التعريف والنظرة العامة
Broadly termed as فتق repair, hernioplasty is a surgical procedure that treats different types of hernia, especially inguinal hernia, by pushing the organs back to their original position and adding a synthetic meshwork or patch to act as support.
The procedure is often used interchangeably with herniorraphy but they have some notable differences including the fact that herniorraphy repairs the abdominal wall without introducing any supportive device like a patch.
Hernioplasty is one of the most common surgeries performed in the world with an excellent outlook. It does not only repair the condition but also prevent its recurrence.
من يجب أن يخضع للنتائج المتوقعة
Hernia is a general term for a condition characterized by the bulging of organs out of their place usually due to a weak support such as damaged or poorly developed tissues or fascia (a wall of the connective tissues).
There are many types of hernias depending on where they occur. The most common is an inguinal hernia wherein the contents of the abdomen, such as the intestines, go out of the abdominal wall and move to the inguinal canal. In the long term, if the condition is not resolved, the organs may become pinched and result in the obstruction of the intestines (incarcerated) or the necrosis of the gut as the blood supply in the area becomes severely limited (strangulation).
Once the hernia is repaired with hernioplasty, the possibility of a recurrence on the same site is just 1 percent, making the procedure one of the most effective treatment options for the condition. However, hernioplasty is not the primary treatment method for hernia. In many cases, non-surgical methods like weight loss, medications, and change of diet and lifestyle are recommended before surgery is considered.
كيف يعمل هذا الإجراء؟
Hernioplasty may be done either through traditional open method or using a laparoscopic technique. In an open surgery, a huge incision is made in the groin to access the hernia sac while in laparoscopic, three to four incisions are made in the affected area and a laparoscope, as well as tiny surgical instruments, are inserted into these incisions. In cases where the organs have gone out of the abdominal wall, they are simply pushed back into their place. But if the organs slide to the inguinal canal, the hernia sac will be removed first (herniotomy).
The surgeon then looks into the quality of the abdominal wall. If the tissue is healthy, only a herniorraphy is performed since the wall is strong enough to withstand any additional stress. However, if it’s already weak, herniorraphy is performed and followed up by a hernioplasty where the surgeon attaches a mesh or a patch to provide support.
A typical hernioplasty lasts for around 45 minutes to an hour and can be performed under general, spinal (epidural), or local anesthesia depending on the surgeon’s recommendation, the severity of the condition, and the patient’s unique circumstances.
المخاطر والمضاعفات المحتملة
Prior to the actual procedure, the surgeon meets with the patient for pre-surgical assessment and instructions. Those with pre-existing conditions will have to undergo pre-operative care and will be advised to stop taking certain medications to reduce serious risks and complications such as embolism or poor blood clotting.
Patients who undergo the surgery are at risk of developing an infection especially at the wound site, allergic reactions to the anesthesia, death of the tissue due to poor blood supply, damage to the nerves and blood vessels, and infertility among males if the cord that helps transport sperm to the penis is damaged.
- Malangoni MA, Rosen MJ. Hernias. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 46.