Umbilical hernia: postoperative period. Umbilical hernia. Symptoms Diagnostics. Operation

Removal operation inguinal hernia performed on newborns, adult men and women. All patients, regardless of the chosen technique and state of health after treatment, undergo recovery of the body after anesthesia and further stabilization of internal organs and general condition. Weakness of the umbilical ring connection 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 after tens of years.

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

Early rehabilitation period

The sutures are removed after surgery to remove an umbilical hernia after about a week. The procedure for adults is painless, but discomfort are present. Immediately after the seam is exposed, you need to wear a wide belt or support bandage. You can completely abandon the bandage only after full recovery muscle tissue, which happens on average after a month and a half and depends on the speed of wound healing in each individual person.

By following all the prescribed preventive measures by 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, and straining during coughing can lead to sutures coming apart, suppuration, and infection of the wound.

What should you do in the first two weeks after treatment of an umbilical hernia?

• Follow a daily routine: this simple recommendation not a formality, but a condition for successful rehabilitation of adults. For the first two days, a person should lie down 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 diet is followed throughout the recovery period;
• In the second week after removal of the sutures, pain may still persist, so painkillers or injections and physiotherapeutic procedures are prescribed;
• The rehabilitation period for older people is more difficult, since you need to monitor possible appearance serious complications: respiratory failure, tachycardia, wound infection.

Massage and physiotherapy after suture removal

IN postoperative period massage is indicated more for newborns and children with birth defect muscular-ligamentous apparatus. Adult patients are also recommended to have regular massage to fast healing wounds, improving blood circulation at the surgical site. The procedure can only be performed by a professional, since after the operation the muscles are still weak and can be easily damaged.

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

Already from the third week after 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 every day before breakfast, stretch and warm up the muscles. Bends and turns of the body, squats, leg raises - all these simple exercises should be done in an umbilical bandage and on a soft mat.

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 treatment of an 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 drinks, canned foods.

Immediately after surgery, the patient can only take liquid food for start digestive system. Gradually, the diet is supplemented with soups, purees, steamed meat and fish.

In the postoperative period, it is useful to prepare herbal tinctures at home: rose hips, 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 modern stage Treatments for umbilical hernias are rare, and the reason for this is not the doctor’s mistake, but the patient’s attitude towards the rehabilitation period.

Severe complications after removal of an umbilical hernia:

• Not proper nutrition provokes constipation, which increases intrauterine pressure and leads to recurrent pathology;
• return to soon physical work causes suture dehiscence and hernia recurrence;
• ignoring therapeutic exercises It will make itself felt only after a few years, when the weakened muscles disperse and the organs again lose their usual position.

Abdominal hernia is an extremely common disease. According to statistics provided in 2010 by the Amur State medical academy, “More than 20 million operations are performed annually in the world, which is from 10 to 15% of all surgical interventions at all. Every 3-5 inhabitants of the Earth is a potential hernia carrier. The relevance and complexity of the problem lies in the fact that every 8-10 patients (on average 10-15% of patients) experience relapses of the disease.”

With an umbilical hernia internal organs(intestines, big oil seal– plot connective tissue, covering the intestinal loops) extend beyond abdominal wall in the area of ​​the umbilical ring.

Conservative treatment methods are used only in childhood(up to 5 years). Surgery for umbilical hernia is the only effective method therapy of the disease in adults and adolescents.

Indications for surgery

Emergency surgery to remove an umbilical hernia is performed in the following cases:

In other cases, a planned operation is performed in the absence of contraindications. It is prescribed taking into account the patient’s condition and needs. In some cases, the doctor may insist that it be carried out as soon as possible. Even if there is no rush, it is better not to delay and perform the operation at the first opportunity.

Contraindications

Surgery to remove an umbilical hernia is not performed in the following cases:

1. Children's age (up to 5 years). In infancy, there is a chance that the hernia will disappear on its own as the body grows. So if she doesn't hurt serious concerns and has no complications, the operation is not performed or postponed for several years. Important! It's about only about noncongenital hernias.
2. Infections in the active stage. The operation is a risk in this case, so it is performed after complete sanitation of the body.
3. Incurable diseases. A hernia is not dangerous disease, especially on early stages. However, its removal poses a certain risk, which there is no point in exposing terminally ill patients to.
4. Pregnancy in the second half. Any surgery is a stress for the body, which is best avoided by a pregnant woman. In the absence of serious health risks due to a hernia, surgery is postponed until the end of lactation or at least until the birth of the child.
5. Stroke and heart attack. Anesthesia in this state is difficult to tolerate, so patients are usually not exposed to such risks.
6. Disturbances in cardiovascular and pulmonary activity.
7. Giant hernias in people over 70 years of age. In this case, extensive surgical intervention is required, which is poorly tolerated by older people.
8. Liver cirrhosis with complications.
9. Varicose veins of the esophagus.
10. Diabetes due to lack of effect from insulin administration.
11. Severe renal failure.

