Inguinal Hernia Repair Surgery

By:    Published: March 8, 2012

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Inguinal hernias can be a painful and uncomfortable condition to deal with. Fortunately, these hernias can usually be repaired through surgery. Though there are some surgical preparations and risks involved, most people find that they can recover after undergoing this type of inguinal hernia repair.

What Is An Inguinal Hernia?

An inguinal hernia occurs when a part of the small intestine or intra-abdominal fat bulges through a weak area located at the inguinal ring. It occurs in the groin area and will appear as a bulge on one or both sides of the groin. This type of hernia can occur at any age, even in infancy, and is much more common among males.

Inguinal hernia can be caused by several things. Infants with the condition may have a hernia as a result of incomplete development of the inguinal canal in the womb. In other cases, degeneration of connected tissue in the abdominal muscles can cause an inguinal hernia. Factors like muscle strains, lifting heavy objects, chronic coughing, constipation or weight gain can make an inguinal hernia worse.

Inguinal hernias are repaired through surgical procedures. Surgery is typically recommended for infants and children with inguinal hernias. Adults need surgery if their inguinal hernia is enlarged or causes painful or uncomfortable symptoms. Surgery isn’t required for adults who have an inguinal hernia that does not bother them. However, these types of hernias typically don’t go away on their own and usually get larger, and more painful or bothersome over time.

Surgery Preparations

People who are planning to undergo inguinal hernia repair surgery may need to stop taking certain medications a few days before their procedure. This generally applies only to medications that make it harder for the blood to clot, such as aspirin, ibuprofen, naprosyn, warfarin and clopidogrel. In addition, many patients may be advised to avoid drinking or eating after midnight the night before the surgery.

Patients receive either general or spinal anesthesia before the surgery begins. Very small inguinal hernias may be operated on with only local anesthesia.

Procedure Variations

There are two main operations for inguinal hernia repair surgery:

  • Open hernia repair: This procedure, also known as a herniorrhaphy, involves making an incision in the groin area and then moving the hernia back into the abdomen. In some cases, the hernia sac is removed. The muscle wall is then reinforced with stitches and a synthetic mesh or screen to prevent the hernia from moving back to the groin. This is the type of surgery that is usually used for larger or more complicated hernias.
  • Laparoscopy: With laparoscopic surgery, several small incisions are made in the lower belly area. Then, a laparoscope (a thin tube with a tiny video camera at the end) is inserted into one of the incisions. Images from the laparoscope’s video camera are sent to a monitor so that the surgeon can get a view of the hernia and surrounding tissues. Then, using instruments inserted into other small incisions, the surgeon moves the hernia back and reinforces the muscle wall with stitches and a synthetic mesh or screen. This is usually recommended for smaller, simpler hernias that are easier to repair.

These surgeries are commonly scheduled days or weeks in advance at the convenience of the patient. In rare cases, the intestines can be trapped inside by a hernia. This is potentially life-threatening and calls for emergency surgery.

Risks

With any surgery, there is a risk of bleeding, infection, breathing problems, heart problems or reactions to medications or anesthesia. In addition, these specific surgical procedures for inguinal hernia repair carry some risks, including:

  • Nerve damage
  • Damage to the testicles if a blood vessel connected to them is affected
  • A hernia returning
  • Damage to other organs or blood vessels
  • Long-term pain in the area where surgery was performed

In general, these risks don’t outweigh the benefits of removing a dangerous or bothersome inguinal hernia. However, these risks should be discussed with the surgeon before the procedure takes place.

Prognosis

Those who undergo laparoscopic generally have a slightly faster recovery time and less pain and scarring afterwards. However, those who have larger or more complex hernias may not have the option of laparoscopic surgery, meaning that their recovery time may be longer. Because laparoscopic surgery is usually reserved for smaller hernias, it is sometimes better for a patient to have a hernia removed before it gets very large or painful so that they can have the advantages of faster recovery and less pain that come with laparoscopy.

Typically, patients can get out of bed about an hour or so after their surgery is complete. Most patients go home that same day, but there are some individuals who stay overnight in the hospital after inguinal hernia repair surgery.

The majority of patients who have inguinal hernia repair surgery have very good results. According to the National Institutes of Health, only 3 out of 100 patients have a hernia return after having one of these surgeries.

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