An inguinal hernia occurs when the viscera/tissues protrude through a weak area at the groin. Inguinal (Groin) hernias are the most common type of hernia, predominant in males. There are two types of inguinal hernia in men, indirect and direct. Indirect inguinal hernia: When the hernia follows the path of testicular descent, an area of preexisting weakness since birth. It may be unilateral or bilateral. Direct inguinal hernia: This hernia does not follow the path of testicular descent and more medially located compared to indirect hernias. This is usually bilateral and occurs in adulthood. This is due to a prolonged increase in intra-abdominal pressure like recurrent cough, difficulty in passing urine and chronic constipation. Adults with significant urinary obstruction due to prostate gland enlargement should consult Urologist before surgery.
Initially, all the hernias are asymptomatic swellings. As time passes, they may lead to
A hernia is the result of a mechanical defect and cannot be cured by medicines. Surgery is required for cure. With time the hernia increases in size, the repair will become difficult or patients may develop complications if not treated in time. Doctors usually advise surgery as soon as possible once the diagnosis is made.
This repair is preferred nowadays and is done under general anesthesia. The hernial repair will be done through 3 small holes (one 10 mm and two 5 mm). The abdomen is inflated with carbon dioxide gas. The hernial sac will be dissected out and space is created to place the mesh. Usually, a polypropylene mesh is used for covering the defect all around adequately. Most of the time, patients will be able to walk on the same day of surgery and if stable they will go home without the need to stay in the hospital. There will only be small scars. Laparoscopic mesh repair is preferable for patients who developed hernias after previous open hernia repair and bilateral hernias (hernia on both sides). Fluid collection in the empty space which was previously occupied by hernial contents is called 'seroma' and is very common. This will mimic hernia in the immediate postoperative period. Usually, seromas disappear over 6 weeks without serious consequences.
Through a groin incision, the hernia is explored and reduced. A piece of polypropylene mesh is kept over the defect to reinforce it. It is associated with fewer recurrences and without a significant increase in the complications. This is can be done under general/regional anesthesia.
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