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Inguinal Hernia Surgery

The current top treatment is laparoscopic inguinal plasty. We use the camera, high definition monitor, and specialized instruments to place a mesh inside the hernia, achieving a correct plasty.

What is an inguinal hernia?

It is a defect or hole through which intra-abdominal contents protrude into the inguinal canal. The inguinal canal is a 4 to 6 cm duct that runs in an oblique direction, from top to bottom. It communicates the abdominal region outside towards the scrotal sac in men and the labia majora in women.

Dr. Víctor Calao

Dr. Víctor Calao

Specialist in the timely diagnosis and immediate treatment of diseases of the gastrointestinal tract.

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These are some of the FAQs about Inguinal Hernia Surgery

Most of them are asymptomatic; when symptoms occur, they may start with slight discomfort in the groin area, slight pain in the groin, testicle, or labia majora on the same side of the hernia may be significant pain that may even disable the patient.

Nausea or vomiting may occur when parts of the intestine are trapped in the hernia, and if it persists, there will be evidence of obstruction.

If the patient waits a long time without undergoing surgery, the hernia will worsen, and there will be a risk that the contents will get stuck in the inguinal canal. As we have already mentioned, this content may be intestine and may compromise its integrity, causing an emergency. If the patient still does not undergo surgery, there is a high risk of intestinal perforation.

Another symptom is an inability to walk. Many patients present with an emerged hernia up to the scrotal sac and remain so for years.  However, the abdominal cavity becomes accustomed to not having the contents found in the scrotum. At the time of surgery and wants to return it, the intra-abdominal pressure increases too much. It can cause an immediate recurrence of the hernia (it re-forms hours after surgery) or cause another complication called abdominal compartment syndrome.

The deep ring of the inguinal canal communicates towards the abdominal cavity; therefore, if there is an increase or dilatation in this, the intra-abdominal organs such as the intestine, bladder, or omentum will push it and end up entering the canal, next to the spermatic cord or the round ligament. An increase in volume will appear in the inguinal region that can be easily visualized or palpated through the superficial ring.

In addition to slippage through a dilated deep ring, another form of presentation of a hernia is by rupture of the floor of the inguinal canal due to structural defects of the collagen caused by smoking, congenital molecular alterations, or by constant increases in intra-abdominal pressure as in cases of coughers with chronic bronchitis.

A hernia doctor can easily detect if there is an inguinal alteration. If the patient is overweight or if the hernia is starting, an ultrasound will be required to report the size of the defect in the inguinal ring, the size of the contents of the hernia, and the structures that emerge, which may be intestine and in rare cases bladder, appendix or colon.

The current top treatment for inguinal hernia surgery is laparoscopic inguinal plasty. We use a camera, a high definition monitor, and specialized instruments to place a mesh inside the hernia, achieving a correct plasty.

The contents that were pushed out are returned to the abdomen, and the deep ring is plugged from the inside. The advantage of this procedure is that small incision are used. It is a minimally invasive procedure with rapid recovery. It is the technique that offers a very low risk of recurrence.  The patient can perform daily activities in the first week.

The other option is open groin repair which involves making an incision in the groin area and entering the hernia site from above. A mesh cone, a mesh segment, or both are placed depending on the size and adequately fixed. The advantage of this technique is that it can be performed under regional anesthesia, and in many occasions, it is ambulatory. General anesthesia is not used. The incision can be 5 to 10 cm. In large, complicated hernias, a larger opening will be required.

First of all, the wound should be washed with soap and water, kept dry, and covered with gauze. Patients are told to avoid carrying heavy things or doing very intense exercises with the abdomen because this increases intra-abdominal pressure. The weakest site is the area where the surgery was performed, with the risk of the mesh or the cone moving out of place. The stitches will be removed in 7 to 10 days. The diet should be low in fats and irritants.

In both techniques of inguinal hernia surgery, there may be swelling, bruising, or hematomas at the site of the incisions, with a low percentage. With open techniques, the risk of developing the hernia again is 3 to 5%. In laparoscopic surgery, it is less than 1%. It is sporadic to present chronic pain, which will require different techniques to relieve it.

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