Epigastric Hernia Surgery
An epigastric hernia usually develops in the epigastrium, i.e., the upper central part of the abdominal wall, between the belly button and the rib cage.
Epigastric hernias are usually small as only the midline of the abdomen breaks through the surrounding tissue. These type of hernias are generally painless and may not be noticeable when lying down. Their presence sometimes is harmless, making it difficult to detect it. However, about 2 – 3% of all abdominal hernias are epigastric hernias.
Although epigastric hernias are usually present from birth, they can be caused due to various reasons which weaken the abdominal wall muscles such as obesity, pregnancy, coughing fits, heavy lifting or physical labour.
Unlike the benign diastasis recti, the epigastric hernia may trap fat and other tissues inside the opening of the hernia, causing severe pain and tissue damage.
What To Expect After The Laparoscopy Procedure
- An alternately emerging and flattening lump along the central region of the abdomen that causes severe continuous pain.
- Redness and tenderness over the lump
- Severe pain in a specific spot while straining during bowel movements.
Epigastric Hernia Surgery
TAPP is a minimally invasive surgery performed under general anaesthesia.
- Open surgery is better suited for a smaller hernial growth where there isn’t any visible peritoneal sac through the abdominal wall, which is mostly the case with epigastric hernias.
- It is generally performed under local anaesthesia in adults. However, in kids, surgery done under general anaesthesia, require special care and attention.
- The incision is made through the skin and subcutaneous fat to expose the herniated surface.
- As the lump is usually small, it is easily repositioned with a few sutures without the necessity of any mesh.
Laparoscopic Epigastric Hernia Repair
- Laparoscopic treatment is used only for larger epigastric hernial growth which could be visualized by the laparoscope. The laparoscopic approach cannot be used for small epigastric hernias because there is no visible peritoneal sac from inside the abdomen.
- It is performed as a regular laparoscopy surgery where a laparoscopic camera and two to three operating trocars are introduced within the abdominal wall through tiny (less than quarter inches) incisions made away from the epigastrium for the operative trocars.
- The hernial growth is repositioned, and the damaged wall is sutured with the laparoscopic tools.
- A synthetic mesh is placed over the sight through one of the tools to strengthen the wall muscles further.