Hernia of the abdomen and esophagus

Hernia of the spigelian (lunar) line of the abdomen

Photo: hernia of the lunate line

A hernia of the spigelian line of the abdomen is quite rare. It occurs in the case of a violation of connective fibrous tissue, which binds together the various abdominal muscles. Its location is strictly defined.

In the photo, the hernia looks like a protrusion along the navel line - the anterior superior iliac bone - the outer edge of the vagina of the rectus muscle. In other words, it is called the hernia of the lunate midline.

If it is popularly explained, the umbilical hernia has a higher location, and the inguinal one is lower. The bulging can be one-sided or two-sided, that is, to the left and right side of the vertical line dividing the belly into two parts. The height of the hernia is located below the navel line, but above the pelvic line.


Hernia of this type is not formed by itself. It appears under the condition of increased tension in the peritoneum and simultaneous weakness of its wall. The factors that provoke the occurrence of a hernia of the spigelian line of the abdomen include:

  • weight lifting and heavy physical work,
  • heredity,
  • metabolic disorders, which can lead to obesity or sudden weight loss,
  • birth attempts, severe multiple pregnancy, injuries that have broken the abdominal wall, including during an incorrectly performed surgery,
  • persistent strong cough and constipation, which are accompanied by tension in the abdominal wall.

Whatever the cause of the disease, it requires treatment. Moreover, therapeutic treatment and conservative methods for hernial pathologies are not relevant.

Types of hernia of the lunate line

Thus, the weakening of the abdominal wall is the main cause of all hernias. The hernia of the spigelian line is characterized by the fact that the loss occurs through the disturbed zones of the semilunar line, which delineates the transitional area between the muscles within the boundaries of the spigelian fascia. Unilateral hernias are more common, bilateral rarely occur.

This type of hernia is classified into subcutaneous, interstitial and preperitoneal. With subcutaneous bulging passes through the triple muscular layer of the peritoneal wall.

In the case of interstitial protrusion occurs through the abdominal muscles - transverse and internal oblique, but is closed by aponeurosis of the oblique external muscle. Hernial sac can bulge barely noticeable or reach a sufficiently large size.

The contents of the bulging cavity may include part of the intestine, including the small, colon, transverse and cecum. The gallbladder can also be in the hernial bag along with other organs, but this is rare.

Diagnostic features

Decision diagnosis of hernia spihelium line is difficult. This is proven by medical practice; inexperienced surgeons sometimes make mistakes due to unusual symptoms and for small preperitoneal and interstitial hernias that are covered with aponeurosis. Such errors can be very costly for patients, since infringement is possible, which can lead to tissue necrosis, peritonitis, and other terrible complications.

If hernia is difficult to detect, ultrasound and tomography of the abdominal organs are performed. In urgent moments with infringement, an urgent operation is carried out. In any case, a hernia of the spigelian line of the abdomen is operated on, and the sooner this is done, the better - less risk of serious complications.

The swelling of organs in the case of this type of hernia is not relieved once and for all and is not cured by other methods, surgical hernioplasty is the only way to get rid of the disease.

This is due to the fact that the hernial ring with such a protrusion is nonplastic at the edges, and the hernial bag requires mandatory reduction with simultaneous strengthening of the peritoneal wall.

Types of operations and materials

Modern clinics perform operations to remove a hernia of the abdominal spigelian line using the latest techniques, using innovative materials. For example, 3D endoprostheses are made of elastic components that have plastic memory and are able to bend in different directions.

Such materials make it possible to strengthen the peritoneum wall so that the mesh becomes like a cloth of its own. Polyester, polytetrafluoroethylene, prolen, marlex have a remarkable property, they grow into natural tissue, biologically compatible with it, which makes it possible to establish a strong strengthening of the peritoneal wall and prevent recurrent protrusion.

Hernioplasty or hernia surgery may be different. But surgical intervention is always inevitable, since the hernial ring is prone to expand and organ proliferation becomes more and more. Instead of a small part, for example, of the small intestine, whole loops of the intestine and other organs are found in the hernial sac.

