The advantage of going through epigastric hernia surgery is that you can avoid the pain caused by epigastric hernia and if the epigastric hernia is left untreated and if the surgery is not performed, there can be severe complications. In this section of the article you will learn about the treatment for epigastric hernia, surgery complications, recovery period/ healing time and risk factors for epigastric hernia.
Treatment for Epigastric Hernia
Treatment for an epigastric hernia is not an easy task. Sometimes it requires an emergency operation but sometimes operation can be avoided as the baby is not old enough for epigastric hernia surgery. Toddlers take the surgery for epigastric hernia better than the infants. It is always better to wait for the right age to perform the surgery for epigastric hernia if possible.
When is Epigastric Hernia Considered as a Crisis/Emergency?
An epigastric hernia can lead to incarcerated hernia. An incarcerated hernia is an epigastric hernia that becomes stuck in the “outside” position and beneath the human skin. Incarcerated hernia mostly cannot be an emergency situation but even if it is not medical help should be taken immediately. It can be considered as emergency only when the tissue that creates a bulge in the stomach is not receiving any blood from the body. This kind of situation is called “strangulated hernia”. The tissue might die due to this bulging. Changing of the color to deep red or purple can be a symptom by which strangulated hernia might be recognized. It is sometime very painful and it also can cause vomiting, nausea, abdominal swelling and diarrhea.
Surgery for Epigastric Hernia
Surgery for epigastric hernia like all other surgeries is performed with the help of common anesthesia and will be performed on an impatient or outpatient ground. Children going through epigastric hernia surgery should get the perfect preparation of the surgery. This surgery should be done by a pediatric colon-rectal specialist or a pediatric general surgeon. Starting with the anesthesia, the surgeon start with a cut on any one side of the epigastric hernia. One side of the incision is utilized for surgical instruments whereas Alaparoscope is inserted into one notch. The surgeon tends to isolate the area of the stomach lining by pushing past the muscle. This particular tissue is known as the “hernia sac”. After he/she returns the epigastric hernia sac to its initial place, the surgeon begins to mend the muscle fault.
Smaller defect in the muscle may get the sutured closure. The sutures are kept in that place permanently, and will also stop epigastric hernia from returning. Larger faults may make the surgeon think that the suturing is no more enough. For larger flaws a mesh graft is made used to fill the cavity. This will also be permanent and even if the defect is open this mesh will prevent the epigastric hernia from recurrence.
Larger defects may not be able to take the suture method and it may get the epigastric hernia back on its place. When the mesh is used the chances of epigastric hernia getting back is minimal, but sometimes even that is not enough when the individual has a previous history of rejecting any sort of surgical implants. It can also not work if the patient is not in a condition to use the mesh.
After the surgical mesh is put in its place the muscle can be sewn and the laparoscope will be taken out and the incision closed. This closure can be done in several ways. Firstly with the help of the sutures that is removed with the next visit to the surgeon. Secondly the incision can be help closed with the help of the glue or minute bandages which are sticky known as steri-strips.
What are the Complications of Epigastric Hernia Surgery?
- Wound infection can be a complication of epigastric hernia surgery. Infections may occur after the surgery if not taken care properly. This can be treated with the antibiotics. Also they are given during the operation to minimize the risk of any sort of infection.
- Wound hematoma is a complication of epigastric hernia surgery. A firm swelling can be seen if there is bleeding under the skin. This may result in leak out through the wound. A lot of fluid may lead to the operation table one more time.
- Recurrence of epigastric hernia is a possible complication of epigastric hernia surgery. There is only a 1 to 5 percent chance of the recurrence after the epigastric hernia surgery.
All the risks and complications will be given to your knowledge by the surgeon before you sign any kind of consent form.
What Should You Expect after Epigastric Hernia Surgery?
Epigastric hernia surgery will definitely bring complications and these should be taken really good care of. Some of the things you can expect after epigastric hernia surgery are:
- You will be able to consume fluids and as soon as you are able to tolerate them you will progress slowly to a light diet.
- Stomach wound pain or any sort of uneasiness is expected after the epigastric hernia surgery.
- Pain relief medicines or injections will be required for the first 24 to 48 hours after the epigastric hernia surgery.
- You can take a shower after the epigastric hernia surgery only after the temporary dressing is removed. That will be after 5 days after the operation.
- Giving any sort of strain to your stomach by constipating is to be avoided strictly.
- You may feel sick after the epigastric hernia operation. You can ask the nurse and she can give you injections to make you feel better.
- You are supposed to take in a lot of fibre in your diet and also drink plenty of fluids. If you face a continuous problem in your bowel movement seek advice from your health care personal.
- Resuming sexual relation can be done when you are recovered.
Increasing daily activities are suggested but only gradually. Putting sudden strain on your abdomen is asked to be avoided for 4 weeks after the epigastric hernia operation. Doctors do not suggest driving for at least a week or two. If a person is able to get in and out of the bath without any uneasiness or help one can start driving and gradually increase the distance of your trips.
People may need a certificate for work after the operation which is provided by the member of staff before discharge. Work if it does not include lifting heavy stuffs or any sort of difficult exercises. If it is so doctors suggests waiting for 2-4 more weeks. There are chances for epigastric hernia recurrence if the advice is not taken or the wound is not healed properly.
Increased pain, redness, swelling or discharge of the wound, persistent bleeding, difficulty in passing urine, high temperature, nausea or vomiting are the problems that should be taken care of immediately if seen after the epigastric hernia operation. Some swelling or bruising around the area of the wound is quite normal. There will also be some discomfort and awkwardness where the cut has been made.
Recovery Period/Healing Time for Epigastric Hernia
The recovery period/healing time is good for epigastric hernia. After the epigastric hernia operation one can recover/ heal within two to four weeks. The stomach will be delicate for the first week. During the first few weeks the cut and the wound must be protected from the activities which increase abdominal pressure. One can apply only a gentle pressure on the incision line to prevent it from getting messy again. Regaining after the operation depends on the size of the epigastric hernia and the difficulty faced during its epigastric hernia operation. Pain is controlled by pain relief medications and also home remedies. Walking after the surgery is usual but heavy weight lifting or physical activities are suggested to be ignored for two to three weeks post-surgery. Getting back to work will also be suggested after 1 or 2 weeks.
Activities that should be avoided for some days after the epigastric hernia surgery are:
- Moving from a lying position to a seated position or from a seated position to standing.
- Bearing down during a bowel movement.
Risk Factors for Epigastric Hernia
There are few risk factors for epigastric hernia. There is a low risk of having an epigastric hernia to a born baby or a child. It is mostly seen in adults due to obesity or pregnancy. Sometimes by birth infants get epigastric hernia which may seem to appear or disappear and that is known as a “reducible” hernia. This type is not noticeable unless there is a stress appearing on the stomach due to crying or pushing to have a bowel movement. The appearance makes it diagnosable without any need of testing.
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