a film of connective tissue that lines the inside of the abdominal cavity. As a result, a small pocket from the peritoneum is formed in the scrotum. In a newborn boy, it should completely overgrow and turn into a strand of connective tissue.

However, this does not always happen. Sometimes the vaginal process of the peritoneum (that's what this pocket is called) remains open. It forms a hernial sac into which the internal organs located in the abdomen can fall out.

The ovaries in girls always remain in their place, so they do not have a vaginal process of the peritoneum - accordingly, inguinal hernias also occur much less frequently.

The origin of acquired inguinal hernias is very different from congenital ones.

congenital weakness of the connective tissue and inguinal ring;
excessive physical activity, in which there is a strong straining of the abdomen and an increase in intra-abdominal pressure.

As a physical activity that can increase intra-abdominal pressure, weight lifting is most often used. In some patients, a hernia may form even with severe

Indomitable

Which increases the pressure in the abdominal cavity.

Most often, in boys, loops of thin

which have the most mobility. At an older age, the greater omentum can act as the contents of the hernial sac - a sheet of connective tissue that hangs down inside the abdominal cavity in the form of an apron.

In girls, the fallopian tubes and ovaries often fall into the inguinal hernia.

Sometimes the large intestine of a child has increased mobility. In this case, the caecum enters the hernial sac. As a result, the hernia, as it were, lacks a back wall, and surgeons call it a sliding one.

Symptoms of the disease

The most important and obvious symptom of this disease is the formation of a hernial sac (bloating) in the groin area, which can occur both on the left and on the right side (less often on both sides).

The average size of the protrusion is from 1 to 5 cm. The size of the hernia at an early stage is 2-3 cm and is detected only with muscle contraction. The hernia tends to grow, increasing to a gigantic size (about 10 cm).

Other symptoms of an inguinal hernia include:

Heaviness and burning in the abdomen;
Pain in the area of education that occurs after physical exertion;
Discomfort when walking;
Dizziness and vomiting (rare symptom).

An inguinal hernia is diagnosed on the basis of examination and the clinical picture as a whole. In cases of doubt, the patient is shown an ultrasound. Uncomplicated inguinal hernia does not affect laboratory parameters.

It is necessary to diagnose an inguinal hernia in the upright position of the patient, or when he strains the abdominal muscles. In the supine state, the hernial sac is not visible. On palpation (palpation), the hernia is not painful and has a soft, elastic texture, easily retracting into the peritoneal cavity.

The main problem is that inguinal hernia in men is not treated and can only be removed surgically. If this disease does not cause discomfort and pain, then surgery can be postponed. However, an exacerbation of a hernia can lead to the following complications:

Irreducibility of the abdominal protrusion as a result of the formation of adhesions;
Infringement, in which part of an organ (ovary, bladder, intestine or omentum) is pinched in the hernial ring, which can lead to necrosis (necrosis) of the tissue of this organ;
Intestinal obstruction due to the fact that the loop of the digestive organ, which has entered the gate of the hernia, is pinched or the intestinal patency is impaired;
Inflammation of the testicle.

All of the above complications require immediate surgical intervention. The more advanced the disease, the more difficult the operation will be.

Preoperative preparation

The preparatory measures for the removal of an inguinal hernia in men by surgery include:

Complete laboratory examination (BAC, coagulogram, general blood and urine analysis);
ECG, ultrasound;
Examination of the patient for the presence of chronic diseases;
Clarification of the list of medications taken by the patient;
Quitting smoking, taking drugs and alcohol 2-3 weeks before the planned surgical intervention;
Stopping any food intake 8 hours before surgery;
Forced bowel cleansing (enema).

Carrying out the procedure of hernioplasty

An operation to remove a hernia in men (hernioplasty) is now performed using modern technologies (endoscope), which significantly reduces the recovery time of the operated patient.

Instead of incisions, with laparoscopic hernioplasty, three punctures are made. Through punctures, with the help of special tools, the hernial sac is cut off. Due to this, there are practically no traces of the operation on the surface of the skin, and the muscles located in the abdominal region are almost not injured, minimizing pain. Then the walls of the peritoneum are strengthened.

Hernioplasty today is carried out in two ways:

tension;
tension-free.

In the first case, which is a classic of surgery, the holes formed in the abdominal cavity are closed by tightening the tissues and stitching them together (the Shouldice method).

The second method involves the use of synthetic materials during plastic surgery, which perfectly take root in the human body. During this operation, a special polypropylene mesh (Lichtenstein plastic) is sutured.

Many patients are concerned about the question: “How long does a hernia operation last (q)?” The duration of hernioplasty is less than an hour, which minimizes complications from general anesthesia. Recently, patients who, for one reason or another, are contraindicated in general anesthesia, undergo hernioplasty using local anesthesia.

Bandage after inguinal hernia removal

The medical bandage was developed by scientists as a means of preventing the appearance and growth of hernias, as well as preventing (in the presence of prolapse) infringements. Modern methods of ridding a person of these problems make it possible to do without this supporting frame.

