New ways and opportunities in hernia surgery
Compared to open, traditional surgeries, the emergence of laparoscopic surgery was a big step forward in hernia surgery. But these techniques also have limitations. In the case of abdominal wall hernias, it is a problem to treat a large separation of the abdominal wall or rectus diastasis, because it is not possible to tighten the abdominal wall to its original state with the mesh inserted from the inside. The newly published technique MILOS, or ELAR, helps with this, which means that minimally invasive or endoscopically/laparoscopically assisted, the rectus abdominis muscle is first visited on both sides and then its edges are joined together, closing the expanded part. After that, the entire abdominal wall is reinforced with a mesh behind the muscles. In this way, the net cannot slip, but it does not have to operate in the abdominal cavity, thereby avoiding the risk of intestinal adhesions.
PUMP, which stands for preperitoneal umbilical mesh plastic, is a new technique used in Hungary for the first time in the treatment of umbilical hernias at the Duna Medical Center. This means that a mesh with a diameter of about 10 cm is placed through the umbilical opening behind the abdominal muscles, but in front of the peritoneum. With this technique, the use of mesh in contact with the intestines can be avoided, which can significantly reduce the chance of possible adhesions.
The method developed by Deserda also offers a new opportunity for inguinal hernias for those for whom the use of mesh is not possible or who are averse to it. During this process, we can strengthen the inguinal canal, where hernias appear, with a flap of our own muscle fascia - the sheath of the external abdominal muscle. In this way, abdominal tension can be reduced, but the application of own fascia, which is even stronger than mesh, provides adequate stability.