Groin and legs

Inguinal hernia surgery: preparation and rehabilitation

Inguinal hernia is quite common. This is one of the most common defects in the human abdominal cavity. In addition, it is the inguinal hernia that is considered, to a greater extent, a male disease. This is due to the special structure of the male body, including the structure of the inguinal canal.

In women and children, bulging also occurs. But, as a rule, much less often and is more likely a consequence of weakening of the muscles.

Treatment of inguinal hernia takes place exclusively with the help of surgery, or hernia repair, as this type of surgery is also called. Other methods, referred to as folk, do not bring the desired result and can cause complications.

I have been engaged in the treatment of hernias and diseased joints for many years. I can say with confidence that any hernia can be treated always, even in the deepest old age.

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Sometimes, the bulge that has formed in the groin, descends into the male scrotum. This, again, is associated with the peculiarity of the structure of the body of a man. In this case, the inguinal hernia can still be called scrotal. A scrotal hernia has the same treatment as a bulging in the groin - through surgery.

Despite the prevalence of the phenomenon, many people who are faced with a similar ailment, begin to worry about the treatment of hernia through surgery. There are many factors that encourage people to agree or refuse to have hernia repair:

  • fear of surgery,
  • distrust of the surgeon or of surgery in general
  • poor tolerance of anesthesia
  • fear of complications
  • the difficulty to determine the seriousness of the disease,
  • other factors.

The first stage of preparation for surgery

When a person has been diagnosed with an inguinal hernia, the necessary examinations should be performed. The bottom line is to determine the severity of the hernial protrusion and the possibility of infringement. Infringement can affect the course of the operation, since if an inguinal hernia is pinched, removal of the inguinal hernia is necessary immediately.

A person at such moments does not have time to prepare, because surgery requires moral and physical training. Therefore, if a person has all the indications for an inguinal operation, one should nevertheless agree on it.

If an operation to remove an inguinal hernia is scheduled, the task of the surgeon is to explain what kind of operation it is, how it will be performed, what kind of anesthesia will be involved, what needs to be done to prepare for removal.

Different people differently perceive the upcoming operation of the inguinal hernia. Some ask for advice from relatives, others - climb on the forums and the Internet. But the most qualified answer can be obtained only from a doctor who will do the removal of protrusion.

Be careful!

Before I read on, I want to warn you. Most of the "treating" hernia that advertise on TV and sell in pharmacies is a complete divorce.At first it may seem that the cream and ointment help, but in reality they only remove the symptoms of the disease.

In simple words, you buy the usual anesthetic, and the disease continues to develop into a more difficult stage.

A common hernia can be a symptom of more serious diseases:

  • Muscular dystrophy of the buttocks, thigh and lower leg,
  • Pinch of the sciatic nerve,
  • Seps - blood poisoning,
  • Violation of the tone of the muscular wall of the blood vessels of the lower extremities,
  • Horsetail syndrome, often resulting in paralysis of the lower limbs.

How to be? - you ask.

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So that you do not think that you are being sucked in by the next “miracle cream”, I will not describe what kind of effective drug it is. If interested, read all the information about Hondrexil yourself. Here is the link to the article.

Preparation for the operation will be successful if you follow all the doctor’s instructions and don’t be afraid to ask questions that interest you. A positive attitude is half the battle.

Preparing for anesthesia

For hernia repair, modern surgery uses three types of anesthesia:

  • general anesthesia
  • regional anesthesia
  • local anesthesia.

The choice of anesthesia depends on the tolerance of anesthesia by a particular person, the type of hernia, and its size.

To prepare for future anesthesia, a surgeon examines the history of previous illnesses and the response to past anesthesia. Before anesthesia, wash the patient's intestines and undergo a premedication course.

Premedication takes place several hours before surgery. Its duration and use of specific drugs depends on the condition of the patient. The patient on the night before hernia treatment with anesthesia is prescribed a sleeping pill, and on the eve of it can be administered narcotic analgesics.

If a person has mental or psychological disorders, tranquilizers can be given in small doses. These soothing medications help the body relax and more easily withstand the upcoming stress. In the presence of allergic reactions or intolerance to a particular drug, treatment is not started without the introduction of antihistamines, which extinguish the action of allergens.

Before the operation, the patient is required to examine the oral cavity, and remove prostheses, false teeth.

Treatment of an inguinal hernia through an operation lasts depending on the presence of complications. In general, this time takes from 30 minutes to one and a half hours. Consequently, the effect of anesthesia will not be long.

If the surgery is extreme, the stomach is first washed, and premedication is performed directly on the operating table before anesthesia.

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At the age of 45 I got a hernia. When I turned 58, complications began, I almost could not walk, and these terrible pains, you just can’t imagine how I was in pain, everything was very bad. What did not try, hospitals, clinics, procedures, expensive ointment. nothing helped.

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Who wants to live a long and energetic life without a hernia, take 5 minutes and read this article.

When discussing the forthcoming intervention with the anesthesiologist, it is necessary to mention the presence or absence of diabetes mellitus, and the opportunity to take medications.

General preparation for surgery

What you need to know when preparing for an operation? It is important that at the time of the operation of the inguinal hernia there were no other associated diseases. Therefore, if surgery for inguinal protrusion is planned, you should carefully examine the body for the presence of other diseases.

Then the patient is examined by an anesthesiologist, who will do anesthesia while removing an inguinal hernia. Thus, it is possible to reduce the possibility of complications during the operation.

The choice of anesthesia mainly depends on the protrusion itself. At an early stage, local anesthesia is usually prescribed.

Modern surgery from the necessary tests before surgery requires testing for infections, blood, urine, and coagulogram. The patient will also have an x-ray of the chest and an electrocardiogram.

Stories of our readers

Cured hernia at home. It's been 2 months since I forgot about my hernia. Oh, how I used to suffer, it was a terrible pain, lately I could not walk properly. How many times I went to the clinics, but there only expensive tablets and ointments were prescribed, from which there was no use at all. And now the 7th week has gone, as the hernia doesn’t bother me a bit, I go to the dacha in a day, and I go 3 km from the bus, so generally I go easily! All thanks to this article. Anyone who has a hernia - be sure to read!

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One month before surgery:

  • you should start eating well so that the body has a lot of energy and strength. Stressful situations that await in surgery, exhausting the body. you need to eat meat, vegetables, fruits, all sorts of vitamins,
  • often you can not take aspirin or similar drugs, because they affect the blood coagulation in the body. The risk of hematoma formation increases.
  • The treatment is more successful if the person is in good physical and psychological form. You should do at least the minimum set of permitted physical exercise to prepare the body,
  • should stop smoking and alcohol.

A few days before the hernia repair:

  • It is necessary to refuse diets, a vegetarian way of life or the use of super-calorie dishes. Moderation in food is necessary to replenish reserves of strength before inguinal intervention,
  • women who take oral contraceptives should discuss the possibility of their further use with a surgeon and their gynecologist,
  • treatment with antihistamines in the presence of allergic reactions should be discussed with the surgeon.

