A hernia occurs when an internal part of the body pushes through a weakness in the muscle or surrounding tissue wall. Your muscles are usually strong and tight enough to keep your intestines and organs in place, but a hernia can develop if there are any weak spots.
An inguinal hernia is the most common type of hernia. The hernia can appear as a swelling or lump in your groin, or as an enlarged scrotum. The swelling may be painful.
The lump will often appear when straining and disappear when you lie down.
Inguinal hernias can be repaired using surgery to push the bulge back into place and strengthen the weakness in the abdominal wall. The operation will only usually be recommended if you have a hernia that causes severe or persistent symptoms, or if any serious complications develop.
Complications that can develop as a result of an inguinal hernia include:
Surgery will get rid of the hernia and prevent any serious complications, although there is a chance of it returning after the operation.
Causes an inguinal hernia:
An inguinal hernia usually occurs when fatty tissue or a part of bowel, such as the intestine, pokes through into the groin at the top of your inner thigh. It pushes through a weak spot in the surrounding muscle wall into the inguinal canal. The inguinal canal is a channel through which blood vessels to the testicles pass in men and through which the round ligament, the ligament surrounding the womb passes in women.
Inguinal hernias occur mainly in men. Most are thought to be due to ageing. This is because as you get older, the muscles surrounding your abdomen tend to become weaker. Inguinal hernias can sometimes appear suddenly due to strain on the abdomen, such as straining on the toilet if you have constipation or carrying and pushing heavy loads. They have also been linked to having a persistent, heavy cough.
There are two ways that an inguinal hernia repair can be performed:
There are advantages and disadvantages to both methods. The type of surgery you have will depend on which method suits you and your surgeon’s experience. You should be able to go home the same day or the day after surgery. It’s important to follow the hospital’s instructions on how to look after yourself. This includes eating a good diet to avoid constipation, caring for the wound and not straining yourself too soon. Most people make a full recovery from inguinal hernia repair within six weeks, although many people are able to return to driving, work and light activities within two weeks.
The hospital will send you instructions about when you need to stop eating and drinking before the operation. The operation usually takes about 30-45 minutes to complete and you’ll usually be able to go home on the same day. Some people stay in hospital overnight if they have other medical problems or if they live alone.
Keyhole (laparoscopic) surgery
General anaesthetic is used for keyhole inguinal hernia repair, so you’ll be asleep during the operation. During keyhole surgery, the surgeon usually makes three small incisions in your abdomen. A thin tube containing a light source and a camera is inserted through one of these incisions so the surgeon can see inside your abdomen. Special surgical instruments are inserted through the other incisions so the surgeon can pull the hernia back into place.
There are two types of keyhole surgery:
Keyhole surgery tends to have a quicker recovery time in people who:
However, the risks of serious complications, such as the surgeon accidentally damaging the bowel, are higher with keyhole surgery than with open surgery. The risk of your hernia returning is similar after both operations. Discuss the advantages and disadvantages of keyhole and open surgery with your surgeon before deciding on the most appropriate treatment.
After the Procedure
Most patients are able to get out of bed an hour or so after this surgery. Most can go home the same day, but some may need to stay in the hospital overnight.
Some men may have problems passing urine after hernia surgery. If you have problems urinating, you may need a catheter (a flexible tube that will drain urine) in your bladder for a short time.
Most people make a full recovery from inguinal hernia repair within six weeks, although many people are able to return to driving, work and light activities within two weeks.
Avoid straining. Increase your bowel movements by increasing fiber in your diet or over the counter medications. Be sure to drink 8-10 glasses of water each day.
A hernia is a gap or space in the strong tissue that holds muscles in place. A hernia occurs when the inside layers of the abdominal muscle have weakened, resulting in a bulge or tear.
In the same way that an inner tube pushes through a damaged tire, the inner lining of the abdomen pushes through the weakened area of the abdominal wall to form a small balloon like sac. This can allow a loop of intestine or abdominal tissue to push into the sac.
The hernia can cause discomfort, severe pain, or other potentially serious problems that could require emergency surgery.
The common areas where hernias occur are in the groin (inguinal), belly button (umbilical), and the site of a previous operation (incisional). It is usually easy to recognize a hernia. You may notice a bulge under the skin. You may feel pain or discomfort when you lift heavy objects, cough, strain during urination or bowel movements, or during prolonged standing or sitting. Other times a hernia may be detected by your doctor on a routine physical examination. The pain may be sharp and immediate or a dull ache that gets worse toward the end of the day.
Severe, continuous pain, redness, and tenderness are signs that the hernia may be entrapped or strangulated. Another sign of this is if the bulge used to come and go, but now is stuck out. These symptoms are cause for concern and you should immediately contact your physician or surgeon.
The wall of the abdomen has natural areas of potential weakness. Hernias can develop at these or other areas due to heavy strain on the abdominal wall, aging, injury, an old incision or a weakness present from birth. Anyone can develop a hernia at any age. Most hernias in children are congenital. In adults, a natural weakness or strain from heavy lifting, persistent coughing, difficulty with bowel movements or urination can cause the abdominal wall to weaken or separate.
Laparoscopic Hernia Repair is a technique to fix tears in the abdominal wall muscle using small incisions, telescopes and a mesh. Laparoscopic repair offers a shorter return to work and normal activity for most patients.
Only after a thorough examination can your surgeon determine whether laparoscopic hernia repair is right for you. The procedure may not be best for some patients who have had previous abdominal surgery, prostate surgery, or underlying medical conditions.
There are few options available for a patient who has a hernia.
Most hernias require a surgical procedure. Surgical procedures are done in one of two fashions:
In a small number of patients the laparoscopic method cannot be performed. Factors that may increase the possibility of choosing or converting to the “open” procedure may include obesity, a history of prior abdominal surgery causing dense scar tissue, inability to visualize organs or bleeding problems during the operation.
The decision to perform the open procedure is a judgment decision made by your surgeon either before or during the actual operation. When the surgeon feels that it is safest to convert the laparoscopic procedure to an open one, this is not a complication, but rather good surgical judgment. The decision to convert to an open procedure is strictly based on patient safety.
Following the operation, you will be transferred to the recovery room where you will be monitored for 1-2 hours until you are fully awake.
Once you are awake and able to walk, drink liquids, and urinate, you will be sent home. Some soreness can be expected mostly during the first 24 to 48 hours. You are encouraged to be up and about the day after surgery.
With laparoscopic hernia repair, you will probably be able to get back to your normal activities within a week. These activities include showering, driving, walking up stairs, lifting, working and engaging in sexual intercourse.
Any operation may be associated with complications.
It is important to remember that before undergoing any type of surgery-whether laparoscopic or open-you should ask your surgeon about his/her training and experience with the operation.
Be sure to call your physician or surgeon if you develop any of the following:
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