But it is better to be safe when using it than to allow muscle strain in the groin area. After all, wearing a bandage allows you to remove part of the load on the peritoneum, which reduces the risk of complications and relapses.

An irreplaceable service is provided by a bandage after the removal of an inguinal hernia and when the patient begins to gradually increase physical activity, trying to return to his usual life. Thanks to this device, it is possible to more evenly distribute external pressure and intra-abdominal tension, which occurs as soon as a person makes an effort to lift a load or overcome resistance. This fact creates favorable conditions for the speedy healing of the wound.

The period during which the patient is required to wear a bandage is determined by his attending doctor. This parameter depends on a number of factors: the severity and time of the operation, the dimensional parameters of the protrusion, the contents of the released capsule.

But, as mentioned above, such measures are not mandatory, since innovative technologies can protect the patient from such negative consequences. Therefore, the question of using a bandage during rehabilitation remains with the attending physician.

As you know, most often a hernia in the groin is found in men. For this reason, a male inguinal hernia bandage is considered more common. However, there is also a female version, universal, children's, as well as a bandage for newborns.

Bandage belts are divided into one- and two-sided, depending on the type of hernia. Accordingly, one-sided can be designed for the right or left side. There are also universal options where the side of the location can be adjusted.

A well-chosen belt is in close contact with the skin and does not cause discomfort, it is not visible under a layer of clothing.

In addition to the fasteners and the belt itself, the main part of the bandage is a special metal plate sewn into a fabric bag - the so-called "pelot". The size of the pellot is selected according to the diameter and shape of the hernial opening - it should be slightly larger along the outer borders, by about 10 mm.

An inguinal hernia bandage for women may not differ in any way from the male version, with the exception of those models that are designed to be worn during pregnancy.

If you plan to use the belt for a long time, then you should not buy cheap models - remember that the price directly affects the quality of the product. Cheap bandages wear out quickly, may not endure washing, and are also made mainly from synthetics, which is not very desirable for the skin.

Choose options from natural fabrics - this will save you from allergies and skin irritations. Naturalness is especially relevant in the summer heat, when special attention is paid to hygroscopicity and lightness of clothing.

Ideally, if the basis of the product is cotton. Be sure to try on the belt when buying, because it is so easy to make a mistake in size and buy a thing that will be uncomfortable to wear in the future.

Trying on and putting on the bandage device should be carried out in a horizontal position, on the back. Only in this way can the pressure in the abdominal cavity be reduced as much as possible, so that the bandage can fully fulfill its function. Please note that the fasteners and the pilot do not hang out, but do not squeeze the body either.

Remove the bandage in the same position as put on - on the back. After removal, it is recommended to lightly massage the skin to stimulate blood circulation.

Patients often ask the question: how to make a bandage for an inguinal hernia (q) The fact is that experts do not recommend making such a device on their own. The bandage performs strictly assigned functions, and the slightest inconsistency with its intended purpose will not only not help, but can also cause great harm to the condition of the hernial sac.

The average service life of a bandage belt (with daily use) is approximately 12 months, after which it must be replaced with a new one. The wearing period can be extended if the product is handled carefully, washed mostly by hand at 30-35°C (using mild detergents), never twisted.

Before washing, pay attention to the annotation for a particular model - the fact is that some bandages cannot be washed at all. Such belts are recommended to be placed in a special washable case, which will preserve the cleanliness of the product.

The most common types of bandages for inguinal hernia

The "Jolly" or "Personal" universal bandage devices are designed like underpants with two holding pads on the front. They fasten on the side, and are also equipped with Velcro straps for fastening between the legs. The versatility of such bandages is that they can be customized by adding or removing pads and belts. They are convenient to use both for unilateral (right or left) and bilateral hernia. The products are made from a natural base, they are hypoallergenic.
Denver groin bandages are available in a variety of styles. The most popular of them are a kind of tape with sewn-in pads (on one or the other side), the edges of which are sheathed with a special protection against irritation when worn. The package also includes Velcro straps for additional fixation.
The bandage of the T43 series is made of breathable mesh fabric. It looks like ordinary underwear, which makes it invisible under clothes and comfortable in everyday wear.

The device provides muscle support after removal of an inguinal hernia in men.

An indication for wearing a bandage is:

Overweight patient.
Elderly age.
Weak immunity.
The use of own tissues, rather than a mesh implant, when suturing the hernial orifice.

Therapeutic bandages are designed to prevent the development of hernias, and if available, to prevent an increase in protrusion, to prevent infringement.

In the period after surgery, these products help to avoid muscle strain, reduce the load on the abdominal press, which significantly reduces the likelihood of relapses and complications.

Wearing an inguinal bandage provides a uniform distribution of external load and intra-abdominal pressure on the operated area, reduces compression on the scar zone, which contributes to its rapid healing.

The duration of the use of the bandage is determined by the doctor, depending on the initial size of the hernial protrusion, the contents of the bag, the duration of the operation and its complexity.