The day before surgery:

  • The last meal before the operation should be no later than 19:00,
  • remove the varnish from the nail plate for the convenience of surgeons to recognize the person's reaction to an action,
  • to take hygienic lipstick with you, since after the removal of the hernial protrusion it is impossible to use cosmetics and creams,
  • an enema is done to clean the intestines,
  • should buy a bandage, which will be needed after surgery.
  • prepare the place of operation, hair is removed,
  • women are better off carrying personal care products, because due to stress, menstruation may start earlier,
  • remove contact lenses, false jaw,
  • need to wait with food and water,
  • repeated enema is performed,
  • doctors can band their lower limbs to avoid thromboembolic complications,
  • immediately before the operation it is better to go to the toilet, because later this possibility may not fall out.

Home> Gastroenterology> Surgery for an inguinal hernia in men - types of operations, preparation, prognosis

Surgery for an inguinal hernia in men - types of operations, preparation, prognosis

Surgery is the only effective treatment for inguinal hernia. All other methods (bandages, drugs) can be used only as a temporary measure, or in cases where surgical treatment is contraindicated for any reason.

The purpose of the operation is a radical elimination of the hernia and the creation of conditions that prevent its recurrence. To do this, carry out the removal of the hernial bag and closure of the hernia gate.

Fig. 1 - Types of inguinal hernia in men.

For hernia repair with subsequent plastic surgery, many surgical techniques have been developed - there are more than 100 types of operations for inguinal hernia. However, only a few of them have received practical application.

In Russia, the most popular are operations according to the Spasokukotsky, Girard, Bassini, Martynov methods and their variations. The surgeon gives preference to one or another method depending on the characteristics of the hernia in a given patient, taking into account the specifics of the topography of the inguinal canal, the type of hernia, the size of the hernia gate. Important and own practical skills (level of knowledge of a particular technique).

Comparison of types of surgery

With open surgeries, one skin incision is performed from 5 to 8 cm, with laparoscopic - three, 1.5-2 cm long (see Fig. 2). In endoscopic operations, an optical device (laparoscope) is inserted into one incision for visual inspection, and others are provided with manipulators for direct intervention. The computer screen displays a picture of the operation, which the surgeon and his assistants can follow.

Fig. 2 - Difference between the usual incision and laparoscopy.

Further stages in both approaches consist in removing a part of the peritoneum, the protrusion of which led to the formation of a hernia, as well as further plasticity (strengthening or forming a new) of the inguinal canal. Plastic posterior wall of the channel is carried out using the tendon plates of the oblique abdominal muscles of the patient (tension techniques) or by filing artificial mesh (non-tension methods).

In modern surgery, both non-absorbable (polypropylene) and partially absorbable (propylene in combination with monocryl) transplants are used. The advantage of the latter is that within a few months they dissolve up to half of their volume, and as a result less foreign material remains in the patient's body.

Table 1 - Advantages and disadvantages of various options for hernia repair.

Inguinal hernia - operation, preparation, restoration

Inguinal hernia is one of the most common types of hernia that form in the abdominal wall. As a rule, the disease develops in men and is associated with the peculiarity of the structure of the male inguinal canal. Getting rid of an inguinal hernia is possible only by surgery. If you ignore the disease, it is possible the occurrence of complications that require urgent operational assistance. Consider how the operation is performed to remove an inguinal hernia, which includes preparation for treatment and how the restoration proceeds.

Modern inguinal hernia surgery

To remove an inguinal hernia, there are several types of modern operations.

  • When carrying out plastics with own tissues, the hernia gate is closed by using the patient's own tissues (muscle, fascia and aponeuroses).After such operations, the variation in the recurrence rate ranges from 2 to 15 percent, which depends on the method and correctness of the choice of hernioplasty, the condition of the patient's tissues. The main disadvantages include the preservation of pronounced pain for several days after surgery, which is explained by the tension of the tissues and long periods of physical rehabilitation. After surgery, intensive physical labor is contraindicated for 3 months.
  • Modern operations that allow the removal of an inguinal hernia include laparoscopic plastic surgery. Most often, the closure of the abdominal wall defect is carried out from the inside of the abdominal cavity, for this purpose, a synthetic mesh prosthesis is used. After this method of plasty, the recurrence rate is 2-5%, which depends on the type of hernia and the degree of preparedness of the surgeon. The advantages of this method of treatment include a small invasiveness, therefore, the appearance after surgery of minor pain syndrome, rapid rehabilitation. The disadvantages of the laparoscopic method are the need to introduce gas into the abdominal cavity in order to create the operational space, the need for general anesthesia, the high cost of equipment and technical complexity.
  • The use of plastic methods “without tension” of the patient’s own tissues is becoming increasingly popular. During this operation, the recurrence rate is no more than 1%. Pain syndrome after surgery is minimal, since there is no tension of own tissues. Allowed the possibility of intensive physical labor one month after the operation, there are no restrictions on household physical activity, so that this operation can be carried out in an outpatient clinic. Operations can be performed under spinal and local anesthesia.

Preparation before surgery

In preparation for the operation to remove the inguinal hernia is the passage of a full examination. The appointment of the operation is possible only after the somatic status of the patient is evaluated by the anesthesiologist, thereby minimizing the occurrence of complications. The choice of anesthesia depends on the size of the hernia: if the stage of the disease is early, then the operation is performed under local anesthesia, otherwise general anesthesia is necessary. During preoperative examination, the clinical composition of blood and urine is investigated, a biochemical blood test, an infection test, a coagulogram are taken. In addition, an electrocardiogram and chest x-ray are needed.

Complications after inguinal hernia treatment

After treatment of an inguinal hernia, a relapse is possible, but if the method of surgery was chosen correctly, the surgeon is properly qualified, his probability is very low.

The most unpleasant complication after the treatment of the inguinal hernia is suppuration of the surgical wound, as a result of which the rehabilitation period is lengthened, the likelihood of hernia recurrence increases, and a visit to the doctor for dressings is necessary.

Recovery after surgery

The recovery period after an operation to remove an inguinal hernia takes a little time and is directly dependent on the type of anesthesia used in surgical intervention. If the operation was performed under general anesthesia, the patient can go home the next day; when performing the operation under local anesthesia, the patient needs to be spent in the hospital only a few hours. The outpatient period takes 7-10 days, during which the patient must visit the operating surgeon for dressings and consultations, during which, if necessary, the appointment is adjusted.

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Draw conclusions

We conducted an investigation, examined a bunch of materials, and most importantly, we checked the majority of hernia treatments. The verdict is:

All drugs gave only a temporary result, as soon as the treatment was stopped - the pain immediately returned.

Remember! There is NOT ANY MEANS that will help you to cure a hernia if you do not apply a complex treatment: diet, regimen, physical exertion, etc.

Modern means of hernia, which is replete with the entire Internet, also did not produce results. As it turned out - all this is a deception of marketers who earn huge money on the fact that you are led by their advertising.

The only drug that gave significant
the result is chondrexyl

You ask, why does everyone who suffers from a hernia in a moment did not get rid of it?

The answer is simple, Hondreksil is not sold in pharmacies and is not advertised on the Internet. And if they advertise - then this is a FAKE.

There is good news, we went to the manufacturers and share with you a link to the official site Hondreksil. By the way, manufacturers do not try to profit in public with sore joints; according to the promotion, each resident of the Russian Federation and the CIS can receive one package of the drug IS FREE!

