Abdominal wall is water tight compartment with multiple layers of muscles, which not only protects organs but also has many special functions like spine stabilization for erect posture, breathing, micturition and defecation. A Hernia to explain in common words is like a cloth that is torn or has gap in the top layer and the inner most peritoneal layer comes out with abdominal contents. This destabilizes multiple compartments. Hernia repair is not just repair of gap but also includes reinforcing to stabilize layers to support multiple functions of abdominal wall compartment. Recurrence of a hernia after repair can be due to multiple factors but surgeon factor so please follow the rehabilitation correctly to ensure that the muscle layers remain patent.
Repair of the hernia is done by using a mesh sometimes. The mesh is placed in one particular layer of the abdominal wall, either inside the abdomen which is called the ‘In lay technique’ or above the muscle compartment, just beneath the skin and the fat, which is called ‘On lay technique’. In Lay technique is done usually by laparoscopic method and on lay technique in open surgery.
The mesh we place provides reinforcement to the abdominal wall and the abdominal wall continuity is restored by filling or blocking the gap. By closure of the gap, the abdominal contents do not have access to the passage that was present earlier. Hernia repair depends on the initial cause of the gap and identification, closure of the gap and the correction of the predisposing factors.
Blog Written by:
Consultant – GI Surgeon, Laparoscopic Surgeon, Bariatric & Surgical Oncologist