However, such a preventive measure is not necessary: the use of the latest surgical methods ensures reliable fixation of the sites of inguinal hernia through the use of mesh implants.

Such bandages will be useful during the initial period after the operation, when pain is still present, and when physical activity is resumed.

Intimacy after hernia repair

Patients after inguinal hernia surgery are prescribed special nutrition. The diet is designed in such a way as to reduce the likelihood of intestinal disorders (diarrhea, constipation, increased gas formation) to a minimum, to improve the functioning of the digestive system.

Proper nutrition prevents complications and reduces the risk of recurrence of inguinal hernia.

During the recovery period, the emphasis should be on liquid food.
Portions should be small.
Eat without haste, carefully chewing food.
Four meals a day is optimal.
Particular attention should be paid to protein products: their presence in sufficient quantities is a necessary condition for the rapid recovery of muscle tissue. The diet should include: chicken breast, turkey meat, fish, cottage cheese (preferably low-fat), eggs, milk. Milk is not indicated for individual intolerance: in this case, its use can provoke problems with the digestive tract and increased gas formation.
It is necessary to exclude other products that lead to flatulence: yeast products, legumes, chocolate, sweets, pastries, sour-milk products, fruits, yogurt.
It is better to refuse coffee.
Avoid spicy, spicy, acidic foods (including sour-tasting fruits and vegetables).
All sodas and alcohol should be excluded from drinks.
Attention should be paid to the compatibility of simultaneously used products. An unsuccessful combination also causes intestinal disorders, accumulation of gases and, as a result, an increase in pressure inside the abdominal cavity. This leads to a significant risk of recurrence of the disease.

Any surgical intervention, to a certain extent, leads to the destruction of the integrity of the connective tissue and is an artificial penetration into the human body, to which the body can react in a rather unpredictable way.

This also applies to the removal of an inguinal hernia. After it, a rather short rehabilitation can follow, when recovery is very fast. But another scenario is also possible, in which a number of complications arise.

1. Suppuration of the suture - occurs after many surgical interventions, leads to the appearance of pain and an increase in temperature in the area of the affected area.

2. The recurrence of the disease is often the result of ignoring the doctor's recommendations by the patient. The risk of recurrence of a hernia increases significantly:

in violation of the diet;
as a result of increased physical activity;
due to smoking (it provokes coughing fits, which cause the recurrence of the protrusion);
due to refusal to wear a bandage;
the cause of hernia recurrence may be an incorrectly performed operation or the wrong choice of the method of surgical intervention;
re-development of the pathology is also possible in case of weakness of the walls of the inguinal canal or insufficient strengthening of the posterior wall during the operation.

3. Formation of hematomas. Small formations are eliminated through the use of pressure bandages and cold compresses. With large sizes of hematomas, a puncture is used to eliminate them.

4. Damage to blood vessels, nerves, elements of the spermatic cord. Such complications are the result of the mistakes of the surgeon. Sufficient qualification of the doctor reduces the likelihood of their occurrence to a minimum.

If the nerves are damaged, in the postoperative period there is a decrease or loss of sensitivity of the skin in the scrotum and on the inside of the thighs.
When a part of the spermatic cord is injured, sexual function suffers - up to the development of infertility.
Damage to the vascular system of the spermatic cord can cause testicular atrophy.

5. Hydrocele (hydrocele) is one of the most common complications after hernioplasty.

With unilateral dropsy, half of the scrotum is enlarged.

Often, bilateral dropsy also develops, due to which there is a bilateral enlargement of the scrotum, sometimes reaching such a degree that it leads to difficulty and limitation of the patient's motor activity.

6. Thrombosis of deep veins of the legs. Most often, this complication occurs in elderly and debilitated patients. The disease is manifested by the presence of pain in the calf muscles. The appearance of the legs does not change, the temperature is kept within the normal range.

The main method of treatment of this type of thrombosis is pharmacotherapy. It includes:

anticoagulants;
thrombolytic drugs;
fibrinolytics;
disaggregants.

The correct selection of drugs for conservative treatment generally gives positive results, prevents the further development of thrombosis and helps to restore the patency of the affected vessels.

7. Violation of the intestines. This complication leads to improper processing of the hernial sac. Most often this happens when excising a sliding hernia.

8. Damage to the femoral joint - is a consequence of the imposition of too coarse sutures on the incision in the inguinal region.

9. Infectious complications are quite rare, but the most dangerous consequences of inguinal hernia removal. If necessary, patients are prescribed a course of broad-spectrum antibiotics.

increased pain syndrome;
increase in puffiness;
development of hematomas;
bleeding;
the appearance of a wound infection;
cutting seams;
displacement of the implant.

In the normal course of the rehabilitation period, in the absence of swelling, pain, feelings of discomfort, intimate relationships can be resumed 14 days after hernia surgery, avoiding pressure on the operated area and excessive tension.

In the process of removing a hernia, there is a risk of damage to the nerve endings, intestine or bladder.

