Epigastric Hernia Repair

An epigastric hernia is a type of hernia that occurs when tissue, such as fat or intestine, protrudes through a weakness or opening in the abdominal wall, specifically in the epigastric region, which is located between the navel and the lower part of the breastbone.

Causes and Risk Factors

Epigastric hernias are often caused by a combination of factors, including:

• Weakened abdominal muscles or fascia
• Increased pressure within the abdomen, such as from obesity, pregnancy, or heavy lifting
• Genetic predisposition
• Aging
• Previous abdominal surgery

Symptoms

Common symptoms of an epigastric hernia include:

• A lump or bulge in the epigastric region
• Pain or discomfort in the epigastric region, which may worsen with coughing, straining, or heavy lifting
• Nausea and vomiting
• Constipation or difficulty passing stools

Diagnosis

Diagnosis of an epigastric hernia is typically made through a combination of:

• Physical examination, including palpation of the abdomen to feel for a lump or bulge
• Medical history, including questions about symptoms and risk factors
• Imaging studies, such as ultrasound, computed tomography (CT) scan, or magnetic resonance imaging (MRI)

Treatment Options

Treatment options for epigastric hernia include:

• Watchful waiting, which involves monitoring the hernia for changes in size or symptoms
• Surgical repair, which may be performed through an open incision or laparoscopically

Surgical Repair

Surgical repair of an epigastric hernia typically involves:

• Making an incision in the abdomen to access the hernia
• Pushing the herniated tissue back into place
• Repairing the weakened area with sutures or mesh
• Closing the incision

Laparoscopic Repair

Laparoscopic repair of an epigastric hernia is a minimally invasive procedure that involves:

• Making several small incisions in the abdomen
• Inserting a laparoscope and surgical instruments through the incisions
• Visualizing the hernia on a video monitor
• Pushing the herniated tissue back into place and repairing the weakened area with sutures or mesh
• Removing the laparoscope and closing the incisions

Postoperative Care

After epigastric hernia repair, patients typically:

• Experience some pain and discomfort, which can be managed with medication
• Need to rest and avoid heavy lifting or strenuous activities for several weeks
• May need to follow a special diet to prevent constipation and promote healing
• Should follow up with their surgeon to monitor the healing process and remove any sutures or staples

Complications and Risks

Possible complications and risks of epigastric hernia repair include:

• Infection
• Bleeding or hematoma
• Adhesions or scar tissue formation
• Recurrence of the hernia
• Nerve damage or numbness