Modern surgical methods

Currently, there are several varieties of modern methods of surgical intervention. These types of operations for the removal of inguinal hernia include the following:

  1. During plastic manipulations with own tissues, the hernia gate is closed by applying the patient’s own tissues. For this, muscles, aponeurosis, fascia can be used. After such an operation to remove an inguinal hernia, the recurrence rate is from 2 to 15%, which will depend on the method and the accuracy of the selected hernioplasty, as well as on the condition of the patient’s tissues. The main disadvantage of this type of procedure is the preservation of a strongly pronounced pain syndrome, which lasts for several days after the operation. This can be explained by the fact that the tissue is stretched, and the period of physical rehabilitation is very long. As a rule, after such an operation to remove an inguinal-scrotal hernia, it is contraindicated to engage in physical exertion for 3 months.

Preparing for an inguinal hernia surgery

Preparation for this procedure involves the patient undergoing a full examination. The operation can be assigned after a specialist has evaluated the patient's somatic status. Due to this, it is possible to minimize the occurrence of various kinds of complications.

The choice of anesthesia will be based on what the size of the hernia is. If the stage of this disease is still early, then local anesthesia can be used for the operation, otherwise general anesthesia will be required. During the preoperative examination specialist examines the clinical composition of urine and blood. Also, the patient will need to donate blood for biochemical analysis, coagulation and analysis for infection. In addition, a chest x-ray and an electrocardiogram will be required.

Surgery to remove an inguinal hernia in children

In children, an inguinal hernia is a mid-sized lump that forms in the abdomen. Often a similar phenomenon is observed immediately after birth. There are many methods of treatment of this pathology.Therapy at the same time is selected on the basis of a variety of education. If it is already running, then an operation to remove an inguinal hernia in children will be required.

As a rule, surgical intervention is prescribed for the incision of a hernia. If the intestinal loop is pinched, the blood circulation is disturbed, which can cause necrosis and peritonitis. In girls, in some cases, the ovary and fallopian tube are pinched, which can eventually cause infertility.

A specialist is assigned an operation in the coming days after the diagnosis. In some cases, this procedure is postponed, for example, if the baby has any health problems. However, immediately after improving the general condition, surgery is performed.

Reviews of surgery to remove an inguinal hernia in children suggest that laparoscopy is used in most cases. During this procedure, small punctures are made in the abdominal cavity. As a rule, such operations are painless and do not pose a particular danger to the life of the child. Considering how long an operation to remove an inguinal hernia is by means of laparoscopy, this procedure takes from 30 minutes to 1 hour.

Features of the rehabilitation period

Since a hernia in the groin area in most cases is a result of muscle weakness, during the entire postoperative period, the prevention of measures aimed at strengthening the muscle walls located in the groin and abdomen is considered key.

The duration of the rehabilitation period of recovery of the female or male body will depend on the chosen method of operation. It will also depend on the type of anesthesia that was used at the hernia repair event.

As a rule, the duration of the outpatient period is from 8 to 10 days, if surgery was organized. At this time, patients should adhere to bed rest, save their strength, and also try to avoid any physical activity. In parallel with this, a special diet is prescribed.

Another prerequisite is regular visits to the doctor. Thanks to this, it will be possible to quickly respond to any changes occurring inside the body, and if necessary, take appropriate measures to control the intensity of the pain or change tactics that are aimed at prompt recovery after the removal of the inguinal hernia.

Throughout the outpatient period, exercise is absolutely contraindicated, including even the easiest exercise. The duration of this abstinence should be determined only by the attending physician. However, in the future, light physical exertion is extremely necessary, since with its help it is possible to strengthen muscle fibers well, raising their tone, because of which the patient will be able to avoid another hernia formation.

The purpose of rehabilitation at a later date

When a certain time passes after the operation to remove a hernia, the main goal is to eliminate possible provocative factors that are potentially dangerous for the recurrence of the disease. The following events are organized:

  1. Proper distribution of any physical activity.
  2. Strengthening the muscle corset.
  3. Preventive measures and treatment of predisposing pathologies, which may be accompanied by prolonged cough or chronic constipation.
  4. The fight against obesity, which negatively affects the abdominal wall, as it leads to its weakening.
  5. Refusal of bad habits, first of all, of smoking, as it contributes to the rapid deterioration of muscle tissue and the premature formation of signs of aging.

Causes of pain

As a rule, most patients within 4 hours after surgery for excision of the hernia can move themselves. But while moving, a aching pain or soreness of a cutting character may occur, which is localized in the zone where the incision was made. Pain syndrome in its origin can be different:

  1. Its formation may indicate the presence of a process of healing wounds, accretion of tissues, tissue repair, since during surgical intervention insignificant portions of nerve fibers were damaged. And this, in turn, provokes an increase in the sensitivity of the operated area.
  2. Another cause of pain after the operation is swelling of the tissues.
  3. The likelihood of pain syndrome also depends on the duration of the operation. If this procedure was carried out by an insufficiently qualified doctor, then incorrect manipulations with muscle tissues can lead to their excessive injury.
  4. Soreness is not in all cases considered evidence of any problems regarding scar healing. The pain may be of neurological or muscular origin.
  5. Physical activity during the rehabilitation period in some cases provoke a relapse of the disease, during which sharp pain syndromes are formed. In this case, re-conducting the operation is required.
  6. Soreness may also indicate internal or external discrepancies in operating sutures.

Recovery period

Most experts organize an operation to remove a hernia in the morning. In the evening, the patient is usually the first ligation. During this manipulation of the wound, discharge appears, which is the absolute norm.

Throughout the outpatient period, such dressings should be done every day. But if suppuration is observed in the suture area, or the pain is enhanced, then the dressings are done longer.

If the incision was sewn with silk threads, then the suture is removed for 5-7 days. But recently, experts prefer to sew up surgical incisions with the use of catgut self-absorbable threads, with which you can achieve the formation of an almost imperceptible scar.

Medications in the postoperative period

As for the drug treatment in the postoperative period, it will be based on the presence of certain symptoms. If the patient’s pain syndrome is pronounced, then special pain relievers are applied in the early period. For possible complications, the following medications may be prescribed:

  1. Antibiotics: cephalosporins, Amikacin, Amoxiclav, Meropenem.
  2. Drugs that are prescribed to improve tissue trophism: "Cavinton", "Actovegin", nicotinic acid, "Pikamilon".
  3. Various mineral and vitamin complexes that contribute to the rapid strengthening of the vascular walls: vitamin A, C, D, E, K, zinc, iron, phosphorus, folic acid.

Possible complications

It should be noted that absolutely any surgical intervention destroys the integrity of the connective tissues, and is also considered artificial penetration in the human body. In some cases, the human body reacts to such a procedure in a very unpredictable way.

