The surgical pathology of the abdominal wall includes the pathologies with the highest prevalence in the general population: inguinal hernias, ventral hernias (umbilical, epigastric) and incisional hernias (eventration) and rectus diastasis, among others.
The recurrence (recurrence), when done with simple closure (without mesh) is around 15%, with surgical mesh placement, in groups with experience it has decreased to 2% to 3%, as are the techniques we currently use.
When there is recurrence or recurrence, ideally it should be done with a different technique than the one used in the first surgery, hence the importance of having a specialized surgeon, who knows several surgical techniques, preperitoneal open surgery (Nyhuss technique) laparoscopic, to obtain better results.
There are patient-dependent factors, adequate postoperative rest and control of factors such as obesity, tobacco consumption and/or avoidance of certain overexertion will be fundamental to avoid the appearance of hernia recurrences.
Inguinal hernias are the most frequent, generally of congenital cause. They are due to alterations during fetal development, which lead to the inguinal ring (through which the testicle and the elements of the testicular cord pass) towards the scrotum, not closing completely, favoring later the passage of the intestine and the fat that covers it, through this ring towards the inguinal canal.
And on the other hand, there is also the indirect one, which is due to degeneration and loss of strength of the muscles of the abdominal wall. They occur in advanced ages and almost always in males favored by:
- Weight lifting.
- Chronic cough.
- Continuous efforts to make of the belly.
- Overweight or obesity.
- Muscle ruptures.
- Ascites.
- Peritoneal dialysis.
- Malnutrition.
- Pregnancy.
We also have the additional ones from previous open surgery (eventration) or from laparoscopic surgery trocars that have the same cause as the direct ones.
In recent years, although it has been done for several decades, meshes are placed, almost in 100% of hernia operations, and also with the emergence of many different techniques and laparoscopic hernia surgery, for some cases such as recurrent or bilateral hernia. As well as the use of meshes of different types and different forms of fixation, including self-adhesive.