Article author: Nadezhda Nikolaevna
A hernia of the white line of the abdomen is a lipoma formed in the preperitoneal region of the patient. When protruding, the hernia already has a fairly large size and requires emergency surgical intervention.
According to available statistics published in the media, most often this disease occurs in the male half of the population. It is worth noting that men who are overweight are most at risk of having a hernia in the white line of the abdomen.
This type of hernia has three stages of development:
- The appearance of preperitoneal lipoma.
- Active development of a hernia (during this period, a hernial sac develops and its contents gradually increase).
- Manifestation of a formed hernia.
- White line hernia prophylaxis
- White line hernia
- Treatment in the SM Clinic:
- How can we help you
- Hernia repair using mesh endoprostheses
- Why us?
- Hernia of the white line of the abdomen and all about it
- Hernia classification
- White line hernia
- All about white line hernias
- Causes of hernia
- Why surgery is needed
- Types of hernia of the white line of the abdomen
- Stage of formation of a hernia of the white line of the abdomen
- Signs and symptoms
- Surgery for hernias of the white line of the abdomen
- Plastic hernia of the white line of the abdomen with a mesh implant
- Preparing for an operation
- Treatment of hernia of the white line of the abdomen in GMS Hospital
- White line hernia
At the initial stage, a hernia can develop almost asymptomatically, and therefore, this disease is often diagnosed at a late date, when only surgical intervention can help the patient.
A patient who has this type of hernia may find the following symptoms:
- protrusion of a hernial sac;
- the appearance of pain during any movement of the torso, even with a strong inhalation and exhalation;
- the appearance of nausea, sometimes vomiting;
- belching after eating;
- frequent constipation, etc.
In the case when an infringement of a hernia of the white line of the abdomen occurs, the symptoms of the disease become more pronounced:
- severe vomiting;
- growing pain syndrome;
- strong accumulation of gases;
- defecation delay;
- the appearance of blood clots in feces, etc.
According to many experts from around the world, the main reason for the appearance of a hernia of the white line of the abdomen is a congenital defect in the connective tissue in the white line of the abdomen.
Any strong physical effect on this part of the body can affect the development of this disease. Bad heredity can also be attributed to the reasons for the appearance of a hernia of this type in people.
In the male half of the population, a hernia of the white line of the abdomen very often occurs after strong physical exertion, or after lifting weights. In women, most often this disease manifests itself during pregnancy. It is not strange, but the cause of the development of a hernia of the white line of the abdomen can be a prolonged cough, in which the patient’s abdominal cavity is in constant tension.
If primary symptoms are revealed in himself, or if any protrusion in the area of the white line of the abdomen is detected, the patient should contact a medical institution.
A narrow-profile specialist during a personal examination should collect a complete medical history of the disease, establish the cause of the appearance of a hernia. Without fail, the doctor palpates the area of the white line of the abdomen, so that he can determine the size of the appeared lipoma.
To confirm the initial diagnosis, the specialist appoints a patient a hardware examination, which will determine the exact size of the hernia and its localization in the abdominal cavity.
In most cases, patients are prescribed:
- ultrasound examination;
- multislice computed tomography (spiral).
Treatment of a hernia of the white line of the abdomen without surgery is possible only if the lipoma is small and there has been no pinching. Drug therapy does not bring the desired effect.
Special medicines can only stop a strong pain syndrome. The patient may feel better for a short time, but after a few days the symptoms of the disease will reappear.
In the event that the patient has discovered a small protrusion, the doctor may try to straighten it back on palpation. Sometimes therapeutic massages are prescribed, which should be carried out only by a highly qualified specialist.
Currently, specialty underwear is actively advertised, as well as an abdominal bandage, which, according to the creators, is able to save patients from a hernia of the white line of the abdomen. Unfortunately, these devices absolutely do not interfere with the development of a hernia, but rather contribute to the stretching of the hernial sac.
Photo: hernia surgery
To date, the treatment of hernia of the white line of the stomach with a surgical method is carried out by many Russian medical centers.
When performing hernia repair, specialists primarily allocate a hernial sac, after which it is bandaged and opened. The contents of the bag, after altering it, are carefully inspected.