If immunity is weakened, with deep tissue damage, there is a risk of developing an inflammatory process. Infection of the wound can also occur with incorrect processing of sutures, the absence of antibiotic therapy in the postoperative period.

Violation of potency

During the operation of repeated removal of the inguinal hernia, damage to the spermatic cord is possible. The consequences of pathology can be:

loss of sensation in the groin area;
infertility;
hormonal imbalance;
change in sperm quality;
testicular atrophy.

Surgery in the area of the inguinal canal can provoke the development of a hydrocele. With dropsy, the scrotum increases, limiting the movement of a man. The only effective treatment is surgery.

Feeling pain is a natural reaction of the body to the surgery. The nature of unpleasant sensations, their localization make it possible to suspect the development of complications after the intervention or to make sure that they are absent.

Surgery to remove an inguinal hernia in children

It happens that the patient even before the hernia treatment had damage to some nerve fibers (for example, after a previous operation). With repeated intervention, this can lead to soreness and muscle weakness.

However, the following are considered the most common postoperative complications.

Damage to the spermatic cord during the removal of the hernial sac, as a result of the surgeon's careless action. To prevent this from happening, the doctor must first separate the cord from the rest of the tissues. What threatens this complication (q) Violation of the level of hormones and spermatogenesis, which can lead to infertility and atrophic processes in the testicle.
Damage to the intestinal area during the removal of the hernial sac, as a result of the inattention of the operating surgeon. Also, with tissue plastics or high ligation of the sac, the doctor may violate the integrity of the bladder.
Damage to the hip in the joint when applying coarse sutures. To prevent this from happening, it is recommended to probe all tissues closest to the seam.
Bleeding from damage to the vessel during suturing. This situation is corrected by clamping the broken vessel.
The formation of blood clots in the deep venous vessels of the lower leg often occurs in elderly patients. To avoid such a complication, after the operation, the doctor prescribes anticoagulants - this prevents the risk of thrombosis.
Hydrocele - dropsy of the testicle - one- or two-sided. This complication may require a second operation.
Hernia recurrence. It may appear when the patient violates the rules of postoperative rehabilitation and does not comply with the doctor's instructions.
Infectious complication - the appearance of infection at the site of surgery. Requires additional antibiotic therapy.

The listed consequences can appear either through the fault of the operating doctor, or through the fault of the patient himself, and also due to the individual characteristics of the organism.

The patient should follow all the recommendations of the doctor and adhere to all the rules of rehabilitation treatment. For 2-3 days after the surgical intervention, it is recommended to observe strict bed rest, do not strain, do not engage in physical labor.

In addition, it is important to follow a certain diet that excludes the use of foods that provoke flatulence - these are raw vegetables and fruits, legumes, sweets.

If you follow all the above rules and carefully follow the doctor's prescriptions and advice, the consequences of an inguinal hernia will not affect you.

The principle of surgical removal is to separate the abdominal cavity and the hernial sac. It is also necessary to prevent the entry of internal organs into it. The operation is delicate and requires special technical skills.

It is important to preserve all anatomical formations of the spermatic cord. Mesh implants are not used for surgical intervention in babies. The operation is always performed under general anesthesia. The duration of hernia removal does not exceed 30 minutes.

The most common way to get rid of a hernia is its plastic surgery. This procedure is called laparoscopy. It is used to examine the opposite side in patients suffering from a unilateral hernia.

There is a risk of a missed hernia or a risk of complications after such an intervention. Possible damage to the structures of the spermatic cord. The safety of the procedure has been proven when a hernia is removed through a hernial sac. In this case, a positive result is observed.

Which method to use, the doctor decides based on the possible lethality, the complexity of the situation, as well as observation during a routine revision. Laparoscopy has shown many benefits. Even despite the fact that the probability of having a pathological process on the other hand is at a high level.

Surgical intervention with correction of a hernial protrusion with the introduction of an implant 5 days of stay in the clinic - from $ 28,000
The introduction of an additional implant - from $ 6,500
MRI procedure - from $ 1,500
Specialist consultation - from $ 500
Diagnosis before surgery - from $ 550
Anesthesia during surgery - from $ 2,000

As a rule, in the absence of complications, a week after discharge, the patient can fly home.

Despite the low-impact operation, some dietary restrictions after it still exist. For example, on the first day after surgery on a hernia of the esophagus, preference is given to clean water without gas, which you can drink no more than 300 g.

The next day, the patient’s diet can be somewhat diversified by including fruit and berry juices and compotes (not sour, citrus juices are prohibited), weak broths from chicken or beef, vegetable broths (we do not use cabbage), weak black, green and herbal teas . Dishes should be liquid without the inclusion of hard lumps. It is also allowed to eat some jelly.

The postoperative diet for a hernia of the esophagus is not much different from the diet after other abdominal operations. Easily digestible meals are preferred. On the third day, the patient's diet may already contain mashed semi-liquid soups.

In the future, the diet becomes more diverse: soups, mashed potatoes, liquid and viscous porridge-smear, dairy products (yogurt, fermented baked milk, puddings, milk porridge and casseroles). With a negative reaction of the body to milk, it is allowed to replace it with soy products.

