Hernias
Hernia operations are among the most common operations performed in Switzerland. Minimally invasive surgery is now the gold standard for inguinal hernias.
In hernia surgery, we treat gaps in the abdominal wall and in the groin. The gaps can be congenital or develop over time. Hernias can also form in the area of the scars after surgery. Parts of the abdominal organs can then protrude under the skin through the gaps in the abdominal wall. If left untreated, hernias become larger and larger over time. Surgical treatment is therefore advisable.
At Swiss1Chirurgie, we offer treatment for all hernias. Whenever possible, we use minimally invasive surgical techniques.
Which hernias are common?
1 Abdominal wall hernia
An epigastric hernia is caused by a weak spot in the abdominal wall. It can occur at any age. It is usually located in the upper abdomen in the midline. The risk of incarceration is quite high with an epigastric hernia, so surgery is usually advisable.
2 Umbilical hernia
An umbilical hernia is caused by an incompletely closed abdominal wall at the level of the navel. This gap is often congenital. In infants, the hernia can close on its own. In adults, it should be treated if symptoms occur or if it increases in size.
3 Incisional hernia
Incisional hernias can occur after an operation in the abdominal cavity. They are very common after operations involving a large abdominal incision, but they can also occur after minimally invasive surgery. Whether they need to be operated on depends on their size and the symptoms. In any case, an incisional hernia should be assessed by a surgeon.
4 Inguinal hernia
An inguinal hernia is the most common hernia of all. Due to a natural weakness in the abdominal wall, the peritoneum can bulge downwards over the inguinal ligament and push intestines downwards. Men are affected much more frequently than women. Inguinal hernias do not always cause symptoms. Nevertheless, they should always be treated surgically as they can become very large over time and cause the bowel to become trapped.
What symptoms do hernias cause?
Hernias are often noticeable as a visible bulge/swelling. This can lead to feelings of pressure or tension, especially when lifting heavy loads. More rarely, the bowel becomes trapped. In this case, the pain is extremely severe and emergency surgery is necessary because the trapped bowel can die.
What diagnostic options are there?
In addition to the doctor-patient consultation, a physical examination and possibly a radiological diagnosis are necessary. Depending on the problem, this can vary between ultrasound, computer tomography (CT) or magnetic resonance imaging (MRI).
How is the operation performed?
The basic consideration is to strengthen the abdominal wall. This is done by inserting a plastic net (polypropylene), which is integrated into the fabric.
The gold standard of inguinal hernia surgery is the laparoscopic surgical method known as “total extraperitoneal hernioplasty” (TEP). This involves inserting a mesh in the space between the muscles and peritoneum using a camera and two working instruments.
Only three small incisions are required on the abdomen, so the method is gentle and allows a quick return to everyday life.
Occasionally, due to special circumstances (e.g. previous operations, large scrotal hernia or severe secondary diseases), we have to decide on open surgery according to Lichtenstein; this is possible under spinal anesthesia and theoretically even under local anesthesia.
For umbilical hernias and epigastric hernias, we decide between an open and laparoscopic technique, depending on the size and cause of the hernia. Here too, a mesh insertion is recommended from a certain size to prevent recurrence.
Incisional hernias must always be repaired using mesh. Otherwise the risk of a recurrent hernia is too great.
How long is the hospital stay after the operation?
Unilateral inguinal hernias or smaller umbilical hernias are generally operated on an outpatient basis. This means that you enter the clinic on an empty stomach and can go home the same day after the operation.
We usually plan the remaining hernia operations with a stay of 2 nights or 3-5 nights for large abdominal wall hernias.