Thanks to the active development of the medical industry, today patients undergo very gentle operations, without the required incision of the skin. Such surgical intervention is called laparoscopy, which is performed using special medical equipment.
In the umbilical region of the patient, a laparoscope needle is punctured, after which a laparoscope tube equipped with an optical device is inserted into the hole and the necessary surgical procedures are performed.
The use of a laparoscope allows the specialist conducting the surgical intervention to examine from the inside a hernia of the white line of the abdomen on the screen of the monitor, since the optical device enlarges the image by 40 times.
During the operation, doctors use the following methods:
Photo: laparoscopic method of operation
- Mayo method – when performing plastic surgery of the hernia sac;
- Martynov or Napalkov method – with a divergence of direct muscle tissue located in the abdominal cavity.
During the operation, plastic is done, in which the patient’s own tissues can be used, or artificial materials, for example, a special medical net. Patients without fail, the doctor removes diastasis of the rectus muscles located in the abdominal cavity.
When infringement of a hernia of the white line of the abdomen, the patient needs emergency hospitalization and unscheduled surgical intervention.
The danger of this stage of hernia development is that the patient disrupts the work of many internal organs and the circulatory system, the nervous system begins to function poorly, dangerous pathological processes develop, etc.
In the treatment of hernia of the white line of the abdomen, patients should:
- observe the daily routine;
- stick to a diet;
- limit or completely eliminate physical activity;
- drink more flu >
Name of medical institution The cost of surgical treatment of hernia of the white line of the abdomen (in rubles) Moscow Center for Phlebology and hernia treatment at Beauty clinic Doctor from 32 to 000,00> Delta Clinics Multidisciplinary Medical Center to 20 000,00 Multidisciplinary Clinic Miracle Doctor from 18 700,00 to 37 400,00
Patients who have a hernia of the white line of the abdomen may encounter various problems, which over time lead to serious consequences:
Photo: hernia bandage
- the contents of the hernia will gradually increase in size, as a result, a strong protrusion of the lipoma will occur;
- a hernia can be infringed, as a result of which patients will develop necrosis;
- against the background of a strangulated hernia, peritonitis often develops, which requires emergency surgical intervention;
- development of intestinal obstruction (food will pass through the intestines with great difficulty);
- the formation of phlegmon (suppuration is an urgent surgical case and requires qualified medical care);
- inflammation of adjacent organs;
- the development of intestinal peritonitis, etc.
White line hernia prophylaxis
To prevent the development of hernias of the white line of the abdomen, people can carry out a number of preventive measures:
- Healthy food;
- wear a bandage during pregnancy;
- perform special exercises that strengthen the muscle tissue of the abdominal cavity;
- protect the abdomen from injury;
- beware of heavy physical exertion;
- normalize your weight (if there is obesity, then you need to go on a diet);
- empty the intestines in a timely manner, etc.
For treatment, there are folk remedies that stop the further development of hernia, avoiding severe consequences, or help prevent the transition from one stage to another. But still, the hernia can be cured only promptly, with the elimination of the gaps of the rectus abdominis muscles and the closure of connective tissue defects, with special prostheses.
White line hernia
The white line is the space between the rectus abdominis muscles. This narrow strip is formed by weaving the tendon fibers and is located strictly in the center, from the sternum to the pubic bone. As a result of the weakening of tendon fibers, the abdominal organs bulge under the skin, resulting in a hernia of the white line of the abdomen.
Noticing a mild, painless formation above or below the navel, be sure to get a doctor’s consultation to clarify the diagnosis.
Shishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews.
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Treatment in the SM Clinic:
Highly qualified surgeons and experience in the treatment of the white line of the abdomen
The use of modern methods and mesh implants
Quick recovery after surgery. The patient is in the hospital for up to 3 days
How can we help you
A hernia of the white line of the abdomen is insidious in that there is a high risk of its infringement, the development of inflammation of the organs, bowel obstruction. Taking medications, physiotherapy, wearing a bandage, the use of folk remedies – these measures can only smooth out the symptoms of the disease, but do not return the organs to their places and do not strengthen the connective tissues.
The only effective treatment is surgery to remove a hernia and strengthen the walls of the abdominal cavity – hernioplasty.
The key to effective treatment of hernia of the white line of the abdomen is in the experience and high professionalism of the doctor. The specialists of the Surgery Center possess both of them, which allows them to successfully operate hernias of any severity.