Food should be as close to body temperature as possible. After the operation, swelling of the operated organs and tissues at the puncture sites is possible, and hot and cold food will be additional factors of their irritation, delaying the recovery process.

Do not rush with solid food, because swelling of the esophagus after surgery causes a decrease in the lumen of the organ and associated swallowing disorders (dysphagia). It is desirable to boil porridge strongly, grind soups, boiled and baked vegetables for the first time, eat meat only in the form of minced meat, puddings or mashed potatoes (for example, use meat baby food), chew boiled eggs and scrambled eggs well.

Casseroles (without a hard top crust), puddings and mousses will be a good help to the usual meat, vegetable and sweet dishes. When preparing sweet desserts, you can use milk, vanilla, fruit and berry fillers, but not coffee, cocoa, chocolate, coconut flakes.

The frequency of meals after surgery is at least 6 times a day. Portions should be small and leave behind a slight feeling of hunger, which disappears after 20 minutes. On the second and subsequent days after surgery for a hernia of the esophagus, you can drink up to 2 liters of water per day, but this should not be done during meals.

It is very important not only what and when the patient eats, but also how he does it. You need to eat food slowly, focusing on the process of digestion and chewing well even small lumps in dishes.

At the same time, it is very important to monitor your posture. The back should be straight while eating so that the digestive organs do not experience any pressure at this time and for at least half an hour after eating.

Yes, you should try to stay upright for 30 minutes or more after eating. Sitting is not forbidden, but it is still better to move around a little without heavy physical exertion, bending over, lifting weights, etc.

Both fresh yeast bread and crackers are considered not the best choice after surgery for a hernia of the esophagus. It is best to use a small amount of yesterday's bread or other pastries made without yeast.

Crackers are prohibited because of their ability to mechanically damage the inflamed walls of the esophagus, but they can be consumed when soaked (for example, by adding small pieces of chopped bread fried in the oven or toaster to soups).

Patients should adhere to such a diet for 6-8 months. Further, if desired, you can gradually include the usual foods and drinks in the diet, including soda, which until that time was taboo.

But as practice shows, not everyone returns to their former way of life. It is believed that a habit is formed in 21 days, it is clear that in a few months, patients get so used to a new regimen and diet that they no longer experience passion for their previously beloved heavy, fatty, fried foods.

Clinic	Address	Price
Surgery, Phlebology, Arthrology	Moscow, street 1905, 17 Moscow, st. Malaya Dmitrovka, 8 building 1	On average 25,000 rubles
Scandinavian Health Center	Moscow, st. 2nd Cable, d.2, str. 25, 26, 37	28 000 rubles
Delta Clinic	Moscow, Nastavnicheskiy lane, 6	20,000 - 40,000 rubles
Center for Phlebology and Hernia Treatment	Moscow, Nakhimovsky prospect, 56	39,000 - 87,000 rubles
Road Clinical Hospital	Moscow, st. Stavropolskaya, domovl. 23, bldg. one	23,000 - 24,320 rubles
Email En. Laser Technology Clinic	Moscow, Shmidtovsky proezd, 16, building 2	25 000 rubles

Exercises

Exercise "Scissors". Starting position - lying on your back. It is necessary to raise the legs above the floor, spread them apart from each other, then cross. Perform 5-10 times, then return to the starting position.
Exercise "Bicycle". Starting position - lying on your back. The legs are raised above the floor, then alternate bending / straightening of the legs is performed, simulating cycling.
Exercise "Squats". For one approach, a man needs to do 3-5 squats and 2-3 push-ups from the floor. At the first stage of training, an incomplete squat is allowed to prevent excessive stress on the groin muscles.

After the operation, the patient needs to perform the "Bicycle" exercise.

A complete list of required exercises must be approved by the attending physician. Classes begin with a minimum program, gradually increasing the load. After therapeutic exercises, there should be a feeling of pleasant fatigue in the muscles, the appearance of acute pain, severe discomfort in the inguinal zone requires an immediate cessation of exercises and a visit to a doctor.

Starting position: lying on your back, legs bent at the knees wide apart. Without lifting the shoulder girdle from the floor, tilt the knee of the right leg to the heel of the left leg, return to its original position.

Starting position: lying on your back, straight legs together, arms outstretched to the sides with palms up. Without lifting the body from the floor, reach out with your left hand to the palm of your right, then change hands. Repeat with each hand 5 times.

Starting position: lying on the stomach, straight legs together, arms bent at the elbows, the chin rests on the hands. Focusing on the toes and straining the abdominals and buttocks, raise the knee of the right leg from the floor, keeping the leg straight.

It is undesirable to tilt the torso in a standing position and exercises in which a significant part of the body weight is transferred to one leg (for example, lunges to the sides).

And without exception, all exercises with a hernia of the spine cannot be performed without removing the pain syndrome.