This also applies to an inguinal hernia operation. If recovery is fast, then the rehabilitation period is very short. However, there is another scenario, during which various complications arise. The causes of such complications can be different, ranging from non-compliance with the rules during the rehabilitation period and ending with the infection in the wound. The main consequences that may arise after surgery:

  1. Suppuration in the seam area.
  2. Relapse of the disease, which occurs due to the patient's ignoring the recommendations of a specialist.
  3. Formation of a small hematoma in the suture area.
  4. Damage to nerves, blood vessels, as well as some elements of the spermatic cord.
  5. Hydrocele, which is the most common complication after hernioplasty.
  6. Formation of deep vein thrombosis in the lower leg region.
  7. Intestinal dysfunction.
  8. Various infectious complications.

Conclusion

Considering where to do an inguinal hernia operation, this procedure is performed in any hospital. In Moscow, you can apply to such private medical institutions as "MEDSI", "ON CLINIC". If you suspect such a disease, it is imperative to seek help from a medical institution. If an operation to remove a hernia in the groin area is not arranged in time, then after a while the disease can provoke very unpleasant consequences. In the postoperative period, the patient should follow the recommendations of the doctor to avoid possible complications.

Classification

The operations for inguinal hernias are performed in the following ways:

  1. Open Access to the hernial bag is carried out through a long incision on the anterior abdominal wall and in the groin area. The intervention was directed to the return of the internal organs to the correct position. The tissues forming the hernial membranes are cut off, the gates are stitched together. The operation has a long recovery period and a high risk of complications.
  2. Laparoscopic. It is performed under local anesthesia using special tools that are inserted through small incisions. A video camera inserted into the abdominal cavity allows you to fully control the course of the intervention. The operation allows simultaneous overlapping of the internal openings of the inguinal and femoral canals. The risk of complications is minimal, the frequency of relapses does not exceed 2%. Laparoscopic hernioplasty is a complex procedure requiring the use of expensive equipment.

Laparoscopy is performed under local anesthesia using special tools that are inserted through small incisions.

Open way

The most common open methods are:

  1. The Bobrov-Girard method. Implies bandaging and cutting off the hernial bag with further stitching the edges of the external and internal oblique muscles.
  2. Operation Bassini. It is a reinforcement of the posterior part of the inguinal canal by pulling up the spermatic cord and hemming oblique and transverse muscles to the pupart ligament.
  3. Hernioplasty according to Scouldice. Tensioning operation is used for large hernias. The posterior part of the groin is strengthened by doubling the transverse muscle and suturing the external aponeurosis.
  4. Operation Postempskogo. It consists in the elimination of the inguinal canal and interpachal spacing with the creation of a stroke with a different direction.
  5. Alloplasty in Liechtenstein. Non-tensioning operation involves the overlapping of the hernia gate with a special mesh.

The procedure for conducting open surgery includes setting general anesthesia.

The procedure for conducting open operations includes the following steps:

  • general anesthesia,
  • dissection of tissue located in the area of ​​protrusion,
  • making a long incision on the anterior abdominal wall,
  • layered separation of soft tissue
  • examination of the contents of the hernial bag (helps to determine the viability of tissues),
  • resection of the affected areas of the intestine (carried out in the presence of signs of necrosis),
  • returning organs to the correct position
  • suturing the hernia orifice or strengthening weakened tissue with a mesh,
  • suturing of surgical wounds.

Laparoscopy

Endoscopy for inguinal hernia includes the following steps:

  • introduction of a laparoscope equipped with a video camera through a puncture located in the navel,
  • insertion of surgical instruments through other punctures,
  • reposition of internal organs into the abdominal cavity under the control of a laparoscope,
  • elimination of the hernia gate through the installation of an implant
  • drainage installation.

The endoscope is sometimes inserted into the preperitoneal opening, manipulations are performed between the layers of the abdominal muscles without dissecting the wall.

Contraindications

Routine hernia repair is not performed:

  • in case of large hernia in elderly patients in the presence of pathologies of the respiratory, digestive and excretory systems,
  • with cirrhosis and liver cancer, combined with portal hypertension,
  • with ascites (accumulation of a large amount of fluid in the abdominal cavity),
  • with an enlarged liver and spleen,
  • with varicose veins of the vessels of the esophagus and intestines,
  • with decompensated diabetes,
  • in acute renal failure,
  • with oncological diseases in the later stages,
  • with infectious lesions of the skin.

When to see a doctor for an inguinal hernia

Inguinal hernia is the most common type of hernia. It may look like swelling, bulging, a bump in the groin or on the inner surface of the upper thigh. Sometimes an inguinal hernia leads to an increase in the scrotum (the sac in which the testicles are located). Swelling can be painful.

An inguinal hernia usually consists of adipose tissue or a part of the intestine and bulges through the inguinal canal - a weak spot in the muscle wall in the lower abdomen. Through it normally pass the blood vessels that feed the testicles or the circular ligament of the uterus. More often, an inguinal hernia develops in men, since their inguinal canal is shorter and wider. In women, inguinal hernia is less common. The risk increases with age, because with aging, the tissues of the anterior abdominal wall lose their elasticity.

The immediate causes of hernia formation can be: lifting or carrying weights, severe straining during constipation, a long, painful cough, etc. The hernia is intermittent and sometimes disappears while lying down. In addition to the cosmetic defect, an inguinal hernia in children and adults can cause discomfort when walking, causing discomfort and pain, especially during exercise.

If you suspect an inguinal hernia in yourself or your child, consult a surgeon. As a rule, to confirm the diagnosis, a routine examination is sufficient. After the diagnosis, the surgeon will give you the necessary recommendations for further examination and treatment.

It is only possible to completely heal an inguinal hernia with a surgical operation. Therefore, routine surgical treatment is recommended for every person with such a diagnosis. Even if the hernia does not bother you, over time it can grow in size and cause dangerous complications:

  • intestinal obstruction — when a part of the intestine gets stuck in the inguinal canal, stool discharge stops, nausea, vomiting and abdominal pain develops, the hernia becomes sharply painful,
  • infringement - when a part of the intestine is pinched so that blood stops flowing into it, an emergency operation is required for several hours to release the pinched tissue and restore blood circulation, otherwise part of the intestine dies and the tissues are destroyed.

If you see similar complaints, immediately consult a doctor or, if there is no such possibility, call an ambulance (from a 911 or 112 mobile phone, from a landline - 03). With the development of complications, as well as if the hernia does not reset itself, an emergency operation will be required.

Rehabilitation

The rehabilitation period lasts 4-6 weeks. At this time, exclude any physical activity, including sex and weight lifting. During the first days after surgery, dressings are regularly changed, the wound is kept clean and dry.After discharge from the hospital, the patient should eat boiled and steamed food, rest more often, spend more time in the supine position. Wearing a bandage helps prevent hernia recurrence, contributing to the normal course of the healing process.

In addition, you must regularly visit the surgeon and the therapist.
More information about the recovery period, after removal of the inguinal hernia, read here.

