Inguinal Hernia - Type, Cause, Symptom & Treatment
Hernia is defined as the protrusion of an organ through the structure or muscle that usually contains it. Inguinal Hernia is most common type of hernia in human body. Mostly seen in Male. It is very rare in Female. Inguinal hernia is very common problem seen in india.
There are mainly two types of Inguinal Hernia – Direct and Indirect. Both are divided based on the location.
- Indirect inguinal hernia is most common type of inguinal hernia among both types.
- Direct inguinal hernia occurs medial to Inferior epigastric artery. The area where direct inguinal hernia occurs is known as Hesselback’s triangle.
Mostly direct inguinal hernia occurs in Old age group due to muscle weakness.
Indirect inguinal hernia is most common type among both types of hernia. Most commonly seen in young male. Inguinal hernia though very rare in female but indirect variety is most common among both types.
Predisposing factors for inguinal hernia are chronic cough, constipation and urinary tract diseases like Benign prostatic hyperplasia. Anything that increases intra abdominal pressure that can cause hernia.
In inguinal hernia , content of hernia sac can be FAT (OMENTUM,MESENTERIC FAT) or Part of INTESTINE.
Main symptoms of inguinal hernia are swelling in inguinal region while standing or straining which reduces in size on lying down condition and sometimes patients feels dragging type of pain on long standing hernia.
Hernia becomes emergency condition when content of hernia sac are not reducible and if it becomes obstructed or strangulated. In that condition emergency surgery may require.
Hernia can be seen in new born babies also which is known as congenital hernia. Congenital hernia occurs due to persistent patent processus vaginalis.
As inguinal hernia is very common in general population. Treatment of inguinal hernia is also that simple and straight forward.
There are other so many non surgical methods which are being tried by patients and doctors but none of them are proven or able to treat hernia.
Treatment of inguinal hernia is only surgery.
Types of surgery for inguinal hernia – OPEN and Minimally invasive methods (LAPAROSCOPIC OR ROBOTIC)
In any way Hernioplasty is considered GOLD STANDARD treatment for inguinal hernia. In hernioplasty MESH (POLYPROPELENE) is being placed in both OPEN and Minimally Invasive Methods.
In open surgery incision is kept at site of hernia at inguinal region and after reduction of hernia mesh is placed.
In laparoscopic or Robotic surgery small incisions are placed over abdomen and telescope and instruments are inserted from them and hernia reduced and mesh is placed and fixed using either suture or tacker.
Compare to open surgery Minimally invasive surgery like Laparosopy/Robotic is having advantage of Less pain, Small cut over abdomen, Faster recovery and less hospitalisation.
In congenital hernia MESH is not placed and only hernia sac is reduced and HERNIOTOMY done.
Complications of open hernia surgeries are more as compared to Lapaproscopic/Robotic surgery , as Surgical site infection, Seroma formation ,Neuralgic pain due to nerve entrapment also known as Inguinodynia, Mesh infection, Bleeding etc.
In laparoscopic surgery complications are there but less common and are bleeding, Nerve entrapment etc. Less common surgical site infection or mesh infection.
In minimally invasive surgery (Laparoscopic/Robotic) there are mainly two types .
TAPP (trans abdominal pre peritoneal) and TEP (totally extra peritoneal)
Above mentioned types are based on the approach and plane from which surgery is being performed. In both types mesh is placed in same plane.
Advanced version of TEP is e-TEP which is enhanced view or extended view TEP. Which very much popular now a days.
Now a days Minimally invasive surgery has almost replaced open surgery in inguinal hernia.
Precautions to take after inguinal hernia surgery
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- Avoid strenuous activity at least for 3-6 months after surgery
- Avoid weight lifting for 3-6 months
- Avoid weight gain
- Wear tight under wear for at least first 1-2 weeks to avoid cord edema or seroma formation
- Regular walking
- Treat predisposing factors like cough , urinary problems and constipation to avoid recurrence Hernia recurrence is less common or can say less then 1% in both OPEN or Minimally invasive methods. So many patients are having fear of recurrence but if proper surgery is done and proper care is taken afterwards then there are no chances of recurrence.
Thank you for reading my blog on inguinal hernias and their treatment options. I hope you found the information helpful and informative.
If you or someone you know is dealing with an inguinal hernia, remember that early diagnosis and timely treatment are essential for a successful recovery. If you have any concerns or questions about hernias, don’t hesitate to consult a Dr. Hamikchandra Patel. Or For more Information Visit Dr. Gastro.