  1. Obstructive open-type hernioplasty is the installation of 3D endoprostheses through an external abdominal incision, which can be of considerable size. In this case, the following surgical procedures are performed:
  • retraction of the removed organs into the peritoneal cavity to their former place is done,
  • the hernial sac itself is removed,
  • the opening of the exit hernial gate is truncated,
  • weakened areas of the peritoneal wall are strengthened with 3D implants installed during the operation.
  1. Obstructive obstructive hernioplasty is an endoscopy, that is, opening access to the hernia sac through three small punctures. During this operation, an introduction to the punctures of video equipment and manipulators is performed. With their help, the necessary manipulations are made to reduce the contents of the bag to the peritoneum, to remove the bag, to eliminate the defect in the wall and to insert the mesh to strengthen the walls.
  2. Stretch hernioplasty is an operation in which the opening and weakening of the abdominal walls are eliminated by the method of tensioning own tissues. This is a painful operation that requires patience from the patient during a long postoperative period. But the main drawback is that after the tension hernioplasty often there are recurrences of the hernia. This reason stops many patients choosing a more practical option using 3D endoprostheses.

Photo: implants for hernioplasty

Doctors and patients prefer the second type of operation, namely laparoscopic punctures, which brings minimal harm to the body. This preference is based not only on the low degree of morbidity of the method, although this is paramount. The aesthetic advantage of such operations is also important. Suffice it to say that after laparoscopy there are no traces on the skin of the abdomen and the recovery period is quick and painless.

Other advantages of the method include the reduction of the timing of the operation itself and observation of the patient after surgery, since relapse and re-prolapse are excluded.

Hernioplasty plus abdominoplasty

Since the protrusion of the hernial sac is always associated with stretching of the skin and the formation of excess skin on the abdomen, overgrowth of the bag with fatty deposits, hernioplasty in combination with abdominoplasty is offered to patients. That is, not only the removal of the hernia of the spigelian line, but also the modeling of the forms of the abdomen, which may include the following manipulations:

  • skin tightening - plasticity of excess skin,
  • liposuction - removal of excess fatty tissue,
  • correction of areas covered with cellulite,
  • correction of stretch marks - stretch marks, which were formed due to the tension of the dermis tissues during the formation of bulging.

The result of such corrections you can see on the pre-operative and postoperative photos, illustrating all the nuances of eliminating a hernia of the abdominal spigelian line. The price for operations in clinics is quite adequate. An open obturative hernioplasty without complications can be done in foreign clinics for an average of 35,000 rubles.

The more complex the operation, the more expensive it will be, for example, recurrent hernia is operated on by the open method for 42,000 rubles, and laparoscopy - for 85,000 rubles. Hernioplasty with abdominoplasty is the most expensive. Depending on what kind of corrective plastic you will do, you can pay from 190,000 rubles.


The main reasons that can trigger a neoplasm are considered:

  • weakness of the abdominal muscles,
  • increase in largely abdominal pressure.

Experts have identified a number of factors that predispose to the manifestation of a hernia spigelian line of the abdomen. These include:

  • heredity,
  • not normalized physical activities
  • childbirth
  • overweight,
  • pregnancy, in which there is noted the multiplicity, large fruit,
  • injuries
  • chronic diseases that can cause a prolonged, intense increase in intra-abdominal pressure.

Spigel's hernia exhibits symptoms that are similar to those of other types of abdominal hernias. This pathology can be localized on one / two sides of the abdomen. It is represented by a tumor-like formation, which is localized on the anterior wall of the peritoneum. Usually it is soft, elastic. In the case when the hernia is small, a specialist can correct it.

In the presence of pathology there are complaints about:

  • heaviness
  • discomfort
  • dull, undulating pain in the affected area.

Sometimes pains can decrease when lying down, their strengthening is usually noted at tension of muscles of an abdominal tension (long), by the end of the day.


