Do surgeons ever play with the organs

If the abdominal wall tears, internal organs can escape

Being overweight increases the risk of breaking the abdominal wall or developing a hernia. The peritoneum or parts of the intestine push outwards through a gap in the abdominal wall. In any case, hernias should be treated surgically, says Dr. Bernd Stechemesser, surgeon at the Hernia Center Cologne, Zeppelinstrasse. In an interview with Leading Medicine Guide, the specialist surgeon describes the latest surgical methods in hernia surgery.

Why is there an increased risk of developing a hernia if you are overweight?

Dr. Bernd Piercing Knife: This is very easy to explain: the more weight, the more the entire abdominal wall is under tension. The tissue is heavily stressed and tears can occur in the abdominal wall or around the navel.

What are the most modern surgical methods today when it comes to hernia surgery?

Dr. Bernd Piercing Knife:The laparoscopic procedure is modern today. It's a minimally invasive form of surgery. Laparoscopes or endoscopes, which are rigid devices with a maximum diameter of one centimeter, are brought to the operating field through small incisions in the abdominal wall. At the end of the laparoscope there is a camera and light source or a surgical tool. Even when we operate openly, our incisions keep getting smaller. The latest technique in hernia surgery is the Milos or eMilos technique. The supporting plastic net with which we close the crack is no longer attached to the abdominal cavity, but to the abdominal wall. This considerably reduces possible complications because the mesh and intestinal loops no longer come into contact with one another.

Does such a plastic net stay in the body for life?

Dr. Bernd Piercing Knife:Yes, the connective tissue problem persists for life. But modern meshes are much larger-pored, the plastic is durable and the implant grows optimally into the abdominal wall. Today we only fix it at four to six points and no longer sew it as extensively as before. The network will only be exchanged if it is absolutely necessary, but we try to avoid this if possible.

If a patient has had a hernia operation before, is they more likely to have to have a second operation for the same reason?

Dr. Bernd Piercing Knife:It depends on which method it was operated on. If the break has only been closed with one seam, then the probability is up to 60 percent. If a plastic net was used, the risk is only four to eight percent. In any case, you should contribute to your own health by controlling your weight and avoiding cigarettes after the operation.

Yes? Why do cigarettes also play a role in preventive care in addition to weight?

Dr. Bernd Piercing Knife:Smoking constricts the blood vessels and thus causes a poorer blood flow to the entire body tissue. Scar tissue in particular should be well supplied with blood so as not to tear again.


Smoking after the operation? Bad idea

Anyone who smokes knows that the quality of their skin and hair is negatively affected with each consumption. Not only does it look paler, the skin can also become extremely dry and the pores can clog. Nicotine also reduces the absorption of vitamin C - which in turn is important for our immune system and for all metabolic processes such as hormone formation and the development of connective tissue. It promotes the absorption of iron - a trace element that is responsible for the transport of oxygen through the blood. If you have recently had an operation, you should definitely stop smoking now at the latest: Nicotine leads to wound healing disorders, but also to cardiovascular complications and bleeding.

And what about pregnancy?

During the last few months of pregnancy, the straight parts of the abdominal muscles are pushed apart. So-called umbilical hernias can sometimes develop around the navel. After the birth, this area becomes smaller again, and the abdominal wall becomes compact and closed again through postnatal exercise. However, if a hernia is still felt or painful after the birth, then you should seek advice from a specialist.


Is sport also a part of prevention?

Dr. Bernd Piercing Knife:Exercise ensures good blood circulation and is therefore always recommended. You should only refrain from excessive ab training - in order to possibly achieve a six-pack. You can also get a “break” with it.


What exactly is a (hernia) hernia?

Hernias are caused by weak spots in the abdominal wall. Weak connective tissue and high pressure loads, for example if you are overweight, cause the peritoneum to emerge through the tear or break. Parts of the intestine can get into the hernial sac. As a rule, abdominal wall hernias can be felt or seen as a bulge. In any case, you should definitely consult a doctor.


In the case of an abdominal wall hernia, is it possible without a hernia operation?

Dr. Bernd Piercing Knife:The answer is short and sweet: No. It should always be operated on. Because a hernia doesn't go away on its own. On the contrary, it tends to get bigger and bigger over time. The process can take years. But an intervention at the beginning is in any case less complicated.

Does the age of the patient play a role?

Dr. Bernd Piercing Knife:No, we surgeons do not see age as a criterion. It depends on the overall state of health. And why shouldn't we operate on a fit, very old person and thus restore quality of life?

Can you get a hernia during pregnancy? The abdominal wall is then under great tension.

Dr. Bernd Piercing Knife:Yes, that can happen, but the estrogens in pregnancy soften the connective tissue and thus reduce the risk. It can happen that a pregnant woman gets an umbilical hernia, but the softer tissue does not jam it and often regresses completely afterwards.

Thank you for the interesting conversation and the interesting insights into hernia surgery!

Would you like to find out more about him or do you want to contact the doctor directly? Then visit Leading Medicine Guide.


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