Ivan, 40 years old, Moscow: “For a long time I had a large inguinal hernia, which prevented normal life and work. He tried to relieve his state of exercise, massage, wearing special devices. However, the hernia did not disappear and did not decrease in size. The appearance of pain syndrome led to a doctor who advised non-tension surgery. The hernial orifice was blocked by a mesh, which caused the loss of organs to stop. The only drawback of the operation is the presence of scars on the skin. ”

Sergey, 50 years old, Kazan: “There was a small inguinal hernia for more than 5 years, it did not cause any particular anxiety, however, during the medical examination, the doctor advised to undergo surgery. Chose laparoscopic intervention. He passed all the necessary tests, underwent an ultrasound scan and began to prepare for the intervention. The procedure was performed under general anesthesia, punctures were made with a laser. After the operation, he was in the hospital for 2 days, did not experience severe pain, and there were no long-term complications. Hernia since then does not bother for 2 years. The only drawback of the method is the high price. ”

Indications for the operation of the inguinal hernia

In itself the presence of protrusion already serves as a pretext for the operation. The only exception is the impossibility of surgical intervention, in principle, in the presence of other pathologies.

Indications for immediate hernia repair are due to a number of factors that entail a threat to the life and health of the patient. These include:

  • infringement,
  • adhesions in the peritoneum,
  • intestinal obstruction with intestinal obstruction with malignant neoplasms,
  • recurrent manifestation of hernia after surgery,
  • the inability to reposition the hernia sac,
  • probability of rupture of the hernia gate,
  • bulging in the area of ​​scarring after the previous operation.

With planned therapy, the attending physician compares the justified benefit with the risk factors individually.

Rules of preparation for surgery

The patient undergoes hernioplasty surgery. full medical examinationwhich includes:

  • laboratory blood tests
  • screening for infections, including HIV,
  • coagulogram,
  • determination of blood group and Rh factor
  • general urine analysis,
  • Ultrasound examination of the abdominal cavity in order to detect abnormalities and other pathologies,
  • ECG,
  • collection of information in the history of the presence of chronic diseases,
  • antihistamine preparation is carried out as necessary.

Before the intervention prescribed cleansing enema and 8 hours before the hernia repair, the patient is already prohibited from eating.

With increased excitability, the patient is given tranquilizers or injected hypnotic one day before the procedure.

Medical training is also carried out by means of hygienic procedures: the place of localization is cleanly shaved and sanitized. From the mouth remove dentures, and remove contact lenses.

The type of anesthesia is selected by the anesthesiologist individually, based on the clinic of the disease, which may be local, general or regional.

Open stretch hernioplasty

Tension method - classics of surgerywhich is actively used to this day. The essence of the method is based on the reduction of the peritoneal organs through open access to the affected area.

Further actions are stitching the edges with an ordinary surgical suture. With this type of procedure, the muscular structures of the inguinal canal are stretched.The main disadvantage is discomfort, pain and the possibility of relapse.

Open non-tensioned hernioplasty

Non-tension method implies graft insertion to the affected place. The graft is a polymer mesh, inactive with respect to human tissues. Such a grid is well acclimatized, and the procedure has a minimal invasiveness, which accounts for the popularity of the method known as the Liechtenstein method.

Such a surgical technique reduces the risk of relapse and complications to a minimum.

Laparoscopic Hernioplasty

Laparoscopic (endoscopic) the method is the most gentle. Such a procedure is carried out by means of three punctures in the groin, in which a probe is inserted to track the progress of the operation, and the actions themselves are carried out with microsurgical instruments.

The endoscopic method produces both closure and the introduction of a synthetic mesh. The main advantage of this procedure is cosmetic effect and minimal soreness, minus - the duration of the conduct and the impossibility of applying for large amounts of pathology.

Laser hernia removal

Laser surgery - new direction in medicine, which is characterized by minimal pain, bloodlessness, cosmetic effect and rapid recovery.

The essence of the method lies in the "evaporation" of liquid substances with a laser for the convenience of reposition of the organs of the peritoneum and "soldering" the edges of the affected muscle structure.

Features of surgical removal of inguinal hernia

Gender affiliation plays a crucial role in the causes and likelihood of occurrence, as well as in the treatment of the disease.

Men are more likely to undergo this disease.. This is due to the features of the anatomical structure (the presence of the so-called vaginal process), due to which often inguinal hernia is accompanied by inguinal-scrotal pathology. The contents of the formed bag often fall: the omentum and organs of the peritoneum.

Surgery for men is performed by all available means, with minimal health risks.

Women are less prone to the appearance of pathological protrusion, unlike men. They have no vaginal appendix, and the pelvic organs have a permanent place of localization since its inception. At the same time, such organs nevertheless fall into the area of ​​the hernial sac.

Most pathology makes itself felt in the postpartum period. Mostly it has a spherical shape and is bilateral. Women are suitable for any methods of surgery, but on the basis of individual indications.

In childhood, the disease also occurs with the same probability as in adults (more often in boys).

Note! Statistical information suggests the following ratio of pathological protrusion in boys: in 50% of cases the right side is exposed to hernia, and only in the left side in 10%.

In the absence of infringement the pathology is not operated on in children under 5 years of age. Therapy is carried out with the help of auxiliary measures - bandages. Often, the weakness of the abdominal wall, when a child reaches 5 years old, passes by itself and does not require surgical intervention.

Is relapse possible?

Among the methods described above, the minimal risk of recurrence belongs to non-tightening types of surgery, both with the open method of operation and with laparoscopic surgery.

High same recurrencetension plastic due to the large traumaticity of muscle structures, which often leads to their rupture. Also do not exclude and re-bulging in the area of ​​scarring.

In the laparoscopic method, as already mentioned, the risk of recurrence appears in the case of a large size of the hernial ring and a significant volume of the hernial sac.

In other cases, the procedure is successful and during the week there is a transition to the rehabilitation period.

Types of pathology

The most common problems are also other types of hernia: umbilical, abdominal, diaphragmatic and femoral. In men, an inguinal hernia tends to descend into the scrotum. Types of inguinal hernia:

  • Direct hernia goes through the bottom of the canal. Her path passes through the groin channel by the spermatic cord.
  • Oblique hernia comes out through the inguinal ring. Along the way, attaching the spermatic cord, passes through the canal in the groin.

Why does the disease occur?

There are several factors that provoke the appearance of an inguinal hernia:

  • Predisposing factors. This means that the man has "conditions" for its occurrence:
    • Hereditary weakness of the connective tissue in the peritoneal walls.
    • Extended internal and external "gates" of the inguinal canal for a genetic reason.
    • If absent or reduced physical activity occurs muscle atrophy, leading to illness.
  • Producing factors. This is when the increased pressure inside the peritoneum is created:
    • Excessive physical exertion provokes the appearance of an inguinal hernia, especially the lifting of heavy objects.
    • Chronic cough.
    • Chronic constipation.
    • Constant strong tension of the walls of the abdominal cavity. (Occupational disease of movers, trumpeters and other workers).

Important! If the work is associated with the tension of the abdominals, try not to overwork and listen to your body.

Symptoms and diagnosis of inguinal hernia

The main symptom of the disease is hernia sac formation in the groin area. Bloating may appear on the right or left side, in rare cases with both. The average inguinal hernia has a size of 1 to 5 cm. At an early stage of its development, it is detected only when the muscles contract, and its size is about 3 cm. But the hernia tends to develop, so it can reach large sizes of approximately 10 cm.

Among other symptoms male inguinal hernia are such:

  • Weight and burning in the abdomen.
  • After exercise, the appearance of pain in the area of ​​education disease.
  • Feeling uncomfortable when walking.
  • Rarely, an inguinal hernia manifests itself with vertigo and vomiting.

