The term defines the protrusion of an intra-abdominal organ through a weak spot or a gap of the abdominal wall. Predisposing factors for hernias are the following:
- Incomplete formation of the abdominal wall, causing hernias to neonatal and infants.
- Degeneration of the abdominal wall due to age, malnutrition and insufficient diet.
- Systematic and prolonged increase of the abdominal pressure due to obesity, chronic cough, constipation, multiple labour and heavy craftwork.
- Trauma and previous open surgical operations.
Several hernias are categorised according to their location and their pathogenesis:
Epigastric hernias or linea alba hernias, locating between the sternum and the umbilicus.
Umbilical hernias, locating between the umbilicus.
Inguinal and femoral hernias, locating at the groin or at the area where the large vessels pass from the torso to the thigh.
Post-surgical hernias, locating at previous incisions.
Modern surgical treatment of hernias is performed by applying the principals of minimally invasive surgery. Every type of hernia can be treated robotically or laparoscopically, offering numerous advantages to the patient:
- Complete application of minimally invasive surgery.
- Very small incisions, by which we minimize surgical trauma.
- Minimizing post-surgical pain.
- Excellent aesthetic result, practically leaving no scars.
- Early recovery and hospital discharge.
- Less hospital cost and faster return to work.
- Maximizing image 10-15 times, achieving minimal tissue trauma and bleeding.
- Almost extinction of post-surgical complications related to the wound, such as infection, herniation, chronic pain etc.
- Fewer respitory and cardiovascular complications.
- Avoidance of post-surgical adhesions.
- Protection of the patients from disease transmission (hepatitis, AIDS), once single use tools are utilized.
- Repair of bilateral inguinal hernias through the same incisions.
- Operation of choice for the repair of recurrent inguinal hernia after previous open repair.
- Operation of choice for the repair of athlete’s hernia.
Abdominal abductors syndrome or athlete’s hernia is a well-known condition affecting athletes and young people with intense physical activity. This condition occurs due to the progressive degeneration of the posterior wall of the inguinal canal, resulting to an invisible, small and clinically not detectable inguinal hernia. Athlete’s hernia is associated by groin pain escalating during physical exercise, while the frequency and the intensity of the symptoms are worsening. Pain is usually located at the groin, the perineum and the haunch. Increasing intra-abdominal pressure can reproduce the pain or cause reflection to the testicles.
Treatment is exclusively surgical. Robotic or Laparoscopic total extra-peritoneal repair with mesh placement offers the best results. The repair is done through three small incisions of few millimetres, without injuring the lower abdominal muscles, such is done with open procedures.
The benefits are more obvious in cases of bilateral hernias, when the repair is performed through the same small incisions as in the unilateral cases.
After the operation the patient feels little or no pain at all, returns to training after two weeks and in full activity in four weeks, in contrast with the open surgery, where the recovery usually lasts 3-4 times longer.