Difficulties in diagnosing this pathology arise under the following conditions:

  • small size of hernia
  • herniation is interstitial,
  • the presence of a large layer of subcutaneous fat,
  • localization of pathology under the peritoneum.

Symptoms may resemble signs of diseases such as: adnexitis (in women), appendicitis, renal colic.

If any difficulties arise in the diagnosis, the specialist can use the following diagnostic methods:

  1. Magnetic resonance imaging.
  2. Ultrasound procedure.
  3. CT scan.

The most informative diagnostic methods, experts consider ultrasonography, computed tomography. They allow doctors to detect symptomatic abdominal hernia.

According to anamnestic data, the patient periodically appears protrusions in the area located between the navel, the anterior superior spine of the ilium.

An objective examination marked pain in the characteristic area for this pathology. The specialist needs to differentiate the disease with a number of others that are similar in symptoms:

  • renal colic,
  • hepatic colic,
  • appendicitis.

Considering the risk of complications in a spigelian hernia of the abdomen, the therapy is usually performed surgically. The danger of this pathology is due to the narrow hernial ring, their non-plastic edges. These features are dangerous infringement of hernial contents, which is observed in almost 40 - 70% of the total number of cases.

The operation can be performed openly, laparoscopically. Of course, the advantage remains for laparoscopically performed surgery. Because of its minimally invasiveness, the patient’s recovery after surgery is faster. For its implementation it is necessary to fill the belly with carbon dioxide. The laparoscope is inserted through small incisions made in the abdomen. The surgeon can push back the hernia, repair the defect, watching his actions on the monitor. After this method of operation, there remains a minimal risk of scar formation, and non-intensive postoperative pain is felt.

Experts usually prescribe a planned hernia repair to patients. Conducting hernioplasty doctors can use different cuts:

From the point of view of anatomy, doctors recognized oblique pararectal incision as the most successful access to the hernia. It helps to spare the nerve trunks of the anterior abdominal wall, their branches.

Treatment of abdominal spihelium hernia

A hernia of the spigel line is dangerous because it is poorly diagnosed, especially at the very beginning of the development of the disease. With the development of lunate hernia, the risk of its pinching and squeezing of intestinal fragments is high. This, in turn, can lead to disruption of its blood supply, obstruction and the occurrence of a purulent process. The bulging can be adjusted independently, but this will not lead to the disappearance of the hernia.

A hernia of the spihelium line of the abdomen is treated only by surgical intervention.

In order to maximize the quality of treatment, a Hernia Surgery Center has been established at SM-Clinic, which is located on Volgogradsky Avenue.

Surgery for hernias of the abdominal spihelium line

Removal of a hernia of the spigelian line of the abdomen is a difficult operation requiring high professionalism from the doctor. In the Center of Surgery "SM-Clinic" patients take specialists who own low-impact methods of surgical treatment of hernias.

The task of the surgeon is to isolate the hernial sac, return the organs to their anatomical location and strengthen the muscular walls of the abdominal cavity using the technique of non-tensioned hernioplasty. Our doctors perform operations for various types of hernia and any severity of the disease. Depending on the results of the examinations, they perform the following types of surgery:

Minimally invasive method of treatment of abdominal spigelian hernia using synthetic endoprostheses.

The operation is performed through an abdominal incision; mesh implants are used to strengthen the internal muscle tissue.

Plastic hernia of spigelian hernia of the abdomen using mesh implants

Previously, the patient’s own tissue was used to strengthen the weakened muscles of the abdominal wall by stitching the edges of the hernial gap. Among the disadvantages of the tension hernioplasty are a significant number of relapses (20–30%) and a long (up to 1 year) recovery period.

Specialists of the Surgery Center apply advanced technologies and perform non-tensioned hernioplasty using synthetic mesh prostheses. Such an implant is able to close even large defects of the abdominal wall and does not require the tension of body tissues. As a result, the risk of recurrent hernia is reduced, in the postoperative period, patients practically do not feel pain, and the recovery period lasts only a few weeks.