If these symptoms occur, you should immediately contact the surgeon.

The diagnosis is made after inspection and installation of the clinical picture of the patient. If the doctor has any doubts, he prescribes an ultrasound. If a male inguinal hernia develops without complication, then it does not affect the laboratory test results.

Diagnose inguinal hernia upright, and also when the patient strains the abdominal muscles. In a prone position, an inguinal hernia is not visible. During the feeling, the bag does not give any painful sensations, its consistency is soft and elastic, easily set back into the abdominal cavity.

An inguinal hernia cannot be cured by conservative methods; therefore, a man who is ill is prescribed an operation to remove it. If such a defect is not a source of pain and discomfort, then surgery is postponed for a while. But it must be remembered that the hernia may escalate, which may cause The following complications:

  • Due to the formation of adhesions, the impossibility of its reduction to the abdominal cavity appears.
  • Pinched part of the organ (bladder, ovary, omentum or intestine) in the hernial ring, leading to necrosis (necrosis) of the tissue of the affected organ.
  • Obstruction of the intestine or violation of the intestinal patency as a result of pinching its loop when entering the hernia.
  • Inflammation of the testicle.

These complications need emergency surgery. The longer the visit to the surgeon is postponed, the more difficult the operation will be.

Conducting surgery and hernioplasty

Surgical intervention due to male inguinal hernia held by endoscope, thanks to which the terms of the rehabilitation period are significantly reduced.

Today, no tissue breaks are made; instead of them, three punctures are performed laparoscopically. Through them, special instruments are inserted that cut off the hernial sac. These manipulations almost do not damage the skin of the abdomen, as well as the abdominal muscles, reducing the pain almost to zero. After that, doctors spend strengthening the walls of the abdominal cavity.

Hernioplasty is performed by the following methods:

In the first classic case of surgical treatment, the holes that were obtained by the patient during punctures during the operation are closed by tightening the tissues and stitching them (according to Scholdis method).

Another method is based on the use of synthetic materials, which showed quite good results when interacting with the body. Plastic according to Liechtenstein is carried out by stitching a special polypropylene mesh.

How long does the surgery take?

Hernia surgery lasts less than an hourFor this reason, complications after general anesthesia are minimized. Recently, however, there is a tendency to perform surgery to remove a hernial sac in a man by local anesthesia, in case the patient is not well tolerated by general anesthesia.

Possible postoperative effects

Hernioplasty does not pass completely, as, however, and any other operative intervention. Since in the course of it, though a little, the connective tissues are still destroyed.

Each organism is individual, so complications after operations are different. There are also some factors that impede the recovery process.

Serious consequences surgical intervention for the removal of the inguinal sac in a man are such phenomena:

  • Infectious lesion wounds.
  • Violation of the integrity of the spermatic cord due to inaccuracy or inexperience of the doctor. Such a complication is fraught with impaired hormonal and spermatogenic background, which leads to testicular atrophy and infertility.
  • Disruption of intestinal tissue and bladder.
  • Thin veins and thrombosis of the shin can occur in inactive and elderly people.
  • Damage to the hip joint.
  • The appearance of dropsy.
  • If the postoperative regimen is impaired, a re-inguinal hernia occurs.
  • The occurrence of hematoma.
  • Due to a violation of the postoperative regimen, recurrent hernia may appear.

Due to the possible consequences of hernia removal, it is necessary strictly observe the regimeprescribed by a doctor to follow his recommendations and stick to the designated special diet. Only in this case, the doctors give an optimistic forecast for a speedy recovery.

If all the conditions are met, the postoperative rehabilitation period will depend on the anesthesia, the type of surgery and hospital.

If local anesthesia was performed, the patient will be able to leave the hospital within a few hours after surgery. Some clinics prescribe a patient the next day or two for safety.

General anesthesia involves the patient in the clinic for at least two days.

Endoscopic plasty will delay the patient in the hospital for 2-3 days. The operation with cuts will take 1 day, obstructive hernioplasty will require to wait several hours.

In the outpatient period after hernioplasty, which lasts 9 days, the patient is removed stitches.

Diet after surgery

During the recovery period it is necessary to take only liquid food, in small portions and unhurriedly. You need to eat from 4 times a day, eat protein rich foods. Since it is the “building material” of the organism, the recovery period will pass much faster. Many proteins contain the following foods:

  • Fat-free cottage cheese and milk.
  • Chicken meat.
  • A fish.
  • Eggs
  • Buckwheat.

Some foods that cause fermentation in the intestines and disrupt its operation should be excluded. For example, do not eat sweet foods, dairy products. The doctor will prescribe a diet, it must be followed to avoid complications.

During the recovery period do not drink alcohol and smoke. Instead of coffee, drink tea or chicory. The acidic gifts of nature are undesirable. Carbonated drinks are also prohibited.

Exercises for recuperation

During the rehabilitation period, heavy exercise is prohibited, but you cannot refuse to move. Therefore it is necessary to do morning exercises or spend complex recovery exercisesaimed at stimulating the groin muscles and the abdomen as an aid to the body to regain its tone.

The most common are:

  1. On the mat, located on the floor, lie on your back. Hands lie along the body. Straight legs should be raised to 45 degrees and perform the movement of "scissors", crossing the legs alternately. In the same position, perform the "bike", imagining that you pedal it.
  2. Standing on all fours, alternately lift your legs up.
  3. When lying on the right side, lift the straight left leg up, turn the other side, do the exercise similarly with the right leg.
  4. Feet shoulder-width apart, start squats. It is not necessary to perform squats to the floor, go down as you can. Then do some push ups. They can be done on your knees.

These exercises must be done regularly, while it is important to monitor well-being. There should be no discomfort and pain. Every day, increase the number of repetitions. As the general condition improves, other exercises can be included in this complex.

Before you begin this exercise, you should consult with your doctor. Do not try to perform all the exercises of the complex, since such an overstrain can badly affect the body and lead to complications. Usually, doctors prescribe a similar gymnastics after 3 weeks after surgery.

Thus, with timely access to the surgeon and the fulfillment of all postoperative prescriptions that are necessary for the complete restoration of the body, a person quickly returns to a normal lifestyle.

Causes of inguinal hernia in men

Inguinal hernia is more common in men than in women. This is due to the peculiarities of the anatomical structure of the body. The inguinal canal of a woman has the appearance of a slit, has reinforced walls, because the loss of the organ from the abdominal cavity is difficult. In men, on the contrary, the inguinal canal in the cross section has the shape of a triangle. With the weakening of the tissues of the abdominal wall, the internal organs are more likely to leave the boundaries of the abdominal cavity.

It is established that the causes of the formation of an inguinal hernia are:

  • weight lifting in the wrong body position
  • loading and unloading operations without the use of a strengthening bandage,
  • congenital or acquired weakness of the tissues of the abdominal wall,
  • increase intraperitoneal pressure
  • defects of peritoneal perineal aponeurosis.

The presence of defects or dystrophy of the fibers of the direct and oblique abdominal muscles has the greatest role. It is in this place that the organs in the abdominal cavity can go beyond the anatomical location and cause an inguinal hernia in men.