According to specialists in physical therapy, an individual set of exercises correctly selected by a doctor for spinal hernia should be performed regularly and for a long time. But it is worth it to move freely and without pain.

So, for overweight patients, the complex will include exercises aimed at reducing body weight, which, in combination with a diet, will give fairly quick results. With a sliding hernia of the esophagus, exercises are included that help return the organs to their normal position without surgical intervention. And also those that help fight reflux and the pain caused by it, belching, hiccups.

If we are talking about a paraesophageal hernia of the esophagus, then classes in this case will be appropriate after the operation and the return of the stomach and intestines under the diaphragm. When it will be possible to start classes, the attending physician decides based on how quickly scarring of the sutures occurs at the site of suturing the diaphragmatic opening.

Physical exercises will be aimed at strengthening the muscles of the diaphragm and restoring the contractile function of its opening, which serves as an additional external sphincter for the esophagus and does not allow food to return from the stomach back.

These can be both breathing exercises, in which the diaphragm is directly involved, and ordinary physical activities that do not involve an increase in pressure inside the peritoneum. It is at this point that you need to pay close attention so as not to harm yourself if you decide to do the selection of exercises on your own, and not entrust it to a specialist.

When performing any exercises for a hernia of the esophageal opening of the diaphragm, you need to remember a few important points:

In no case should you exercise immediately after eating. Physical exercises are recommended to be done in the morning on an empty stomach, and during the day before the main meals. Breathing exercises can be done a couple of hours after eating, and given that with a hernia, fractional meals are recommended at intervals of 2.5-3 hours, then again it turns out that classes will be carried out before meals.
During classes (however, as in the rest of the time) there should not be any sudden movements: tilts, turns, flexion-extension, jerks. All exercises should be performed slowly, gently and smoothly, listening to your feelings. If the pain intensifies, this is a signal that the exercise is performed incorrectly or physical activity is exceeded and rest is required.
Performing a set of physical exercises, you need to carefully monitor your breathing. Unnecessarily holding the breath, we thereby can provoke an increase in intra-abdominal pressure.
With a hernia of the esophagus, clothing that squeezes the stomach is not recommended, and during classes, clothing should generally be as free as possible and not interfere with proper breathing.
Classes are not held in the acute period of the disease with severe pain and excruciating heartburn. First, with the help of medications and alternative methods of treatment, you need to relieve acute symptoms, and then start training the muscles of the diaphragm. This applies to all exercises, except for relaxation, which, on the contrary, can relieve acute pain.
After surgery for a hernia of the esophagus, physical and breathing exercises are possible only as directed by a doctor. In the first days and weeks after the operation to suture the diaphragmatic opening, as well as in the case of perforation of the esophagus or perforated ulcer, vigorous physical activity can provoke suture divergence.

When choosing exercises for losing weight or maintaining physical fitness on your own, you need to avoid those that require tension in the abdominal muscles, sudden movements, and include the use of weighting agents.

What exercises can not be done with a hernia of the esophagus (q) All those exercises that require straining the stomach. Doctors do not recommend to pump the press, raise the torso from a supine position, work with a barbell, squat with dumbbells, perform the “scissors” exercise that strengthen the abdominal muscles, etc.

Ordinary squats, torso bends, twisting of the spine, elementary exercises for arms and legs are not prohibited for patients with esophageal hernia, but when performing them, overwork and sudden movements should be avoided.

If all these requirements are taken into account, physical activity with a hernia of the esophagus will not do harm, but will only benefit, preventing relapses of the disease.

The choice of effective exercises also depends on the degree of development of the pathology. So jumps that help the stomach and esophagus to take a normal position will be relevant for grades 1 and 2 of axial (sliding) esophageal hernia, and for grade 3 massage procedures are more suitable, movements in which have a strict direction and a more active influence on organs protruding into the chest, than normal vibration.

With a fixed hernia of the esophagus, self-massage is quite dangerous, because the digestive organs are already strongly clamped in the diaphragmatic opening, which increases the risk of pinching, which is life-threatening for the patient. Therefore, such procedures should be entrusted to specialists.

Therapeutic exercises for a hernia of the esophagus are called so because its principle is not “more”, but “more often and in moderation”. You should not include a large number of various exercises in your classes and load the body for half an hour or more.

An active lifestyle, massage procedures, physical and breathing exercises for esophageal hernia are full-fledged methods of treating a disease that cannot be neglected, especially since they have much fewer side effects than drug therapy.

But at the same time, you need to understand that any disease weakens the body, so excessive physical activity will only deplete its strength, which is so necessary to fight the disease, while moderate exercise will help restore them.