The purpose of the operation is to gain access to the hernial sac, fix the organs and strengthen the tissues of the abdominal cavity using a mesh endoprosthesis. The doctors of the Center are proficient in all existing methods of performing operations and perform the following interventions:
Minimally invasive procedure to remove a hernia through several punctures and strengthen the abdominal cavity with polymer nets.
Hernia is removed through a small incision in the navel. mesh endoprostheses are used to strengthen tissues.
Combines open and endoscopic surgery, is used to remove a hernia and perform a complete reconstruction of the white line of the abdomen.
Hernia repair using mesh endoprostheses
Specialists of the Surgery Center give preference to modern methods of hernia treatment and apply the technology of non-tension hernioplasty. Thanks to the use of nets made of polymeric materials, it is possible to avoid tension of the body tissues, and as a result, to significantly reduce the patient’s recovery period, reduce pain after surgery and minimize the possibility of complications. We use high-quality materials from foreign manufacturers, which allows us to achieve a high effect in the treatment of hernias of varying severity.
High qualification and experience of doctors
Surgeons of the Center are highly qualified specialists with significant experience in Russia and abroad.
Large Surgical Center
The Surgery Center has 10 operating rooms and more than 80 operating specialists in all areas of modern surgery.
Modern low-traumatic techniques
Endoscopic and laparoscopic surgeries are performed through mini-punctures, as well as radio wave bloodless surgery.
The Center’s specialists are developing surgical treatment tactics and a rehabilitation program for each patient.
Each patient is under the supervision of the attending physician and medical specialists until discharge. The hospital is equipped with intensive care units.
-hour comfortable hospital
-hour medical supervision, highly qualified doctors and nurses, comfortable wards, individual menu.
Comprehensive treatment using modern possibilities of rehabilitation medicine significantly reduces the rehabilitation process.
Patient transportation from any region
Own ambulance service provides medical transportation and hospitalization of patients in our hospital from any cities and regions.
Hernia of the white line of the abdomen and all about it
A white line hernia in men and women occurs in approximately 10% of all abdominal hernias. At the location, the following types of hernias are distinguished:
- supra umbilical – is located above the umbilical opening;
- umbilical – less common and localized in the navel;
- the umbilical – is formed under the navel and is rarely diagnosed.
Most often, single hernias are found, however, in severe cases, multiple protrusions are formed, located one above the other.
- Preperitoneal lipoma. It appears under the influence of provoking factors, while only fatty fiber comes out under the skin.
- Beginning hernia. At this stage, the peritoneum enters the hernia gate, creating a membrane for the gradually protruding abdominal organs.
- Formed hernia. The hernia sac is finally formed, in which the omentum, fragments of the small intestine and stomach are located.
Symptoms of the disease depend on the stage of its development. At the very beginning, the hernia is not felt and does not cause discomfort to the patient, therefore, it is most often discovered by chance during an examination for other diseases. At the second and third stages, the protrusion increases in size, it can not only be palpated, but also seen. As a rule, patients complain of:
- pain in the region of protrusion, which increases with physical exertion, coughing, etc .;
- disruption of the intestines;
- the presence of blood in the feces (if parts of the intestine are in the hernial sac);
- nausea and vomiting.
The last symptoms are characteristic of a strangulated hernia of the white line of the abdomen. To avoid the development of complications, consult a doctor as soon as you notice a protrusion.
To diagnose a hernia in the Center for Surgery, traditional and modern methods are used:
- visual examination, palpation, auscultation;
For a more accurate determination of the contents of the hernial sac, the doctor may prescribe a contrast radiography of the stomach, multispiral computed tomography.
The treatment methods that many patients resort to – wearing a bandage, alternative methods – do not give any result, and often lead to complications. You can get rid of a hernia of the white line of the abdomen only with the help of surgical intervention.
The doctors of the Center carry out operations on non-tension hernioplasty using artificial implants. This technique allows you to close the hernia gate and strengthen the weakened tissue without tension.
Our surgeons perform laparoscopic, open and hybrid operations. Laparoscopic surgery is performed under general anesthesia, and access to the hernial sac is through punctures. The advantages of endoscopic surgery are low trauma and quick recovery of patients. Open hernioplasty is performed if during the examination contraindications to endoscopic surgery were identified. Hybrid surgery is performed through a small incision in the navel or bikini line.