How to prepare for the removal of an inguinal hernia

If we are not talking about infringement, the operation is carried out in a planned manner. Considering the violation of the integrity of the tissues and the probable risks of complications, a written authorization for surgical treatment is taken from the patient.

Preparation for surgery is as follows:

  1. Blood and urine tests.
  2. Detection of hypersensitivity to anesthetics.
  3. Examination for the presence of concomitant pathologies that can interfere with the successful implementation of treatment.
  4. ECG to eliminate heart problems.
  5. The ban on smoking and alcohol intake 2-3 weeks before the appointed date.
  6. A course of antibiotics to prevent the development of infection.
  7. Cleansing enema on the eve of the day selected by the surgeon.

Directly on the day of the operation, the patient is forbidden to eat, drink, smoke. Care should be taken to remove hair on the surgical site.

After the onset of anesthesia, the doctor proceeds to perform the operation.

Information about the types of operations and their features

If we talk about operations to remove an inguinal hernia in men, then we can distinguish two methods: tension and non-tension hernioplasty. In recent years, non-stretch hernioplasty is used more frequently. This is due to fewer postoperative complications, a decrease in the number of relapses and the possibility of laparoscopic operations.

Stretch Hernioplasty

This technique was used by doctors in the last century. Now stretch hernioplasty is used extremely rarely, only if other methods of surgical intervention are impossible for any reason.

The essence of the operation is as follows:

  • the surgeon makes an incision on the hernial bag and examines its contents,
  • if necessary, the omentum is removed, and the prolapsed organ is set back into the abdominal cavity,
  • the groin of the inguinal hernia is sutured - the doctor puts stitches on the stretched adjacent tissues,
  • then the hernial sac is excised, external sutures are applied.

When performing this operation, blood circulation in the stretched tissues is disturbed. Lack of nutrients leads to atrophy of muscle tissue, stitches become thinner and break with time. A weakened abdominal wall is not able to hold the organ at the anatomical site, because after a different time after the operation, the inguinal hernia in a man appears again. Unfortunately, stretch hernioplasty is a leader in the number of relapses.

Another disadvantage of this type of intervention is the duration of the rehabilitation period. Tissue injury leads to a man experiencing discomfort for a few weeks, and in some cases pain. After the tension hernioplasty, the patient can stay in the hospital for up to two weeks.

Non-tensioned hernioplasty

The basis of this surgical method of treating an inguinal hernia is the use of endoprostheses for closing the hernial ring and strengthening the inguinal canal. The doctor imposes modern materials of synthetic or biological origin, thanks to which the body adapts to the endoprosthesis and rejection does not occur.

The operation is carried out as in the previous method, but at the stage of suturing the hernia gate, the surgeon imposes a special mesh. The material is made taking into account the characteristics of the body, over time it grows into tissues and resolves. Thus, the reinforcement effect is achieved: a strong frame is created, which keeps the prolapsed organ in place and does not allow the abdominal tissues to disperse.

In some cases, such hernioplasty can be performed under local anesthesia. This gives an advantage over other methods: the risk of complications due to general anesthesia is excluded. Minor tissue damage can reduce the rehabilitation period, reduce painful and unpleasant sensations. Relapse of the inguinal hernia in men is observed much less frequently.

Laparoscopic surgery

Laparoscopic inguinal hernia surgery is most beneficial for the patient. A feature of this type of surgery is the use of endoscopic equipment.

The doctor makes several punctures on the patient's skin. Through one, the endoscope is gently inserted into the hernial sac. This is a medical device equipped with a video camera and a source of artificial light.The resulting image is transmitted to the monitor, located in the field of view of the surgeon. The doctor has the opportunity to examine the hernia in more detail, during manipulations the tissues are less injured. The operation is performed using special surgical instruments that are inserted into other punctures.

Advantages of laparoscopy of an inguinal hernia:

  • barely visible scars remain at the puncture site,
  • rehabilitation period is reduced to 2-3 days,
  • in the postoperative period there is practically no pain.

In addition, with this approach, there is practically no recurrence.

Among the shortcomings of the surgeons point out the need for the use of general anesthesia, coupled with the load on the body. For this reason, laparoscopy of an inguinal hernia is not indicated for elderly patients, as well as for people who have contraindications to general anesthesia.

What you need to know about the preparation for the operation?

Preoperative measures for the removal of an inguinal hernia are the same as in other cases of surgical intervention.

  1. Blood and urine tests.
  2. Instrumental examination - ECG, ultrasound of the hernia, radiography and other methods,
  3. Examination to identify possible allergies to drugs, including anesthetics.

At the stage of preliminary examination, the doctor is convinced that there are no contraindications to the operation. If there are no factors capable of interfering with surgical treatment, the date of the intervention is appointed. In cases of strangulated inguinal hernia, surgery is performed on an emergency basis; in other situations, a course of antibiotics may be prescribed to reduce the likelihood of infection.

On the eve of the appointed day, a light supper is allowed, and on the day of the operation, eating and drinking is prohibited. Patients are warned not to smoke. Immediately before the operation, if possible, you need to take a shower.

Postoperative period

After surgery to remove an inguinal hernia, the patient is in the hospital. The term depends on the method of surgical intervention: after laparoscopy of an inguinal hernia, observation is necessary for two to three days, after non-stretch hernioplasty performed in an open way - up to two weeks.

At this stage, the doctor monitors the patient's state of health. For severe pain, analgesics are prescribed, and antibiotics are used to prevent the inflammatory process. The stitches are removed about a week after surgery, but the doctor can adjust the time in one direction or another if necessary.

Exercise is limited to up to six months, depending on the method of operation for the removal of inguinal hernia in men. To engage in heavy physical labor and lift weights is prohibited. The load should be increased gradually, in accordance with the recommendations of the doctor. To strengthen the weakened muscles of the abdominal wall requires special exercise.

Diet after inguinal hernia removal

Special attention should be paid to nutrition. After surgery, the body especially needs nutrients, so the daily diet should be properly balanced. On the first day, food intake is limited or allowed to drink a weak meat broth. On the second day, you can eat soups with cereals, mashed potatoes, mashed liquid porridge.

Features of the diet in the following days, see the table.

Permitted products and dishes

Prohibited foods and dishes

  • white crackers
  • lean meats and fish,
  • dairy products,
  • cottage cheese,
  • fruits and vegetables, except those prohibited,
  • weak tea
  • non-sour juice.
  • bread or bakery products
  • grapes, apples, prunes, cherries,
  • milk in any form, including milk cereals,
  • beans, peas and other legumes,
  • carbonated drinks and alcohol,
  • cabbage, asparagus, corn,
  • strong coffee.

If in doubt whether a product is allowed, ask your doctor.Remember that diet in the postoperative period after the removal of an inguinal hernia is an important factor that reduces the likelihood of complications.

Prognosis for inguinal hernia

It is believed that with an inguinal hernia, the prognosis is conditionally favorable. This means that if a man did not delay the visit to the doctor and underwent surgery at the initial stage of hernia formation, then there is almost no chance of complications. Otherwise, there is a risk of pinching, the consequences of which are unpredictable.

