Cirurgia é tratamento-padrão para corrigir hérnia abdominal

Estimativas do Ministério da Saúde indicam que entre 3% e 8% dos brasileiros apresentam algum tipo de hérnia na região do abdômen. Apesar de ser um problema relevante de saúde pública, as hérnias podem ser tratadas com cirurgia e, na maioria dos casos, nunca mais incomodam.

As hérnias abdominais correspondem ao escape de uma víscera através da parede abdominal, geralmente refletindo o enfraquecimento, afastamento ou a ruptura da musculatura do abdômen.

Nem sempre as hérnias dão sinais, principalmente quando são pequenas. No entanto, quando começam a escapar pelos orifícios do abdômen, podem ser reconhecidas com abaulamentos na região ou causarem muitas dores.

As dores relacionadas às hérnias abdominais costumam ser piores durante esforços físicos, como levantar objetos pesados ou ficar durante muito tempo em pé, ou quando a parede do abdômen é contraída rapidamente durante o esforço para evacuar ou tossir. A pressão feita ao colocar a mão na boca e soprar, exame típico realizado em jovens durante o alistamento militar obrigatório, também pode indicar a presença de hérnias.

Os sintomas relacionados às hérnias abdominais podem surgir e desaparecer espontaneamente, voltando a se manifestarem de novo. Às vezes, porém, a víscera pode ficar presa no orifício da hérnia, deixando de retornar à posição normal. Quando isso acontece, há um bloqueio da circulação sanguínea no trecho aprisionado, podendo provocar a necrose desse tecido. Se for uma alça intestinal, pode até ocorrer um rompimento. Nesses casos, além da dor, surgem náuseas e vômitos.

Diagnóstico e tratamento

Na maioria dos casos, as hérnias abdominais são diagnosticadas pelo médico em simples avaliações clínicas, olhando e tocando a região, mas às vezes podem ser necessários exames de imagens.

O tratamento-padrão é cirúrgico e quanto mais cedo for realizado, melhor, sendo que nos casos de hérnias aprisionadas, a cirurgia deve ser realizada com urgência.

As cirurgias contra a hérnia podem ser abertas ou por laparoscopia, considerada minimamente invasiva.

Ambos os procedimentos são realizados por meio de um pequeno corte sob anestesia local ou peridural. A hérnia é empurrada para dentro do abdômen e o orifício é fechado com uma tela, feita de material resistente e próprio para essa correção.

A recuperação pós-operatória da hérnia costuma ser rápida. Geralmente no mesmo dia ou no dia seguinte o paciente recebe alta hospitalar, mas deve seguir algumas orientações médicas, como não fazer esforço físico por dez dias.

Entre os possíveis efeitos pós-cirúrgicos, estão: dor, lesão de nervo, infecção e, às vezes, recidiva da hérnia.

A cirurgia robótica é considerada uma evolução da cirurgia minimamente invasiva laparoscópica. O cirurgião estabelece os acessos laparoscópicos e introduz a câmera e os instrumentos de trabalho no interior do corpo do paciente por meio de pequenas incisões feitas pelo robô. Com isso, o médico tem uma excelente visão para realizar a cirurgia, além de contar com movimentos precisos dos braços do robô.

A experiência obtida pela instituição no tratamento dos mais variados tipos de hérnia contribuiu para a criação de cursos médicos na área desde 1998.

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