In the treatment of hernias, we use modern materials and tools, which allows us to reduce the length of our hospital stay to 1-2 days, and the rehabilitation period to 2-3 weeks.
White line hernia
A hernia of the white line of the abdomen is a pathological condition when the internal organs and preperitoneal tissue protrude through the holes in the tendon plate along the midline of the abdomen. It looks like a small rounded formation that decreases or disappears when lying down and increases with tension in the abdominal muscles – sneezing, coughing, weight lifting, etc.
All about white line hernias
A white or midline is formed by intertwined microbundles of the tendons of the abdominal muscles. It is located in the center of the abdomen and stretches from the sternum to the pubic bone.
With weakening of the tendon fibers, the subcutaneous fat layer initially enters the lumens of the aponeurosis, and then the intestinal loops, omentum, which, going beyond the boundaries of the peritoneum, form a painful protrusion. If you notice a small formation in the navel area, be sure to go to the surgeon’s appointment.
Treatment of pathology is surgical. Although such hernias reach large sizes only occasionally, they are often infringed, so you need to consult a doctor immediately if a defect or a suspected hernia is discovered.
Causes of hernia
- Underdevelopment of aponeurosis (in children)
- Postoperative Scars
- Peritoneal injury
- Situations leading to a regular increase in abdominal pressure
Why surgery is needed
Hernias of the white line of the abdomen have a high probability of pinching, which leads to the development of severe complications, up to peritonitis and sepsis. Drug therapy, folk remedies or wearing a bandage only smooth out the symptoms of the disease, but do not eliminate it. The only effective means is surgical treatment.
At the GMS Hospital hernia treatment center, operations are performed to excise hernias of the white line of the abdomen and strengthen the walls of the peritoneum with artificial implants, that is, by the method of non-tension hernioplasty. Treatment at GMS Hospital is:
- A team of surgeons with many years of experience in successfully treating hernias.
- Modern operating and comfortable hospital.
- Advanced surgical techniques.
- The use of endoprostheses from leading manufacturers.
- Minimum hospital stay (1-3 days).
- Quick recovery after an intervention.
The technical capabilities of GMS Hospital make it possible to fully use modern achievements in the field of surgery and permanently rid the patient of a hernia without the risk of its relapse.
Types of hernia of the white line of the abdomen
Depending on the position regarding the umbilical ring, emit:
- Adrenal hernia – located above the navel.
- Pericupal – localized close to the umbilical fossa.
- The umbilical are located below the navel.
Such formations are found in both men and women. More often a single defect is diagnosed, but sometimes multiple hernial sacs are formed.
Stage of formation of a hernia of the white line of the abdomen
Wide hernial gates do not form immediately, the pathology has several stages of development:
- Preperitoneal lipoma – part of the subcutaneous fat layer comes out through the holes of the aponeurosis, forming a small round seal
- Initial – the peritoneum penetrates into the hernia gate, forming a membrane for the internal organs protruding through the weakened tendon plate
- Formed hernia – a hernial sac, the content of which is a section of the intestine, omentum, stomach
The volume and complexity of the surgical intervention depends on at what stage the hernia was diagnosed.
Signs and symptoms
The severity of the clinic of the disease will depend on the stage. At the initial stage, the formation does not reveal itself in any way and is diagnosed by chance, when contacting a doctor. The second and third stage of the disease are accompanied by the following symptoms:
- Painful swelling – pain during movement, coughing becomes more intense.
- Dyspeptic disorders – heartburn, nausea, vomiting.
- Bloating, stool disorders.
The appearance of acute, progressive pain, severe nausea and vomiting, impurities of blood in the feces and the inability to correct the hernia indicates pinching and requires urgent intervention.
Since the pathology has a similar clinical picture with some other diseases, a differential diagnosis is carried out, including:
- Surgical examination with palpation
- Ultrasound hernia
- GIT with barium
- Multispiral abdominal computed tomography (MSCT)
During the diagnosis, the surgeon determines the exact stage and nature of the disease. This is necessary in order to choose the most correct therapeutic tactics, minimizing the risk of relapse.