Treatment of inguinal hernia

Rehabilitation

Recovery from surgery for inguinal hernia

When to see a doctor for an inguinal hernia

Inguinal hernia is the most common type of hernia. It may look like swelling, bulging, a bump in the groin or on the inner surface of the upper thigh. Sometimes an inguinal hernia leads to an increase in the scrotum (the sac in which the testicles are located). Swelling can be painful.

An inguinal hernia usually consists of adipose tissue or a part of the intestine and bulges through the inguinal canal - a weak spot in the muscle wall in the lower abdomen. Through it normally pass the blood vessels that feed the testicles or the circular ligament of the uterus. More often, an inguinal hernia develops in men, since their inguinal canal is shorter and wider. In women, inguinal hernia is less common. The risk increases with age, because with aging, the tissues of the anterior abdominal wall lose their elasticity.

The immediate causes of hernia formation can be: lifting or carrying weights, severe straining during constipation, a long, painful cough, etc. The hernia is intermittent and sometimes disappears while lying down. In addition to the cosmetic defect, an inguinal hernia in children and adults can cause discomfort when walking, causing discomfort and pain, especially during exercise.

If you suspect an inguinal hernia in yourself or your child, consult a surgeon. As a rule, to confirm the diagnosis, a routine examination is sufficient. After the diagnosis, the surgeon will give you the necessary recommendations for further examination and treatment.

It is only possible to completely heal an inguinal hernia with a surgical operation. Therefore, routine surgical treatment is recommended for every person with such a diagnosis. Even if the hernia does not bother you, over time it can grow in size and cause dangerous complications:

  • intestinal obstruction — when a part of the intestine gets stuck in the inguinal canal, stool discharge stops, nausea, vomiting and abdominal pain develops, the hernia becomes sharply painful,
  • infringement - when a part of the intestine is pinched so that blood stops flowing into it, an emergency operation is required for several hours to release the pinched tissue and restore blood circulation, otherwise part of the intestine dies and the tissues are destroyed.

If you see similar complaints, immediately consult a doctor or, if there is no such possibility, call an ambulance (from a 911 or 112 mobile phone, from a landline - 03). With the development of complications, as well as if the hernia does not reset itself, an emergency operation will be required.

Treatment of inguinal hernia

Conservative methods of treatment, such as medication, strengthening the abdominal muscles, wearing bandages during inguinal hernia are not effective. Some of them are rarely used only as a temporary measure, when surgical treatment is currently contraindicated. For example, if a person has a cold or other acute illness.

Completely get rid of the inguinal hernia and prevent the development of complications is possible only with the help of surgery. An operation for an inguinal hernia consists of several stages:

  • hernia repair (retraction of the hernial contents and removal of the hernial bag),
  • hernioplasty (restoring integrity and strengthening the anterior abdominal wall).

Taken together, it usually takes 30–45 minutes. If the operation went well and there are no complications, you can be allowed to go home the next day after treatment. Usually the period of hospitalization for inguinal hernia is from 1 to 7 days. After discharge, you must take care of the seams, avoid over-voltage and follow the instructions of the doctor on proper nutrition to avoid constipation. Most people recover completely after an inguinal hernia within 6 weeks, many as early as 2 weeks after the operation can drive the car again, work and do light physical labor.

Surgical treatment of inguinal hernia is carried out through two possible access:

  • open surgery (laparotomy) - one incision is made a few centimeters on the anterior abdominal wall, through which the surgeon sets the protrusion back into the abdominal cavity,
  • the operation of minimal intervention (laparoscopy) is a more complicated technique, when the surgeon sets a hernia with micro-tools inserted through dot incisions in the abdomen.

Each method has its advantages and disadvantages. The type of surgery you are assigned will depend on the characteristics of the hernia, your health condition, and the surgeon's experience.

Open surgery for inguinal hernia

An open inguinal hernia surgery is often performed under local anesthesia (with injections, the tissues in the hernia area are anesthetized) or regional anesthesia (anesthetic is injected into the space near the spine). This means that during the operation you will be conscious, but you will not feel pain. Sometimes the removal of a hernia is performed under general anesthesia (under general anesthesia), that is, with consciousness and pain sensitivity turned off at the same time.

When the anesthesia works, the surgeon will make one incision over the hernia. Usually the incision is 6-10 cm in length. The surgeon then sets the contents of the hernia back into the abdominal cavity. Next, the doctor proceeds to hernioplasty. A synthetic mesh is placed over the weakened portion of the abdominal wall where the hernia was, to strengthen the tissue and prevent re-formation of the protrusion. Then seams are applied to the incision. This is usually done with special threads that dissolve a few days after the operation.

If the hernia is strangled and part of the intestine is damaged, the affected area can be removed, after which the two ends of the healthy intestine are stitched together. This is a more difficult operation that requires more time to recover. Therefore, you will have to stay in the hospital for no less than 5-6 days.

Surgery for inguinal hernia: which one is better?

Laparoscopic and open hernia treatments are safe and effective ways to treat inguinal hernias. As a rule, recovery after laparoscopic surgery is less painful, since there is less damage to the abdominal wall. For people who are operated on for recurrences (re-formation) of an inguinal hernia using the laparoscopic method, recovery is faster. The same is observed with bilateral hernia repair. Therefore, laparoscopy is usually recommended for recurrent hernia or bilateral hernia. Minimally invasive surgery can also be recommended if the surgeon is not sure what type of hernia you have.

But in people with newly formed unilateral inguinal hernia, there was no significant difference in the recovery period after laparoscopy or open surgery. At the same time, laparoscopic surgery is considered more complex. Thus, the risk of serious complications, such as accidental damage to the intestine by a surgeon, with minimally invasive intervention is higher than with an open operation. Therefore, it is believed that the primary unilateral hernia is better to operate with an open method.

The risk of hernia recurrence is the same in both cases. Even after successful removal of the hernial protrusion, over time it may appear again.In addition, the choice of the method of surgical treatment of hernia is affected by:

  • general health - the elderly or people with poor health may be too weak to undergo anesthesia, so they can recommend an open operation under local anesthesia,
  • The surgeon’s experience — open surgery is more common than minimal surgery, so not all surgeons have experience with laparoscopy for hernia repair.

Abdominal surgeons or herniologists deal with surgical treatment of inguinal hernias.

Hernia repair: possible complications

An inguinal hernia repair operation is a routine procedure with virtually no risk. However, in about 1 out of 10 cases after the operation, a hernia can form again, in about 1 out of 50 cases this occurs within two years after the operation. Other potential complications of surgery for inguinal hernia:

  • accumulation of fluid or blood in the place where the hernia was (as a rule, it passes without treatment)
  • swelling, tenderness and bruising on the scrotum or at the base of the penis in men,
  • pain or numbness in the groin area caused by nerve damage or pinching during surgery.

The risk of complications increases if you are over 50 years old or you have another disease, such as heart disease or breathing problems. Much easier, better and with fewer complications and recurrences are planned hernia repair operations than urgent interventions for strangulated hernia.

Watch the video: Recovery from Abdominal Hernia Repair Often Takes Longer Than Patients Expect, Study Finds (April 2020).

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