The first two exercises are performed lying on your back, arms extended along your body:

Raise your legs outstretched above the floor, maintaining an angle of 45 degrees. We begin to make "scissors", crossing our legs and spreading them again. Starting perform three to four approaches for each leg, gradually increasing the amplitude and number of approaches.
We raise straight legs above the floor and perform a “cycling”. Start with five sets.
Take a position on all fours. Support is made on the elbows, socks and knees. We begin to slowly raise one leg without jerking, leaning on the other. We do five approaches, and change the leg.
Position - lying on the right side, legs straight, resting on the hands. We begin to slowly raise the left leg. Five repetitions, then change the leg.
Sit down, leaning on the right leg, the left one is extended forward, hands are on the knee. We begin to make slight swings with a straightened leg. Change supporting leg.
Take emphasis lying down. Push ups. You can facilitate the exercise by resting on the floor not with your toes, but with your knees.
Stand up with your feet shoulder-width apart. We do squats. Their amplitude depends on the well-being and physical capabilities of the patient.

These exercises should be performed daily, listening to your feelings. If there is pain or other discomfort, it is necessary to interrupt the session. If everything goes well, the load can be gradually increased.

If there is a desire to add a number of other exercises, this can be done only with the permission of the doctor.

An umbilical hernia is a fairly common pathology that can occur in people of all age categories, regardless of gender. In adults, a hernia usually occurs due to a weakening of the umbilical ring, and also due to a persistent increase in intra-abdominal pressure. In children - due to a delay in the formation of the anterior abdominal wall.

Treatment of pathology is carried out exclusively surgically in a hospital setting. institutions, a method of radical therapy called hernioplasty. The operation of the pathology is performed after carrying out diagnostic measures with the condition that the patient has reached the age of 5 years and has no positive dynamics.

Diagnosis of an umbilical hernia

Diagnosis of umbilical hernia is not difficult. Usually, a pediatrician or therapist detects pathology by visual inspection and probing the problem area. An umbilical hernia looks like a spherical protrusion of tissues in the navel. In some cases, an intestinal loop is visible through the thin skin. On palpation of the bulge and surrounding tissues, a defect in the abdominal wall and the hernial sac itself are palpated.

However, for accurate differentiation of the disease, consultation with the surgeon is also required. To exclude other pathologies with similar symptoms, the surgeon may prescribe the following diagnostic procedures:

Esophagogastroduodenoscopy (EGDS).
X-ray methods of research - herniography, radiography of the stomach.
Ultrasound examination of the organs that are in the abdominal cavity, as well as the hernial sac itself.

After the diagnosis is made, the patient is recommended hernia repair to avoid complications.

Surgical techniques for removing an umbilical hernia

The methods of hernioplasty that do not exist today can be classified into the following types:

Hernia repair with the patient's own local tissues. In medical circles, this kind of intervention is called tension hernioplasty.
Surgical treatment using a mesh (an implant made of a polymeric inert material) for hernioplasty. This type of surgery is called tension-free hernioplasty.

The disadvantages of the first option are a long rehabilitation period (up to 12 months) and a high probability of recurrence of the pathology. After all, in the process of plastics, there is a significant tension of the tissues in the area of suturing the hernial ring. This contributes to the insolvency of the seam, improper scarring, postoperative pain syndrome, complications and relapses.

With mesh hernia repair, the recovery period is reduced to 30 days, and the probability of recurrence of a hernia is approximately 3-1%.

Methods for the treatment of umbilical hernia can also be classified depending on access:

Open cavity operation.
Laparoscopic hernioplasty.

The main methods of surgical treatment of umbilical hernia (open type), depending on the method of processing the gate of the protrusion:

Hernioplasty according to Liechtenstein is one of the simplest and safest methods of treatment. It does not require long-term preparation of the patient, is easy to perform, and has the lowest rates of complications and relapses. The only drawback of hernia repair according to Liechtenstein is the relative high cost of the implant.
Hernioplasty (stretch) according to Bassini. This classical method of surgical intervention is used to this day. The best conditions for Bassini plasty are a small protrusion that occurred for the first time in a relatively young patient.
Hernioplasty according to Mayo and according to Sapezhko. These are very similar stretch hernia treatments. The only difference between them is where exactly the umbilical ring is cut. The Mayo method involves cutting the umbilical ring across, and according to Sapezhko, this procedure is carried out along the navel.

The choice of method for umbilical hernia repair depends on several factors: the preferences of the operating surgeon, the characteristics of the clinical picture of the pathology (localization and size of the protrusion), the physiological characteristics of the patient and his financial capabilities.

Preparing for the operation

It should be noted that the preoperative preparation of a patient for laparoscopic or open hernioplasty of an umbilical hernia differs slightly from the preparation for any surgical intervention. After diagnostic measures, the attending physician discusses with the patient and appoints the optimal date for the operation. Before this date, the patient must undergo all the necessary studies by contacting the local clinic:

Determination of blood group and Rh factor.
General clinical blood test.
Blood test for biochemistry.
Blood test for clotting.
General clinical analysis of urine.
Fluorography.
Electrocardiogram.
HIV analysis.
Analysis for hepatitis and syphilis.
Abdominal ultrasound.

Also, if necessary, other laboratory or hardware studies can be prescribed by the doctor.

A few days before an open or laparoscopic hernia repair is performed, the patient should stop taking any anticoagulants and blood-thinning drugs, such as aspirin. In any case, the attending physician should be informed that the patient has taken / is taking such drugs.

