Sometimes, after surgery, a hernia can develop at the site of the operation. This is known as a laparocele, occurring in approximately 10 to 30 percent of surgical incisions involving the abdominal muscles.
Treating laparoceles involves a complex surgical procedure, but progress in minimally invasive surgical techniques alongside traditional approaches has enabled the restoration of abdominal wall function.
What Is a Laparocele?
Laparoceles are hernias that occur at the site of a surgical scar. In approximately 10 percent of laparotomies (abdominal surgical incisions), the muscle-fascial wall can be weakened or subsided, allowing the peritoneum (innermost layer of the abdominal cavity) to protrude through.
Since the peritoneum cannot restrain itself, it protrudes through the hernial port, forming a laparocele.
Clinically, laparoceles present as swelling around the surgical scar. Some individuals may not experience any symptoms, while others may feel discomfort or pain, particularly during periods of stress, and notice a visible bulge in the abdomen.
Laparocele: The Risk Factors
Laparoceles may be more likely to occur in the presence of certain predisposing factors, including:
- Overweight or obesity;
- Old age;
- Previous wound infection;
- The type and extent of the surgical incision – a wider incision carries a higher risk of laparocele development.
Laparoceles: Complications Not to be Underestimated
Similar to other abdominal hernias, laparoceles can present complications, as it might:
- Become incarcerated and constricted
- Affect the blood supply and skin tissue
Given these potential complications, it is crucial to undergo a specialized surgical evaluation and examination for a laparocele. A specialist can determine the appropriate surgical approach to repair the defect in the abdominal wall.
Laparoceles: How is Surgery Performed?
There are two primary surgical approaches for treating laparoceles: the traditional method and the laparoscopic treatment.
The traditional method:
- The surgical access is made through the existing scar.
- This procedure involves isolating and reducing the laparocele, followed by placing a mesh to close the hernial opening and prevent further protrusion of the peritoneum.
- This type of surgery is typically used for large laparoceles.
The laparoscopic treatment:
- Several small incisions are made on the abdomen to introduce surgical instruments and a camera into the abdominal cavity.
- The hernia is reduced, and then a mesh is placed inside the peritoneal cavity and attached to the abdominal wall using staples.
- This method eliminates the need for re-incision of the surgical wound.
Laparoceles: The Advantages of Laparoscopic Surgery
Choosing laparoscopic treatment for operating on a laparocele offers several advantages, including:
- Reduced risk of infectious complications and formation of seromas (serum collections)
- Shorter hospital stays
- Faster recovery times
Nonetheless, laparoscopic treatment still carries some risks. It is a surgical procedure that should be performed by surgeons trained and experienced in treating abdominal wall pathologies.