For non-tensioned hernioplasty, we use modern materials made in the USA and EU countries, including 3D grids, which make it possible to most effectively eliminate a spigelian line hernia.

What you should do

Why us?

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 theaters and more than 80 operating specialists in all areas of modern surgery.

Modern low-impact techniques

Endoscopic and laparoscopic surgeries are performed through mini-punctures, as well as radiowave bloodless surgery.

Specialists of the Center develop tactics of surgical treatment 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 wards.

24-hour comfortable hospital

Round-the-clock medical surveillance, highly qualified doctors and nurses, comfortable wards, and an individual menu.

Comprehensive treatment using modern opportunities of restorative medicine significantly reduces the rehabilitation process.

Transportation of the patient from any regions

Own ambulance service provides medical transportation and hospitalization of patients to our hospital from any cities and regions.

Hernia of the spihelium line of the abdomen and everything about it

Abdominal spigelial hernia is a rare pathology and is difficult to diagnose. As a rule, the protrusion is formed on the right side, however, development of a bilateral hernia is also possible.

According to the location in the layers of the abdominal wall, the hernia can be:

  • subcutaneous, located directly under the skin,
  • interstitial, being between the internal oblique muscle and aponeurosis,
  • properitoneal, located in front of the peritoneum.
The size of the protrusion can vary from 5 to 20 cm.

Remember that a hernia can develop over several years, adversely affecting the condition of the bulging organs.

Symptoms of abdominal spihelium line hernia

In general, symptoms of a hernia of the lunate line are similar to signs of other types of abdominal hernias. Usually bulging does not manifest itself in the initial stage. Later, symptoms that are characteristic of many diseases of the gastrointestinal tract organs can join: heaviness in the stomach, recurrent pains in the epigastric region, disorders of the bowels, etc. Often, the symptoms of the spigel line are "masked" as appendicitis symptoms, since pain occurs on the right side below the navel. An unequivocal sign of a hernia is a tumor-like formation in this area.

Types of operations to remove a hernia of the lunate midline

In recent years, private clinics have been practicing new methods for treating abdominal hernias. Apply 3D equipment that is biologically compatible with human tissue. In the process of recovery, the element grows into tissues, thereby making the peritoneal wall more durable and elastic, preventing the occurrence of relapses.

In most cases, the introduction of implants (hernioplasty) is combined with abdominoplasty. This suggests that the protrusion of the tissue is always accompanied by deformation of the skin. After surgery to remove the hernia sac, correction of excess skin is necessary, so this procedure is best performed in conjunction with treatment.

Under the abdominoplasty mean the following procedures:

  • plastic surplus skin,
  • destruction of body fat
  • elimination of cellulite zones,
  • elimination of stretch marks of the skin and soft tissues formed in the process of pathological protrusion.

The complexity of the operation depends on the stage of the hernia of the abdominal spigilian line. The cost of the correction is calculated in the range from 45 thousand rubles to 90 thousand rubles.

Important! Please note that a complex operation will cost several times more than a normal correction.

Symptoms and consequences of untreated hernia

Spigel's hernia is almost the same as other types of hernia that form in the abdominal region. Often the disease progresses in one of the parties, only in case of complications the disease affects both sides.

What does a spigel's hernia look like in tissue section

The protrusion of the lunate abdominal line in the early stages is practically not diagnosable. Symptoms of this defect are not always characteristic, often the patient complains of:

  • pulling, pressing, wavy colic,
  • symptoms like intestinal colic
  • pains similar to appendicitis,
  • women have cramping pains.

The disease develops quite rarely, but its advanced stage is dangerous to human life. The lack of timely treatment entails disruption of the digestive and circulatory system, causing the death of intestinal tissues and stomach.

Gymnastics Paul Bragg for the spine: 5 exercises that will change your life

For many years trying to cure joints?

