UMBILICAL, EPIGASTRIC AND HYPOGASTRIC PROCEDURES

Umbilical, Epigastric and Hypogastric

A ventral hernia is defined by a protrusion through the anterior abdominal wall fascia. These defects can be categorized as spontaneous or acquired or by their location on the abdominal wall.

INTRODUCCIÓN

Specific types of hernias:

  • Epigastric Hernias occur from the xyphoid process (below the sternum) to the umbilicus.
  • Umbilical Hernias occur at the umbilicus.
  • Hypogastric Hernias are rare spontaneous hernias that occur below the umbilicus in the midline (uncommon).
  • Incisional Hernias occur after surgical incisions.

TREATMENT

Varies, depending on the specific type of hernia you have. In summary umbilical, epi and hypogastric hernias are repaired with the traditional “open” approach. Moreover, incisional hernias Dr. Rosales prefers to repair them, in almost every case, by the laparoscopic approach. The mesh (prosthetic material) used (if required) depends on the specific situation.

UMBILICAL HERNIA
EPIGASTRIC HERNIA
HYPOGASTRIC HERNIAS

UMBILICAL HERNIA

In infants are congenital and are quite common; they close spontaneously in most cases by the age of 2 years. Those that persist after this age are required to be repaired surgically.

In adults, this type of hernia is acquired in most cases; there are more common in women and in patients with any condition that results in increased intra-abdominal pressure.

SIGNS AND SYMPTOMS

 

  • A bulge in the umbilical region is the primary diagnostic finding in most of the cases, and this bulge can enlarge upon increases in the intra-abdominal pressure or the standing position.

 

TREATMENT

Generally, this type of hernias require such a small incision that laparoscopy is almost never the best option; therefore, Dr. Rosales prefers to repair them by using “open or conventional” technique.

Small defects are closed primarily; this means that no mesh (prosthetic material) is needed, the patient’s own tissues are approximated by sutures.

Defects greater than 1.6 inches (4 cm) require a “tension-free repair,” this means they are closed using a prosthetic mesh (to reduce the risk of recurrence and postoperative pain).

EPIGASTRIC HERNIA

Epigastric hernias are two to three times more common in men. These hernias are located between the xiphoid process (just below the sternum) and umbilicus and are usually within 5 to 6 cm of the umbilicus. They are multiple in up to 20% of patients, and about 80% are just off the midline. In the vast majority of cases, the defects are small in size.

SIGNS AND SYMPTOMS

 

  • A bulge in the epigastric region is the primary diagnostic finding in most of the cases; this bulge rarely changes in size with increases of intra-abdominal pressure or standing position.
  • Pain usually is out of proportion to the size of the defect, due to the current incarceration of underlying fatty tissue.

 

TREATMENT

This type of hernia is also repaired by Dr. Rosales using the traditional “open or conventional” technique. Simple closure of the defect, similar to umbilical hernias; small defects can be even repaired under local anesthesia.

Uncommonly, these defects can be sizeable and contain omentum (intra-abdominal fatty tissue) or other intra-abdominal viscera and may require mesh repairs.

HYPOGASTRIC HERNIAS

These types of hernias are so uncommon that is not worth mentioning specific details; diagnosis, symptoms, and treatment are pretty much the same than for umbilical and epigastric hernias.

 

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