Important! Each case is considered by a doctor individually. Only a specialist should decide whether the potential effect of the operation outweighs the risks for the patient or not.

Preparing for surgery

The patient needs to within a month before the planned surgical intervention:

3 days before surgery you need to stop taking blood thinners. Before visiting the hospital or medical Center everything needs to be done hygiene procedures, it is advisable to shave your stomach and pubis (otherwise the nurse will do this). In the morning you need to stop drinking and eating.

Types of surgery and progress

Principle of surgery

The operation can be performed under a guidewire (into a vein) or local anesthesia(the area around the navel is chipped). This point is discussed separately with the doctor. With conduction anesthesia, painful sensations are excluded, but after the operation the patient feels worse, attention is impaired, and weakness is present. In case of relapse of the disease or emergency surgery, it can be used general anesthesia using an intratracheal tube.

During planned surgery, hospitalization usually occurs on the day of surgery or the day before. You will have to spend 3 to 5 days in the hospital. The main surgical techniques are described below.

Intraperitoneal Olshausen method

The technique is used for embryonic hernias. After the onset of anesthesia, the surgeon opens the hernial sac and returns all the contents back to abdominal cavity. Sometimes there may be a liver in it, in which case an additional incision is made to reduce it.

If there are unresolved embryonic organs (intestinal duct, allantois) in the hernial sac of a newborn child, they are removed. The hernia membranes themselves are excised. The fabrics are sutured in layers.

Hernioplasty using Sapezhko, Lexer or Mayo methods

This is a traditional method of treating hernia in children over 5 years of age and adults. Various methods They differ slightly in the location of the incision, the method of separating the hernial sac and the application of sutures. The choice is made based on the location and size of the protrusion.

After the onset of anesthesia, the surgeon makes an incision directly adjacent to the hernia. If it is small, then they try to preserve the navel for reasons of aesthetics appearance patient.

The surgeon peels off the hernial sac from subcutaneous tissue. It is released, and the autopsy is performed in the cervical area (the actual opening from which the internal organs “fall out”). After this, the contents of the hernial sac (intestines, etc.) are “refilled” back into the body cavity. The neck is tied with silk threads. The hernial sac is removed. The fabrics are sutured in layers.

The recovery period is quite long and can reach one year. This technique is fraught with complications, the risk of which is higher than with minimally invasive interventions. Painful sensations persist for 2-3 months after surgery.

Surgery using mesh implants

The technique was put into practice about 30 years ago. It is carried out similarly to the previous method: during a planned operation, the contents of the hernia are immersed back into the abdominal cavity; during emergency intervention and detection of foci of necrosis, it is removed.

The main difference is a mesh implant is sewn into the tissue. It relieves the body cavity of excess pressure and prevents the development of relapses. The mesh gradually becomes overgrown with its own tissues; it does not cause an immune response and does not decompose, since it consists of chemically inert, biocompatible materials.

The mesh endoprosthesis is fixed using special non-absorbable threads. They are made from prolene. More modern techniques involve the use of a stapler and securing the implant with tantalum staples. Abroad, they began to produce meshes with Velcro, which simply need to be pressed onto the underlying tissues for fixation.

Laparoscopic surgery

This type of intervention has additional contraindications. It is not recommended for:

• For immunodeficiencies, including HIV infection.
• In cases of liver dysfunction;
• During menstruation.

Most often, laparoscopy is used in combination with mesh implant prosthetics.

During the operation, the surgeon does not make an incision, but three small punctures. Special tubes called trocars are inserted into them. The largest is located in the navel area. This is where the endoscope with camera and light source is placed. The rest are filled with instruments for the necessary surgical procedures. A grabper is placed in one - a device for capturing tissue and delivering an implant. A suture device or stapler with staples is inserted into the other puncture.

laparoscopic method for removing umbilical hernia

Much less after laparoscopy recovery period than after standard operation. This is associated with little trauma to muscle tissue and a reduced risk of injury. nerve endings.

