Where is anterior abdominal wall? What is in its structure?

The area between the rib folds and the inguinal regions is called the anterior abdominal wall. The anterior abdominal wall consists of the skin, subcutaneous adipose tissue, muscles, sheaths surrounding the muscles and periton. In the middle region of the anterior abdominal wall, there is a structure in which the baby is connected to the mother with a cord and closes after birth, which becomes the umblicus.

What is abdominal wall hernia?

Abdominal wall hernias are the protrusion of the intra-abdominal organs from any weak point, which is innate or ensuing, in the anterior abdominal wall other than the inguinal region.

How many types of anterior abdominal wall hernia are there?

  • Epigastric hernia
  • Umbilical hernia
  • Incisional hernia

Which complaints do anterior wall hernia cause?

Distention(Swelling) and pain are the most important complaints. The most common complaint is often the distention (swelling) that disappears by lying down or pressing on it. Sometimes pain may be the first sign, but it is often seen with swelling. The most important factors that increase pain are heavy lifting, straining and long standing.

If the organ emerging from the weakness in the anterior abdominal wall cannot return to belly, ie if it is incarcerated in the hernia, severe pain, nausea, vomiting and inability to defecate ocur, this is called a strangulated hernia and requires urgent surgery.

How is the treatment of anterıor abdomınal wall hernia performed?

As in all hernias, the treatment of anterior abdominal wall hernias is surgical closure of the orifice (opening) and strengthening with a synthetic patch. There is no treatment with a corset or any medical product.

Which surgical technis are used?

Before determining the type of surgery, there are some issues that should be considered by the surgeon. The type of surgery is decided after evaluating the patient’s age, current diseases, medications used, the size of the hernia, the rate of the abdominal wall and hernia opening, whether there is an operation before the same hernia and whether there is an infection. Open surgery; It is reached to the area of ​​weakness with the incision made on the herniation. Later, the herniated organs and tissues are sent into the abdomen and the defect is closed to the stitch and reinforced with a synthetic patch. Laparoscopic surgery; It is performed with special devices placed through small incisions made on the opposite side of the hernia at a distance to see the hernia area and perform the procedure. The hernia is seen from the inside with a device called laparoscope and having an optical imaging process. The organs and tissues in the hernia are pulled into the abdomen and the weakness in this area is repaired with a patch, with or without closing the opening.

Since the incisions are smaller than the open method, they have less pain and they have the advantages of returning to normal life earlier. Robotic surgery; It is a procedure similar to laparoscopic surgery, but it provides convenience to the surgeon with 3-dimensional visualisation. By  using a platform away from the patient, the surgeon performs the surgery by guiding the special instruments placed on the patient as in the laparoscopy.