Conservative therapy in this case has no effect. Completely end hernial protrusion is possible only with the help of surgery. Surgeons of the GMS Hospital successfully treat midline abdominal hernias, including those complicated by multiple protrusions, and perform open, laparoscopic and hybrid operations on non-tension hernioplasty using mesh implants.
Surgery for hernias of the white line of the abdomen
Intervention is carried out by such methods:
- Laparoscopic hernioplasty is a less traumatic endoscopic technique when excision of a hernia and implantation of an artificial endoprosthesis to close a hernia gate is performed through several punctures in the peritoneum. The use of instruments with integrated optics provides targeted accuracy of the surgeon’s movements.
- Open hernioplasty – an operation is performed through a small incision in the navel.
- Hybrid hernioplasty – used if it is necessary to reconstruct the white line of the abdomen (to eliminate the discrepancy of the rectus muscles). The technique is a combination of open and endoscopic techniques.
Using the technique of non-tensioned hernioplasty and the latest endoprostheses from biocompatible materials can reliably eliminate pathology, minimizing the length of hospital stay and eliminating a possible relapse of the disease.
Plastic hernia of the white line of the abdomen with a mesh implant
During surgery, the doctor gains access to the hernial sac, returns the displaced organs into place, excises the hernia and closes the hernial gate with a mesh endoprosthesis. A feature of the treatment is that simply excising the defect is not enough. It is necessary to eliminate diastasis of the rectus abdominis muscles, with which non-stretched hernioplasty perfectly copes. Artificial implants made of biocompatible materials not only reliably close the hernia gate, but also maximize the weakened peritoneal tissues without tension.
Preparing for an operation
Before the operation, you will need to pass a number of tests, undergo an electrocardiogram and do fluorography. The operation takes about an hour, performed under general anesthesia. Two weeks before the intervention, it is necessary to exclude alcohol, do not smoke on the day of surgery. Be sure to tell the doctor if you regularly take medications – they may need to be temporarily withdrawn.
Treatment of hernia of the white line of the abdomen in GMS Hospital
GMS Hospital uses the latest materials and technologies to treat hernias of the white line of the abdomen, which reduce the length of hospital stay to 1 day, and the entire recovery period to 3-6 weeks. Hernia operations are performed by highly qualified surgeons with many years of experience. If you want to know more about the disease and treatment methods and get advice on your case, come to a consultation with GMS Hospital specialists. You can make an appointment by phone or online.
White line hernia
A hernia of the white line of the abdomen is a pathological process in which a protrusion of the internal organs of the abdominal cavity occurs along the midline of the abdomen. The width of the white line in the normal state is 1,5–2 cm, and below the navel it narrows significantly – up to 0,2–0,3 cm. The difference in tendon fibers with this form of the disease can reach 10–12 cm.
White line hernia in children is very rarely diagnosed. Most often, this type of pathological process is diagnosed in men of young age – at 20-30 years.
The clinical picture of such a disease is quite unambiguous and well expressed – a painful protrusion forms in the front wall of the abdominal cavity, there are abdominal pains, dyspeptic disorders.
Diagnostic hernia of the white line of the abdomen is determined by a physical examination, as well as laboratory and instrumental examination methods. The treatment of such pathologies in most cases is only radical – an operation is performed to remove the hernia. Conservative therapeutic measures in this case are ineffective, as with any other type of hernia.
The further prognosis will be exclusively individual in nature, since it all depends on the timeliness of the beginning of therapeutic measures, the severity of the pathological process and the general health of the patient.
A hernia of the white line of the abdomen can develop against the background of the following etiological factors:
- hereditary violation of the structure of the tendons;
- postoperative scars in the white line of the abdomen;
- abdominal injuries;
- chronic cough, which provokes a strong and constant tension of the abdominal cavity;
- chronic constipation;
- difficult birth, difficult pregnancy;
- pathological processes in which difficulty urinating occurs;
- physical overstrain;
- excessive exercise.
Like other forms of this pathological process, a hernia of the white line of the abdomen in an adult is formed in cases where an overstrain of the abdominal wall occurs.
In children, such a disease can develop against a background of strong and prolonged crying.
According to clinical and morphological signs and the nature of the course of the disease, the following forms are distinguished:
- strangulated hernia of the white line of the abdomen.