Complications

Most often, patients after surgery encounter the following complications:

1. Wound infection. Hernioplasty is a “clean” (implies absence of contact with potential pathogens) operations, therefore antibiotics are not indicated after it. As a preventive measure, they are prescribed if a focus of infection has been detected or once for patients over 60 years of age.
2. Seroma. This is swelling in the surgical site. Most often it occurs when using an implant as a reaction of the body to foreign body. There are no signs of inflammation. Seroma resolves on its own within a few weeks. No treatment is required. However, it is necessary to visit a doctor and possibly do an ultrasound to rule out recurrence of the hernia.
3. Hematoma– hemorrhage in the surgical area. Just like seroma, it can resolve on its own, but in most cases doctors prefer to open the wound and ensure fluid drainage.
4. Neuralgia– dysfunction of nerve endings. Complications occur in 10-15% of cases. Patients are concerned about pain, loss of sensitivity, burning and itching in the surgical area. Neuralgia, as a rule, goes away on its own within 6 months after the nerve endings are restored.
5. Paresis (obstruction) of the intestine. To prevent it, drugs that enhance peristalsis are taken, the patient needs to perform physical activity, and in the first hours after surgery - breathing exercises.

Is there an alternative to surgical treatment?

Official medicine claims that only through surgical intervention is it possible to remove a hernia. On the sites traditional healers and their followers you can find different recommendations:

• Taking various herbal remedies.
• Reduction of the hernia and sealing it with a plaster.
• Taking plantain seeds.
• A compress made of clay or a mixture of honey, propolis and iodine, which must be applied to the hernia.
• Pouring cold water or cold water and vinegar.

Doctors warn that none of these methods have scientific basis. Moreover, delay can be dangerous, since there is always a risk of strangulation of the hernia and the development of necrosis. At the first diagnosis, it is necessary to start planning the operation, and not waste time on ineffective and dubious means.

Only in children can the disease go away on its own.Remember, an umbilical hernia in adults cannot be cured without surgery!

Rehabilitation period

At planned operations and uncomplicated hernias, the recovery period is easy. The patient can take food the next day after surgery. It's better to give preference first easily digestible products in liquid or semi-liquid form. With traditional hernioplasty, turning in bed is allowed on the second day, and on the third day you can get up and walk a little.

Old school surgeons sometimes recommend long-term bed rest– up to 2 weeks. Modern specialists They call this tactic wrong. So, Doctor of Medical Sciences V.V. Zhebrovsky notes: "Early physical activity prevents the patient from the occurrence of thromboembolism, pneumonia and other complications from the cardiovascular and respiratory systems sick." Many foreign surgeons share the same opinion.

The diet should be maintained for up to 2 weeks. It is possible to prescribe a course of analgesics to relieve pain symptom. A bandage or special underwear may also be recommended during the recovery period. They prevent the risk of relapse. Women can use a support belt for pregnant women as a bandage after surgery - its effect is similar.

Cardiovascular and pulmonary failure may occur in the first hours or even days after surgery in patients with giant hernias or in elderly patients. To prevent this, they must take a position in which their head is higher than their feet and breathe in humidified oxygen. In some cases it may be necessary artificial ventilation lungs.

Rehabilitation of patients with strangulated hernia, who underwent urgent or emergency surgery, is difficult. To prevent the development purulent inflammation they are shown:

• Wearing a tight bandage.
• Daily inspection of the wound, dressings,
• Punctures for the development of seroma or hematoma.
• A course of antibiotics.
• Use of physical therapy.

After discharge, all patients must observe restrictions on physical activity (up to 4 months). Return to work is possible 4-6 weeks after surgery. If the job involves heavy physical labor, a transfer to another position is necessary. It is possible to apply for disability.

Video: features of the postoperative period

Umbilical hernia can be congenital or acquired. In most cases, the first one is reduced or operated on in childhood. Acquired large umbilical hernia in adults can only be treated surgically. In addition, hernias can be:

• Reducible (free). With such a hernia, the protrusion disappears when the patient is in a lying position. Reducible hernias are typical for initial stage diseases.
• Irreversible. In this case, the protrusion cannot be corrected. This type of hernia is typical for advanced stage, in which fusion of the hernia with the hernial opening is possible.

Symptoms of a navel hernia

• Swelling in the navel area, which may be accompanied by redness. If a person accepts horizontal position, the hernia completely disappears.
• Enlarged umbilical ring.
• Nagging pain in the abdominal area at rest, as well as during coughing and physical exertion.
• Intestinal problems: constipation, flatulence, obstruction.