The head of the Institute for the treatment of joints: “You will be amazed how easy it is to cure the joints by taking every day remedy for 147 rubles.

Stories know many names of propagandists of a healthy lifestyle, which Herodick laid the foundation for, his disciple Hippocrates, Aristotle, Galen developed. The poetic “Salerno Health Code” (first edition registered in 1480), which became a guide to diet and hygiene, is known.

History has shown that a combination of proper nutrition and exercise will help to preserve health for a long time, to realize dreams.

One of the big names in Valeology is the name of Paul Bragg. By promoting proper nutrition and physical exercises developed by him, he helped famous politicians, actors and singers, as well as millions of people, to restore health to the spine and joints, as well as the joy of life.

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Paul Bragg's biography is full of contradictions, even the date of birth is in doubt. Having no special education, he read a lot, followed the news of medicine and successfully compiled his knowledge into his health science. He considered himself to be “a man without age”, and, having 81 years behind him, was surfing and was an example of health and vigor.

What is the peculiarity of the approach

The name of Paul Bragg is known by the starvation system.

But this is not the only way to health and longevity.

Brag came to the conclusion that the spine is responsible for the overall health of the body.

All my life going in for sports, being a physical education teacher, on life examples I saw a direct connection between physical activity and health.

According to his autobiography, Paul Bragg began with the recovery of himself and his loved ones, and, having acquired experience and skills, began to help athletes to eliminate the effects of sprains, car accidents and other injuries.

According to his theory and practice, you can begin to restore the health of the spine at any age, the main thing is to perform the exercises regularly.

What can be achieved

Observing the athletes and leading an active life, Paul Bragg argued: "The health, strength, energy of a person depend not on age, but on the state of the spinal column." He developed a number of recommendations and a set of exercises to restore the spine. As a result of the implementation of the complex:

  • every muscle will gain elasticity
  • a natural posture is developed,
  • the spine gains flexibility
  • blood circulation will be restored
  • pain and discomfort imperceptibly reduce to zero,
  • together with the muscles, the internal organs will get stronger,
  • proper deep breathing will be restored.

Paul Brag argued that if you properly take care of your spine, then a person in old age will be healthy, active, will remain in his right mind.

Basic principles and rules

Being a cautious person, Paul Brag warned that it is impossible to do exercises forcibly, if you experience pain or fatigue, classes should be stopped and consulted a doctor. The maximum effect of the complex will be achieved with their smooth implementation.

The first 2 days of training exercises of the complex are performed three times, then - five, on the 6th - 7th day of training, the exercises are performed 10 - 12 times. If you feel improvements in health, then the Bragg complex can be performed 2-3 times a week and not stop there.

The human body is supported and its functioning is supported by 640 muscles, each of which must be loaded. Otherwise, some muscles atrophy, which causes pain or discomfort. And so you need to perform other exercises for arms, legs, upper and lower abdominals. Perfectly develops all muscle groups swimming, walking is very useful.

5 Fields Bragg exercises for the spine

Over time, the spine shortens. Even in the morning and in the evening, when measuring, you can fix a person's different height.

A sedentary lifestyle of a modern person leads to hypodynamia, which is manifested in the reduction of fluid between the vertebrae, followed by their damage. Various injuries (domestic and sports), improper distribution of the load lead to the deformation of the spine.

Even everyday anxiety, stress, and depression cause damage to the core of the body: excessive adrenaline destroys connective tissue, damaging the spinal cord and discs. It is necessary to start performing the complex with psychological preparation, with motivation and not to lose optimism before the end of classes.

Exercise One - Stretching

Lie on your stomach and take a “prone position”: lift your shoulders on straightened hands, resting your toes. Smoothly raise the pelvis and bend up the back, head down lower shoulders. In this position, gently lower and raise the pelvis several times (start with a small swing).