The day before the date for which the treatment of umbilical hernia is scheduled, the patient must come to the hospital with things and research results. Some tests may be repeated at the discretion of the physician. There will also be a final examination by the surgeon. You may need to consult an anesthesiologist.

On the eve of the operation, the patient takes a shower and puts on clean clothes, it may be necessary to give an enema. Open or endoscopic hernioplasty is performed in the morning and on an empty stomach, therefore, after dinner, the patient is forbidden to eat food, and it is also advisable to refuse water.

Technique

Laparoscopic hernioplasty is performed under general anesthesia, open - under general or local anesthesia. In most cases, the latter method of anesthesia is preferred, as it is safer for patients with diseases of the respiratory system and cardiovascular pathologies.

All the methods by which an umbilical hernia is treated have almost the same initial stages:

The doctor makes an incision in the skin and subcutaneous soft tissues, finds the place where the pathology is formed.
What is in the hernial sac is either placed back into the abdominal cavity, or, if indicated, is removed.
Next, the method of hernia repair chosen in the preoperative period is applied.
If the hernia is large, the navel will be removed. However, if the protrusion is small, they try to save the navel.
After completion of all necessary procedures, the tissues are sutured.

Laparoscopy of an umbilical hernia is performed using three punctures. An endoscope is inserted into the puncture in the umbilical region, and the tools necessary to remove the hernia are inserted into both others. During endoscopic surgery, a much smaller amount of muscle tissue is injured than during abdominal surgery.

Rehabilitation after surgery

How long the postoperative period lasts and complications - what is the likelihood of their occurrence - these are the two questions that concern patients the most. The length of stay in the clinic depends on the type of operation performed. If it was abdominal, the patient will remain under the supervision of doctors for 7 days. After laparoscopy, a faster discharge is possible.

At home, the patient gradually returns to his usual way of life. It is highly recommended to wear a special bandage that will protect the fragile muscles of the peritoneum from tears and discrepancies.

Recovery time also depends on the type of surgery. Usually, full recovery occurs no earlier than 1 and no later than 12 months.

Possible Complications

Complications after hernioplasty are extremely rare, but the possibility of their occurrence cannot be completely excluded:

Wound infection can occur if a previously undiagnosed focus of inflammation was detected during the operation. In this case, antibiotics are prescribed.
Seroma, that is, swelling of tissues in the area of surgical intervention. It occurs as a reaction of the patient's body to the implant. This is a short-term phenomenon that goes away on its own, does not require treatment.
Hematoma, that is, hemorrhage of blood in the operated area. The hematoma resolves on its own in most cases, but drainage may be needed.
Neuralgia, that is, a disruption in the functioning of nerve fibers, occurs in 1 patient out of 10. Neuralgia manifests itself with pain, burning and other unpleasant sensations, usually disappears on its own within six months of the operation nozzle. Painkillers are prescribed.

Also in the postoperative period, the patient may begin problems with intestinal motility. To normalize peristalsis, the patient is prescribed appropriate medications. It is also recommended to adhere to moderate physical activity and diet.

Diet after surgery

The diet after hernioplasty must be observed for at least 2-3 weeks, and preferably until the end of the recovery period. Food should be as gentle as possible for the digestive tract. Thus, it will be possible to avoid the occurrence of constipation, which is extremely dangerous during the rehabilitation period.

All meals on the patient's menu should be steamed or boiled. And also carefully crushed - into a puree or liquid state. Preference should be given to dietary and natural products that do not cause bloating and are quickly digested by the body. Also during the day you need to use the amount of clean water recommended by your doctor.

Fatty meats, legumes, cabbage, radish, radish - these products are prohibited for use during the recovery period.

Physical activity and sex life

Early but moderate physical activity is what you need for a quick recovery after surgery. Until the stitches are completely healed, you need to:

If possible, move in a supine position, without creating a significant load on the press area.
Get out of bed and walk around the apartment, performing feasible household tasks.
Go outside, walk at a moderate pace for 10-15 minutes several times a day.

Any significant physical activity, weight lifting, sports are strictly prohibited. Return to work is possible in 1-1.5 months, but only if the patient's professional activity is not associated with heavy physical labor.

As for sexual life, any of its manifestations in the first 2-3 weeks should be limited or excluded. When the stitches are completely healed, sex can be resumed, but in a very "delicate mode". Pregnancy after removal of the umbilical hernia is recommended to be postponed until the moment of full recovery. That is, after the operation and until the moment of conception, 10-12 months should pass.

Hernioplasty of an umbilical hernia is the only reliable method to get rid of pathology in adulthood. Children under 5 years old can simply “outgrow” this problem.

Hernioplasty can be performed in several ways - as an abdominal operation or laparoscopy. There are also several subtypes of open surgery, the appropriateness of which is determined in each individual case of pathology. The duration of the postoperative recovery period also depends on which method of surgical intervention was used. But in any case, rehabilitation takes 1-3, more often 10-12 months.