Epigastric Hernia Surgery in Ankara, Turkey

Epigastric hernia surgery is the repair of a hernia that forms in the abdominal wall between the navel and the rib cage. With this surgery, problems such as bowel entrapment and pain are eliminated, and quality of life is improved.

In hernia repair, open or laparoscopic surgical methods may be preferred. When necessary, the abdominal wall is strengthened using a synthetic mesh and recurrence of the hernia is prevented. The choice of method is made according to the patient’s condition.

In the early postoperative period, rest and regular mobilization are important. Avoiding heavy activities accelerates the healing process. Paying attention to the diet contributes to the process by reducing intra-abdominal pressure.

The risk of complications after epigastric hernia repair is low. Although rare, infection, hematoma, or hernia recurrence may occur. Surgical experience and regular follow-up help achieve positive long-term outcomes.

You can contact Prof. Dr. Ebru Soy, one of the doctors performing Epigastric Hernia Surgery in Ankara, to get information about Epigastric Hernia Surgery prices, the process, and the hospital where Epigastric Hernia Surgery is performed.

What Is an Epigastric Hernia?

Our abdominal wall is a layered, muscular structure that protects and holds our internal organs together. In the very middle of this wall, there is a strong band of connective tissue where the muscles meet, which we call the “linea alba.” We can think of this line like the main zipper of a sturdy coat. An epigastric hernia occurs as a result of a small snag or weakening along this zipper line. At first, usually only a small amount of fatty tissue in front of the peritoneum leaks out through this small gap. That is why many people initially notice it as a small, painful lump under the skin. Over time, however, this gap may widen and more important structures such as the intra-abdominal fatty apron called the “omentum,” or more rarely intestinal loops, may protrude through it.

So, why does this weakness occur? It usually becomes apparent when an underlying congenital predisposition combines with certain straining factors encountered throughout life. Any condition that continuously or suddenly increases pressure inside the abdomen strains this weak point and increases the risk of hernia formation. Some common situations that can trigger hernia formation are as follows:

• Obesity
• Pregnancy
• Heavy lifting
• Intense and strenuous exercises
• Chronic and severe cough
• Persistent constipation and straining

The symptoms you may notice when you encounter this condition are generally quite typical. The most common symptoms of an epigastric hernia are as follows:

• A swelling on the midline between the breastbone and the navel
• A lump that becomes more prominent especially when standing or straining
• Tenderness or pain over the swelling
• A sharp, stabbing aching sensation
• Rarely, nausea

In Which Situations Is Epigastric Hernia Surgery Performed?

When an epigastric hernia is diagnosed, the first question that comes to mind is “Should I have surgery?” When making this decision, how the hernia affects your life and what risks it carries for the future are taken into consideration. In general, we can talk about three different scenarios.

Hernias That Disrupt Your Comfort

This is the most valid and most common reason for this surgery. If your hernia has started to cause you discomfort, surgical repair is the best option. Pain, aching, and discomfort you feel while doing daily tasks or exercising are signs that the hernia now needs to be treated. Sometimes, even if there is no pain, the externally visible swelling may bother a person aesthetically, and this is also a valid reason for surgery. Remember, hernias do not heal on their own and tend to grow over time. Therefore, postponing surgery while you have complaints both lowers your quality of life and increases the risk of encountering a more complex situation later.

Is a “Wait and See” Approach Possible?

Sometimes the hernia is very small, causes no complaints, and is noticed completely by chance. In such cases, a “wait and see” strategy may be followed for a while with the joint decision of the patient and the doctor. This does not mean ignoring the hernia completely. On the contrary, it means monitoring the condition closely. However, it is important to know that this approach may be a temporary solution. A significant portion of patients still decide to have surgery later as the hernia enlarges or begins to cause pain. During this process, it is necessary to make sure that the hernia is not growing and is not showing any warning signs.

A Condition Requiring Emergency Intervention: Hernia Strangulation

This is the most serious and dangerous form of an epigastric hernia and requires emergency surgical intervention. “Hernia strangulation” means that the tissue protruding through the hernia opening becomes trapped and its blood flow is cut off. Tissue whose blood flow is cut off loses viability within a few hours (becomes gangrenous), and this creates a life-threatening situation. It is very important to know the warning signs of this dangerous condition. If you experience any of the following symptoms, you should apply to the nearest emergency department immediately.

• Sudden onset pain in the hernia area that gradually becomes more severe
• A swelling that you previously could push back in with your hand but no longer goes back
• Hardening of the hernia swelling and it becoming extremely tender
• Color changes over the swelling such as redness or bruising
• Nausea and vomiting
• Inability to pass gas and stool

Hernia surgeries performed under emergency conditions are always riskier than planned surgeries. The infection rate is higher, the recovery process is longer and more complex. Therefore, repairing a symptomatic hernia calmly and electively before things reach this dangerous point is always the smartest and safest way.

What Are the Risks of Epigastric Hernia Surgery?

Epigastric hernia repair is a very common and generally very safe procedure in modern surgery. Success rates are high, and patients return to their normal lives in a short time. However, as with any surgical intervention, this surgery also has potential, though generally low-probability, risks. Knowing these risks helps you approach the process more consciously.