  1. Purpose: to influence the part of the nervous system responsible for the connection of the head, eyes, stomach and intestines with the central nervous system.
  2. It is achieved: headaches, eye fatigue and digestive problems practically go away.
  3. Restrictions: be extremely careful for people with problems in the lumbar and cervical, with high blood pressure and overweight

Exercise Two - Torsion

Take the "prone position". Raise the pelvis, head down lower shoulders. Gently turn the pelvis to the left, lowering the left side of the torso.

It is very important to feel the stretching of the muscles and the spine. Then return to the starting position and turn the basin to the right, lowering the right side. During the exercise, the arms and legs remain straight. The first days to perform 2 times, gradually increasing to 12.

  1. Purpose: relaxation of the spine, which contains the nerves responsible for the work of the liver, gallbladder and kidneys.
  2. Achieved: relief of the disease or disorder of the liver, gallbladder and kidneys, the organs perform their functions much better.
  3. Restriction: available to all, but it is necessary to strictly follow the recommendations.

Exercise Three - Low Bridge

Sit down, leaning his hands behind the buttocks. Bend the legs at the knees and lift the body parallel to the floor, resting on the palms of the hands and feet. Gently lower, then raise the body again. The exercise will be performed without jerking, first 3 times, then 12-18 times.

  1. The goal: to remove residual stress and completely relax the spine. Strengthen the muscles attached to the vertebrae and improve the condition of the intervertebral cartilage.
  2. Achieved: stimulation of each nerve center.
  3. Restriction: available to all.

Exercise Four - Boat

It is convenient to lie on your back, arms outstretched. Tighten your knees to your chest and clasp your arms, lift your head and press it to your knees. Fix this position for 5-10 minutes, until it is comfortable.

  1. Purpose: stretching of all vertebrae, especially the part of the spine that controls the work of the stomach.
  2. It is achieved: effective stretching of the vertebrae releases the strangulated nerve endings, leads to the restoration of the body and the normalization of its work.
  3. Restriction: the presence of a hernia of the spine or problems with the lumbar region can lead to nerve incarceration. Perform carefully.

Exercise Fifth - Walking

To lie on the floor, to take the “prone position” position, as in the first exercise to bend your back and lower your head. In this position take a few steps. It is important to remember that the legs and arms remain flat.

  1. Purpose: all spinal sections regulating the work of the large intestine are activated.
  2. Achieved: spinal stretching.
  3. Restriction: the presence of hypertension - posture with his head down can cause an increase in pressure, headache.

How to do the Bragg field exercises for the spine in practice - a video lesson and with pictures - explanations:

Correct posture

This exercise, according to Fields, includes a mechanism to control the natural state of the spine.

To perform it, you must become your back against the wall, as much as possible cling to it. It is necessary to find such a position of the waist that a finger would fit between it and the wall.

It is necessary to involve the stomach, slightly bend the knees, straighten the shoulders - it is very important to remember your feelings in this position.

Having stood for one or two minutes, you can take the first steps without changing your position and, most importantly, your feelings against the wall. Here in this position you need to take steps:

  • on slightly bent legs
  • slightly springy
  • keeping a slight tension in the abdomen and raised shoulders.

How to sit

The soft seats of chairs and chairs lead to a strong tension in the spine and pressure on the intervertebral discs. Chairs are available in standard sizes and differ in the shape of the backrest; nevertheless, working chairs should be tried on: sitting on it, the thigh and shin are at a 90 degree angle, and the seat should not be longer than half the length of the thigh.

In the ideal case, the back of the chair should follow the line of the spine. With computer and office chairs, the situation is a little simpler: an adjustable height of the seat and back, as well as a variable angle of inclination will help you find the right parameters for the chair.

It is necessary to sit correctly: press your back to the back of the chair, your shoulders are straightened, your stomach is tense, you have your head lifted up - this is how you were taught to sit in school. Never to put a foot on a leg - it provokes the development of many diseases, based on vascular infringement, impaired blood circulation, blood stasis. Sitting on a chair should be smoothly, avoiding the impact of the spine.

Watch the video: Surgeons use new technique to fix hernia the size of a football (April 2020).