Laparotomy, all about the operation for Pope Francis
Pope Francis underwent laparotomy surgery due to an incarcerated incisional hernia, a condition that can arise following a previous operation in which a surgical incision was required in the abdomen. All the details
“Pope Francis is fine. He's awake, it's eve, he's already made a joke. I spoke to him 10 minutes ago. He has already joked and teased me, asking me 'when do we do the third?'”. This is the comment of the surgeon Stefano Alfieri who performed the laparotomy surgery Pope Francis underwent yesterday at the Gemelli University Hospital in Rome.
In 2021, in fact, Alfieri had already taken care of the pontiff for an operation on the intestine due to an inflammation of the diverticula.
WHY POPE FRANCIS WAS OPERATED
Pope Francis was operated on for an incarcerated incisional hernia, a hernia that forms on a scar after abdominal surgery if the wound does not close perfectly. This is one of the possible drawbacks of laparotomy surgery, where the surgeon makes a few centimeters incision in the abdomen.
Over time, in fact, Humanitas explains, in about 10% of surgical incisions made on the abdomen there may be a failure of the muscle-fascial wall through which the peritoneum emerges, a thin sheet folded on itself that separates the organs internal from the abdominal wall.
The appearance of incisional hernia can be caused not only by previous abdominal surgery but also by advanced age, overweight or obesity.
This condition can be asymptomatic, but it also happens that it causes discomfort or pain and manifests itself with swelling at the surgical scar. It resolves with an operation performed in the traditional way or laparoscopically.
In the case of the "incarcerated" incisional hernia, the one that struck the pontiff, the blood supply to the herniated part is insufficient to carry oxygen, with serious consequences for the intestine. “The problem becomes serious when an abdominal viscera becomes blocked inside the incisional hernia; what we technically define as 'incarceration of an intestinal loop' occurs with possible serious consequences”, explained Professor Roberto Coppola, director of general surgery at the Campus Bio-Medico University Hospital Foundation in Rome and lecturer campus university.
WHAT THE OPERATION CONSISTS OF
In the presence of a small incisional hernia, laparoscopic surgery can be considered, which consists of three small incisions that allow access to a video camera and work tools, which can be controlled from the outside but which show the area from the inside. of fascial failure.
In cases, however, in which the incisional hernia is of considerable size, a laparotomy operation may be necessary, with a large incision in the abdomen, often practiced on the same scar as a surgical access route.
Both interventions require general anesthesia and the duration of the operation ranges from 2 to 3 hours.
CONVALESCENCE AND RECOVERY
Generally, a two-day hospitalization is required for convalescence. In the case of the Pope, as reported by Avvenire , the hospitalization is estimated at about ten days because, as Alfieri explained, "tenacious adhesions were found between some intestinal loops and the parietal peritoneum", which were the cause of the symptoms.
Once discharged, the patient must avoid physical exertion for at least 15 days and wear an elastic compression bandage for at least a month. Not surprisingly, Alfieri said he had recommended to the Pope "not to make efforts and lift weights" and he looked at him as if to say "I'm the Pope , do you think I lift weights ?".
HOW FREQUENT ARE THE CASES OF LAPAROCELE
Finally, a report by the Italian Society of Endoscopic Surgery and New Technologies (Sice), updated to February 2022, reports that around 17,000 cases of incisional hernias and primitive ventral hernias are recorded every year in Italy. The latter, unlike incisional hernias, do not develop in correspondence with scars and are due to the failure of the abdominal wall in a specific point or in any case of a specific anatomical structure.
This is a machine translation from Italian language of a post published on Start Magazine at the URL https://www.startmag.it/sanita/laparotomia-papa-francesco/ on Thu, 08 Jun 2023 10:59:07 +0000.