Diagnosis of umbilical hernia in adults

To determine the extent of the disease and exclude other pathologies, it is necessary to undergo a number of examinations:

• examination by a doctor and palpation to determine the size and location of the hernia;
• Ultrasound to determine the condition of the hernial sac;
• X-ray of the stomach and duodenum to identify tumors or other diseases that led to the occurrence of a hernia;
• gastroscopy of the stomach and duodenum;
• blood and urine tests.

Treatment of umbilical hernia

If in children an umbilical hernia can be reduced, then in adults it only needs surgical treatment. This is associated with a high risk of strangulation of prolapsed organs. During surgery, the doctor eliminates the protrusion, sets the prolapsed organs and strengthens the umbilical ring. The operation can be performed open or endoscopically. Modern techniques hernioplasties are low-traumatic interventions that allow you to quickly return to ordinary life and having a low risk of developing recurrences after an umbilical hernia in adults. Contraindications to surgical treatment umbilical hernia are:

• pregnancy,
• the patient has chronic diseases that do not allow the use of local or general anesthesia.

The following will be useful:

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 will be beneficial in small quantities. It has a beneficial effect on bowel movements. Fresh fruits perform the same function.

Physical activity

It is strictly prohibited to lift loads of more than 3 kg, large physical exercise, abdominal exercises, swimming, jumping, running and race walking. There is no need to give up sports completely. Light gymnastic exercises are recommended.

Often the attending physician prescribes the use of a supportive medication. You should not make a decision on its use on your own.

What are the features of rehabilitation in children?

Recovery after removal is very fast. There are practically no complications. Rehabilitation is carried out according to the same principle as for adults. What complicates the task a little is that you need to make sure that the baby does not jump or run, 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 or constipation.

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

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

Prevention

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

• Healthy food;
• exclude foods that lead to flatulence and constipation;
• exercise regularly;
• do abdominal exercises;
• refrain from lifting heavy objects or use a bandage;
• regulate body weight;
• use the bandage in the third trimester of pregnancy and after.

Video: Rehabilitation after hernia removal

Surgery for umbilical hernia is now one of the simplest surgical interventions. This is usually a planned procedure. In some cases, when positive result, the patient can be home in a few hours, a recovery and rehabilitation period is necessary.

Umbilical hernia after surgery- the issue is resolved, and most often, the patient no longer returns to this issue, but only if he behaves correctly during the recovery period.

Surgery now uses three main methods for removing an umbilical hernia:

• Implant installation;
• Grid installation;
• Laparoscopy.

The last option is the most gentle, as it is performed through punctures, and the patient will not have any obvious stitches. But the doctor, based on the individual diagnosis of each patient, chooses one or another type of intervention.

The recovery period after laparoscopy is the easiest, and often the patient goes home a few hours later under the supervision of doctors.

If the operation involves installing a mesh or implant to support a weakened muscle wall, the patient must undergo a recovery course in the clinic for about 5 to 7 days, depending on the condition.

For any type of surgeryumbilical hernia, rehabilitation after surgery necessary.

Postoperative period

1. Immediately after the end of the operation, after recovery from anesthesia, the patient is observed by an anesthesiologist and the attending physician who performed the operation.
2. During the first hours, it is necessary to observe bed rest and minimal activity - the area with sutures should be motionless.
3. After the operation is completed, the following are prescribed: painkillers, antibiotics, and, if the doctor sees relevance, physical therapy.
4. If the operation was abdominal in nature, on the 2nd - 3rd day, after examination, the doctor decides to allow you to get up and move around. Most often, you will not be allowed to sit after this kind of intervention.
5. After surgery to remove an umbilical herniait is necessary to use a special device - a bandage. The doctor will personally recommend the size and type, most likely, he will do this before the operation so that you have it with you right away.

Special means

To prevent the release of the hernial sac and reduce pressure on the suture area, it is necessarybandage after umbilical hernia surgery. It's individual postoperative remedy, which is selected taking into account physiological and operational characteristics.

The bandage can be either highly specialized or universal, and during the same operation for two patients, the doctor may prescribe the wearing of different devices.

You should not independently make a choice in favor of one model or another, or agree to use someone else’s bandage. This is a very individual thing, since when choosing, the doctor is based on several characteristics and features of the surgical intervention.

How long to wear a bandage after umbilical hernia surgery, at the first moment even the attending surgeon will not answer you, since the course of the recovery and rehabilitation period different for every man.

