Recommendations after removal of an umbilical hernia. Umbilical hernia: when surgery is needed. Surgery with mesh implants

Surgery to remove an inguinal hernia is performed on newborns, adult men and women. All patients, regardless of the chosen technique and state of health after treatment, undergo to restore the body after anesthesia and further stabilize the internal organs and general condition. Weakness of the connection of the umbilical ring leads to a hernia, and surgical treatment is performed to restore the anatomical position of the internal organs. Each operation has its own rehabilitation period, which can last from a week to six months, and delayed rehabilitation may be required even after decades.

Recovery after surgery in adults is impossible without additional therapeutic measures. Immediately after the removal of the umbilical hernia, the patient must wear a bandage, he is prescribed a strict diet, physical activity is limited, and a course of medications is attributed. After discharge of adults, scheduled examinations are coordinated to monitor the condition, correct nutrition, and undergo physiotherapeutic procedures.

Early rehabilitation period

The stitches are removed after the operation to remove the umbilical hernia in about a week. The procedure for adults is painless, but discomfort is present. Immediately after the seam is exposed, a wide belt or support bandage should be worn. It is possible to completely abandon the bandage only after the complete restoration of muscle tissue, which occurs on average after a month and a half and depends on the rate of wound healing in each individual.

By following all the prescribed preventive measures of the doctor, you can significantly reduce the rehabilitation and wound healing process.

For this, a strict diet, rest regimen, and medication are prescribed. Physical activity, heavy lifting, tension during coughing can lead to suture divergence, suppuration, infection of the wound.

What should be done in the first two weeks after the treatment of an umbilical hernia?

Observe the daily routine: this simple recommendation is not a formality, but a condition for successful rehabilitation of adults. For the first two days, a person should lie and sleep only on his back, on the third and fourth days, you can begin to do simple household work, walk more, but at the slightest fatigue, listen to your body and immediately rest. During this week, dressings and wound treatment are done daily. The entire recovery period is followed by a diet;
For the second week after the stitches are removed, soreness may still remain, therefore, painkillers or injections, physiotherapy procedures are prescribed;
The rehabilitation period of the elderly is more difficult, since it is necessary to monitor the possible occurrence of serious complications: respiratory failure, tachycardia, wound infection.

Massage and physiotherapy after stitch removal

In the postoperative period, massage is indicated more for newborns and children with a congenital defect of the musculo-ligamentous apparatus. Adult patients are also recommended to massage regularly to quickly heal the wound, improve blood circulation at the site of the operation. The procedure can only be performed by a professional, since after the operation the muscles are still weak and easily damaged.

In addition to massage, rehabilitation includes such physiotherapeutic procedures as ultraviolet treatment, electrophoresis, tocotherapy. All this allows you to normalize microcirculation, anesthetize the navel area after surgery and prevent inflammatory processes.

Already from the third week after the removal of the umbilical hernia, you need to start doing gymnastics, performing light exercises on the abdominal muscles. For adults, it is useful to do exercises daily before breakfast, stretch and warm up the muscles. Tilts and turns of the torso, squats, leg raises - all these simple exercises should be done in the umbilical bandage and on a soft rug.

Diet in the postoperative period

A therapeutic diet is necessary to fully saturate the body during the rehabilitation period and prevent digestive disorders.

The diet after the treatment of umbilical hernia is based on the following principles:

Exclusion of spicy, carbohydrate, fatty foods;
Daily meals should include soups, cereals, vegetables, fresh fruits;
Drink plenty of fluids, but limit coffee and milk;
Excluded alcoholic beverages, canned foods.

Immediately after the operation, the patient can only take liquid food to start the digestive system. Gradually, the diet is supplemented with soups, mashed potatoes, meat and steamed fish.

In the postoperative period, it is useful to prepare herbal tinctures at home: rosehip, oak bark, chamomile, sage, yarrow. Infusions and decoctions increase immunity, help reduce pain, relieve inflammation and calm adults after surgery. Nutrition should not be limited only to cereals and soups, for pleasure you can eat sweets, drink juices and a little coffee, but at the same time observe how the body reacts to certain food groups.

Complications and secondary umbilical hernia

Complications after surgery at the present stage of treatment of umbilical hernias are rare, and the reason for this is not a doctor's mistake, but the patient's attitude to the rehabilitation period.

Severe complications after removal of an umbilical hernia:

malnutrition provokes constipation, which increases intrauterine pressure and leads to re-pathology;
an early return to physical work causes divergence of sutures, recurrence of a hernia;
ignoring therapeutic exercises will make itself felt only after a few years, when the weakened muscles disperse, and the organs again lose their usual position.

Recovery after removal of an umbilical hernia: rehabilitation, prevention, diet, bandage

How is an umbilical hernia repaired after surgery? This question, like many others, will be answered by the doctor. An umbilical hernia 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 region. 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.

After the operation to eliminate the umbilical hernia, the rehabilitation of the body begins. It is important to understand that in the first postoperative period, a person will have to stay in the hospital in order to be under the supervision of doctors. In the absence of complications, this period will take no more than one or two days.

Immediately after the operation, the patient is put on a bandage. It should support the stomach and navel area, weakened after the operation. With the permission of the surgeon, you can replace the bandage with a wide belt.

There are cases when the patient is allowed to go home after 2-3 hours after the operation, if the postoperative patient feels well and the body has recovered normally after general anesthesia.

It is also important to have regular check-ups with your doctor after your surgery. If you do not follow the rules, it is fraught with the fact that the hernia will form again in the same place.

The possibility of recurrence of umbilical hernia also depends on the method of operation. Indeed, some methods, for example, as an operation using mesh materials, have a minimum rate of resumption of the navel disease.

