Treatment of large hernias
Written by:An eventration is the result of dehiscence (rupture) of an incision made in the abdominal wall (laparotomy) after previous abdominal surgery.
The rupture causes the abdominal wall to separate and allow intraabdominal content to escape : small bowel loops, intra-abdominal fat, etc., which is no longer protected by a solid tissue of the wall, but only by subcutaneous fat and skin.
The patient experiences the sensation of a bulge in the abdomen that increases with the efforts, pain at that level, intestinal obstruction in case of outflow of small intestine, and of course an important aesthetic deformation in cases of large hernias.
Influence factors such as correct closure of the abdominal wall at the end of surgery, and other derivatives of the patient himself: smoking, obesity, treatment with corticosteroids or lack of proper postoperative rest.
Eventrations treatment
The only solution is surgery to repair the abdominal wall. After suturing the abdominal wall correctly it is widely accepted that a mesh should be placed to reinforce the wall and that it should not be broken again.
The current trend, advocated by the most prestigious Units of Abdominal Wall, is not only to "cover" the eventration hole, but to carry out an authentic reconstruction of the wall leaving the anatomical (muscular) structures in their original place, previous to the appearance of eventration.
This when the eventration is very large means that, in order to reconstruct, it is necessary to release (separate) some components of the abdominal wall (muscles and aponeurosis) from others, in order to reestablish the anatomy and make the suture without tension.
The separation of components is a technique that achieves, not only recover the anatomical structure almost original, but what is fundamental functionality or what is the same the biomechanics of the abdominal wall, so that it works properly and does not cause secondary problems (pain , bad positions, etc.).