Most likely, the wearing period will be from two months to six months, depending, again, on many conditions.

Diet

Diet after umbilical hernia surgery– a separate, very serious topic. Most patients, as soon as they have the opportunity to move and choose their own food, forget about caution.

Patients should knowwhat can you eat after umbilical hernia surgery, how often to eat, and what foods are strictly prohibited in the first days.

It is important to know the basic rules of nutrition:

• Eat 4-5 times a day, in small portions;
• Monitor the quality of the diet, the balance of necessary elements in them;
• Avoid complex dishes;
• Avoid fatty and spicy foods and snacks;
• Avoid fried and baked foods;
• Minimize or avoid consuming dairy products;
• Avoid alcohol.

Opt for boiled, stewed or steamed vegetables. Avoid foods such as potatoes, cabbage, and legumes - they lead to excessive gas formation, and this can damage the postoperative area.

To improve gastric motility, choose foods rich in carbohydrates, less fat, and low in protein.

What can you eat after umbilical hernia surgery?:

• In the first days it is better to stick to liquid food;
• Fruits and vegetables rich in fiber;
• Buckwheat without milk;
• Egg;
• Lean meat;
• Fish.

You need to return to your usual food carefully, introducing complex dishes into your diet only 2–3 weeks after surgery. Some weight loss will be beneficial, and the recovery period will be significantly reduced.

Activity in the postoperative period

Umbilical hernia after surgerywill disappear, but your responsibility for your lifestyle is a condition that the problem will not return.

In the first day or two after surgery, it is better to stay in bed and move minimally. By following your doctor's advice, you can recover quickly.

From active movements possible suture divergence, implant or mesh displacement. This threatens the patient with repeated surgery.

After 3–4 days you are allowed to get up and perform some hygiene procedures. But, it is worth excluding such movements as:

• Incline;
• Squat;
• Lifting things from the floor;
• A sharp bend from a lying position to a sitting position;
• Body rotations;

Recovery after umbilical hernia surgerydepends on the first postoperative days - the more accurately the patient follows the doctor’s orders, the faster and more painlessly the rehabilitation period will pass, and the return to to the usual way life.

Rehabilitation after umbilical hernia surgery in adults

7 days after surgery, as a rule, the patient’s stitches are removed and discharged from the hospital. Butrehabilitation after umbilical hernia surgery in menmust continue.

It is necessary to visit a doctor for dressings and examination. In no case should you do dressings yourself, since the slightest changes that an experienced surgeon will notice may not be noticed by the patient.

It is necessary to continue wearing the bandage and remove it only after the doctor's permission.based on the system:

• Proper physical activity to return to your usual lifestyle and condition;
• Proper nutrition to be careful with sutures and implant;
• Visit a doctor to give further recommendations and monitoring.

Nutrition

Recovery after umbilical hernia surgerywill be of high quality and fast if you follow the nutritional rules for up to 3 months. This is exactly the period when internal and external seams will no longer be at risk.

From postoperative diet you should go out slowly, start eating more complex products in small quantities. The following rules must be followed:

• Maintain a balance of proteins, fats and carbohydrates;
• Give importance to fortified, healthy food;
• Be sure to have a liquid lunch once a day;
• Monitor gastric emptying and avoid constipation;
• Avoid alcohol and cigarettes, since the condition of blood vessels is the main condition for a quick recovery.

Operation on umbilical hernia, and postoperative periodwill pass easily if proper nutrition, both before and after surgery, becomes your habit.

Physical exercise

As soon as the patient leaves the hospital walls, an important stage begins.Rehabilitation after an umbilical hernia in adults– a systematic approach to recovery and return to a normal way of life and work.

In the next three months, you need to start increasing the load, but within acceptable limits, without fanaticism. If you play sports, under no circumstances return to your previous activities.

It is good if the patient consults with a physiotherapist, and he, based on the doctor’s opinion, will develop an individual recovery program.

1. The first exercises three months after surgery should be exercises in a lying position without putting pressure on the abdominal and chest muscles. Perform the exercises without removing the corset.
2. Breathing exercises to strengthen the anterior abdominal wall are necessary before starting strength exercises.
3. Cardio exercises will help you get back into shape after prolonged periods of static activity.

Correct loads, diet, wearing a corset, refusal bad habits, will be able to reduce the periodrehabilitation of umbilical hernia in adults. The desire and serious attitude of the patient and unquestioning compliance with the doctor’s instructions are the main conditions for a quick return to work, sports, and a normal lifestyle.