By the nature of development, the following stages are distinguished:
- the first stage – preperitoneal lipoma, holes in the diverging tendon are small;
- the second stage – the peritoneum enters the hernia gate and the formation of the membrane for the internal organs begins;
- the third stage is a finally formed hernia, which includes a hernia gate, a hernial sac with contents (omentum, intestines, ligaments).
By the level of location, the following forms of the pathological process are distinguished:
- supra umbilical hernia – formed above the navel;
- umbilical – located near the navel;
- hypogastric or sub-umbilical – located below the navel (this form is least likely to occur).
As a rule, such formations are single, but there are also multiple ones, while protrusions are located one after the other.
Only a doctor can determine the stage of development of the pathological process by conducting a physical examination and laboratory and instrumental examination methods.
Diagnosis of a hernia of the white line of the abdomen is possible in the initial stage.
In an upright position, a slight protrusion will be present in the midline region, which will be characterized by the following clinical picture:
- painful education;
- soft to the touch;
- if a person takes a horizontal position, then education disappears;
- with physical activity, pain can intensify.
In general, the symptoms in men, as in women, will be characterized as follows:
- an elastic formation is located in the midline region;
- when straining increases;
- rumbling in the abdomen if the intestine is involved in the pathological process;
- nausea and vomiting;
- delayed release of gases and bowel movements;
- general deterioration of health;
- weakness, growing malaise;
- with physical activity and weight lifting, the pain significantly increases.
With a restrained hernia, the overall clinical picture will be supplemented by the following signs:
- persistent nausea and repeated vomiting;
- blood may be present in feces;
- bloating, a feeling of fullness;
- heartburn, belching;
- pain can be given to the area of the scapula and even lower back.
With such a clinical picture, it is necessary to immediately seek medical help, and not to self-medicate.
A thorough diagnostic program makes it possible to quickly and accurately diagnose.
First of all, a physical examination of the patient is carried out, during which the doctor conducts a palpation examination of the abdominal cavity, finds out the nature of the clinical picture, examines the medical history and collects a personal history.
Despite the fact that the hernia of the white line of the abdomen has specific symptoms, certain diagnostic measures are carried out to determine the nature of the course of the pathological process:
- radiography of the stomach with barium;
- Ultrasound of hernial protrusion;
- MSCT of the abdominal organs;
- X-ray studies with a contrast agent;
- diagnostic laparoscopy of a hernia of the white line.
Additionally, standard laboratory tests are prescribed.
In some cases, it may be necessary to conduct differential diagnostics regarding the following pathological processes:
Based on the results of clinical trials, an accurate diagnosis will be made on the basis of which treatment tactics are determined.
Treatment without surgery in this case will be inappropriate, because by conservative measures to eliminate the pathological process is impossible. In exceptional cases, if the operation is not possible, supportive treatment is prescribed – a bandage for a hernia is selected for the patient. But it should be understood that such a method cannot be considered as a full-fledged treatment, and with prolonged use only leads to a worsening of the condition.
As a rule, a white line hernia is removed. The plastic can be stretched, using local tissues, or non-stretched (using synthetic prostheses).
With such pathological processes, hernioplasty is performed:
- the defect is sutured with purse-string and continuous catgut sutures;
- plastic aponeurosis is performed.
It should be noted that when using local tissues, hernia recurrence is quite often observed.
One of the following hernioplasty methods can be used:
- the grid is located above the aponeurosis;
- the grid is installed between the leaves of the aponeurosis;
- the grid is located inside the abdominal cavity.
In the postoperative period, the patient is prescribed drug therapy, which contributes to the rapid recovery after surgery. A diet is also prescribed. Physical activity in this case is contraindicated.
It should be understood that therapy with folk remedies is contraindicated in this case. In some sources, you can find a method such as bank treatment, but using this is strongly discouraged.
The prognosis will be favorable only if treatment is started on time and correctly. A restrained hernia of the white line is characterized by more negative prognoses, since other organs are involved in the pathological process.
As prevention, it is necessary to follow the general rules of a healthy lifestyle: monitor your health and take measures to prevent those pathological processes that are on the etiological list. Self-medication in this case is impractical, since this can lead not only to complications, but also to death.