General risks that may be seen in any surgery include anesthesia-related reactions, bleeding (hematoma) at the wound site, or infection. Detailed preoperative evaluations and sterilization measures taken in operating room conditions minimize these risks. Some situations that may be specific to hernia surgery are as follows:

• Seroma: Accumulation of body fluid in the surgical area, usually over the mesh. It is generally harmless and is absorbed by the body over time.
• Recurrence (return of the hernia): Reappearance of the repaired hernia over time. This is the most important long-term risk of hernia surgery. However, thanks to modern techniques and the use of mesh, this risk has been greatly reduced.
• Chronic pain: Rarely, a feeling of discomfort or pain that lasts longer than six months may remain in the surgical area.
• Mesh-related problems: Very rarely, situations such as the body reacting to the mesh or mesh infection may be seen.
• Internal organ injury: Although the risk theoretically exists especially in closed (laparoscopic) surgeries, it is extremely rare.

A large part of these risks can be significantly reduced with preoperative preparation (for example quitting smoking, losing weight) and by choosing the correct surgical technique.

How Is Epigastric Hernia Surgery Performed?

For the repair of your epigastric hernia, your surgeon may offer you different options. Which method is most suitable for you depends on many factors such as the size of your hernia, your overall health status, and the surgeon’s experience. Surgeries are basically divided into two main groups: “open” and “closed.”

Preoperative Preparation

Preparation is very important for a successful surgery and a smooth recovery process. There are some important points to pay attention to before surgery:

• Quitting smoking (at least 4-6 weeks in advance)
• Making an effort to get closer to an ideal weight
• Controlling chronic diseases such as diabetes
• Adjusting blood thinner medications under doctor supervision

Open Surgery

In this method, the repair is performed through a single incision made in the area where the hernia is located.

Suture Repair: In this traditional method, after the hernia is reduced, the tear in the abdominal wall is closed with sutures. However, since it brings tissues together under tension, the risk of recurrence is high, especially in hernias larger than 1 cm. Therefore, its use is quite limited today.

Mesh Repair (Mesh Hernioplasty): This forms the basis of modern hernia surgery. The aim is to repair the defect without creating tension by using a mesh. This synthetic mesh integrates with the body’s own tissues and forms a strong new layer in that area, preventing recurrence of the hernia. The anatomical plane where the mesh is placed is very important for the success of the surgery. One of the two most commonly used methods, the “sublay” technique, meaning placing the mesh behind the muscles, turns intra-abdominal pressure into an advantage by fixing the mesh to the wall. In this way, a stronger repair is achieved and wound-related problems are less common. Therefore, retromuscular repair is generally considered the gold standard in open surgery.

Closed (Minimally Invasive) Surgery

In this approach, instead of a large incision, a camera and special surgical instruments are inserted through several small openings in the abdominal wall.

Laparoscopic Surgery: After the abdomen is inflated with carbon dioxide gas, the repair is performed from inside the abdomen under a magnified view obtained through the camera. The mesh is placed to cover the hernia opening from the inside. The biggest advantages of this method are:

• Less postoperative pain
• Smaller scars and better cosmetic results
• Lower risk of wound infection
• Faster return to work and normal life

Robotic Surgery: This is a more advanced technology of laparoscopic surgery. The surgeon controls robotic arms while seated at a console. The 3D image provided by the robot and the instruments’ ability to mimic the movement capability of the human hand provide great convenience to the surgeon, especially in complex repairs. It allows more sophisticated repairs, such as retromuscular repair, to be performed with a closed method. However, the operation time is longer and the cost is higher.

The Process After Epigastric Hernia Surgery

Although your postoperative recovery period varies depending on the technique used and your personal characteristics, it is generally fast and comfortable. Knowing what you will encounter during this process will reduce your concerns.

You are usually discharged on the day of surgery or the next day. It is normal to feel pain during the first few days after surgery, and this can be easily controlled with the painkillers prescribed to you. Since your wound site will be covered with waterproof tapes, there is no problem with taking a shower. It is important not to become constipated during the healing process, so you are asked to consume plenty of fluids and high-fiber foods and not to strain the repair area by pushing.

One of the most frequently wondered about issues is when you can return to normal life. You are encouraged to start walking immediately after surgery. If you have a desk job, you can usually return to work within a week. However, the most critical point of healing is limiting the load on the abdominal wall for a while. During this period, there are some activities you should avoid:

• Heavy lifting (more than 5 kg)
• Pushing or pulling movements
• Exercises that strain the abdominal muscles such as sit-ups
• High-intensity sports

These restrictions generally last for 4 to 6 weeks. This period is necessary for the mesh to integrate with the body tissues and for the repair to reach its strongest state. After you get through this period carefully, you can gradually return to all your normal activities and sports with your doctor’s approval.

What Those Who Have an Epigastric Hernia Should Pay Attention To

While living with a diagnosis of an epigastric hernia, during the period until you have surgery, or if you are not considering surgery, there are some important points you should pay attention to both to protect yourself and to prevent the condition from worsening:

First and most importantly, do not forget the emergency warning signs of hernia strangulation. In situations such as severe and persistent pain, a hard swelling that cannot be reduced, nausea, and vomiting, you should never waste time. Remember that hernias do not go away over time like a muscle pain; on the contrary, they are a permanent tear in the abdominal wall, and the only permanent solution is surgery. During this process, there are some steps you can take to slow the growth of the hernia and improve your general health. These steps will also increase the success of a possible surgery. Some positive changes you can make in your lifestyle are as follows:

• Getting rid of excess weight
• Quitting smoking
• Seeking treatment if you have problems such as chronic cough or constipation
• Learning to lift heavy loads with the correct technique
• Avoiding movements that excessively strain the abdominal muscles

If your hernia is causing you discomfort, the best approach is to evaluate the condition with a general surgery specialist. By deciding together on the most suitable time and the most appropriate surgical technique for you, you can resolve this problem safely and comfortably. Being proactive will protect you from the risks and anxiety of a possible emergency in the future.