But whether the patient is at home or in the hospital, he must be in bed for the first 2-3 days. That is, constantly lie down so that the seams do not open from an unusual load for the body.

Somewhere on the third day, a person may begin to roll over and stand up. At the same time, you need to understand that you need to exclude any physical activity or overwork for several days.

The next day after discharge and for a certain period (and this is 7-10 days), the patient will have to visit the hospital for dressings. Then the patient can make dressings himself. The nurse attached to him will teach him this.

A week after the operation, the patient is prescribed painkillers, antibiotics and physiotherapy sessions, which will help the rapid primary healing of the operated site.

Elderly people after surgery may experience respiratory failure with tachycardia. This may be a bad sign, which is better to tell the operating doctor.

Special treatment after surgery

Like any other operation, the removal of the protrusion requires special care and gentle treatment in the first period after surgery.

In the postoperative period, all the instructions of the surgeon should be followed so that the rehabilitation time passes quickly, without any special negative consequences. The first period the patient will have to abandon the usual way of life. For example, you will need to temporarily forget about physical activity and playing sports.

It is important not to forget about nutrition. No matter how easy the operation is, it should be remembered that this is an intervention in the human body and a certain violation of the integrity of the skin. This means that the body and internal organs need a calm regimen in order to cope with stress and "recover themselves."

A person's nutrition should be carefully monitored during recovery. It is necessary to completely exclude spicy dishes from your diet, eat only natural and healthy foods. Give preference to light cereals and soups that will soften the stool so that the feces are easily excreted from the body. In no case should constipation be allowed.

The first two days after the operation, the patient can only eat liquid food. Gradually, more and more new products can be introduced into the diet so that the stomach gets used to normal food.

Removal of stitches

Somewhere on the 6-7th day after the operation to remove the umbilical hernia, the patient can remove the stitches. This procedure takes only a few minutes and is completely painless. Of course, it cannot be called pleasant, but this is the final stage of the transferred operation.

After removing the stitches, the bandage will have to be worn for another 1-2 months. A bandage or a wide belt helps the body recover until the abdominal area acquires the necessary tone. In addition, the bandage holds the seam, which can disperse from unforeseen stress.

Rehabilitation after various types of umbilical hernia operations

The hernia is disposed of quite easily. There are two main ways to remove an umbilical hernia. The choice of one or another method during the operation depends on the size of the opening of the umbilical ring.

Hernioplasty or classic plastic surgery
Application of mesh implants

These types of operations have their pros and cons. They are used in different situations.

Classical umbilical hernia repair is used during surgery if the umbilical hernia has not reached a large size. In addition, this type is used if the patient has a small ovary opening, since suturing a large opening can cause a re-hernia if ruptured.

Hernioplasty has a longer recovery period. The patient will have to wear a bandage, adhere to a special diet and exclude physical activity for almost a year, otherwise there is a possibility of a relapse - a hernia appears in the same place. This plastic surgery of the navel is carried out under general anesthesia, after which the body recovers more difficult.

If mesh implants are used during the operation, the rehabilitation process is much easier. The bandage will have to be worn for only a month. This applies to both loads and power. In addition, the umbilical hernia is permanently removed by this method - the possibility of recurrence is almost zero, and the operation itself is performed under any anesthesia.

The newest method of operating on an umbilical hernia today is laparoscopy. This technique using a camera is good because it leaves almost no seams, and the rehabilitation period is minimized.

Postoperative rehabilitation in children

As for children, they very rarely experience complications after such an operation. If the hernia did not go away on its own before the baby went to school. Surgeons only help this process to happen.

Rehabilitation in children is completely the same as in an adult.

It may seem that after surgery, the skin around the navel has become less elastic, but this is possible only in the first postoperative period. As soon as the bandage is removed, the muscles will return the lost tone and the navel will return to its natural appearance.

To help the body acquire the necessary strength for recovery will help a special diet. On this issue, it is better to consult a 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 a hernia repair using a mesh, the recovery period is reduced to 30 days, and the likelihood of a 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.

Useful will be:

Prohibited products in the postoperative period

stewed and boiled vegetables;
cereals;
low-fat cottage cheese;
meat;
soft-boiled eggs;
stale bread made from wheat flour;
fresh fruits.

Fiber can be helpful in small amounts. It has a positive effect on defecation. The same function is performed by fresh fruits.

Physical activity

It is strictly forbidden to lift a load of more than 3 kg, heavy physical exertion, abdominal exercises, swimming, jumping, running and walking. You don't have to give up sports completely. Light exercise is recommended.

Often the attending physician prescribes the use of maintenance. It is not worth making a decision on its use independently.

What are the features of rehabilitation in children

Recovery after deletion is very fast. There are practically no complications. Rehabilitation is carried out according to the same principle as in adults. A little complicates the task is that you need to make sure that the baby does not jump and run, so that he does not touch the wound with his hands and does not wet it.

Children are also prescribed a diet. It is necessary to ensure that the child does not develop bloating and constipation.

No exception and the purpose of the bandage. Children need it for a much shorter period. This is facilitated by the absence of excessive physical exertion, rapid growth and elasticity of tissues. The attending physician appoints the specific terms of wearing the bandage.

Timely detection of an umbilical hernia and contacting a doctor will help to avoid unwanted complications, and possibly surgery.

Prevention

Prevention is effective only in the case of an acquired umbilical hernia. For this you need:

eat properly;
exclude food that leads to flatulence and constipation;
exercise regularly;
do exercises for the press;
refrain from lifting heavy objects or use a bandage;
regulate body weight;
use a bandage in the third trimester of pregnancy and after.