When a body tissue like a part of the intestine, protrudes from a weak point in the abdominal muscles it is called an inguinal hernia. There is a pain when you cough, bend, or lift a heavy object.
An inguinal hernia does not have risky complications but it does not get better by itself and can lead to life-threatening complications. At times surgery is done to repair a painful or enlarged hernia. Inguinal hernia repair is a common surgical procedure.
The signs and symptoms of an inguinal hernia are:
- A lump in the area on either side of the pubic bone, which is most clearly seen when standing, especially if you cough or exercise.
- A burning or painful sensation in the area of the lump
- Pain or discomfort in the groin, such as bending, coughing, or lifting
- A feeling of heaviness or slowness in the groin
- Weakness or pressure in the groin
- Pain and occasional swelling around the testicles when the protruding intestine sinks into the scrotum
Signs and symptoms in children
Inguinal hernias occur in newborns and children as a result of weakness in the abdominal wall, present at birth. The hernia is only visible when an infant cries, coughs or tries to have a bowel movement. They may be irritable and have less appetite than usual.
For older children, a hernia is probably more noticeable when the child coughs, tries to have a bowel movement or stands for a long time.
Signs of trouble
If a hernia is left untreated its contents may become trapped (pinched) in the abdominal wall. An incarcerated hernia can be strangled, which interrupts blood flow to the trapped tissue. This type of hernia can be deadly if left untreated.
Signs and symptoms of a strangulated hernia include:
- Nausea, vomiting, or both.
- Sudden, rapidly increasing pain
- A hernia lump that becomes red, purple, or darker
- The inability to pass a bowel movement or pass gas
When to see a doctor
Medical assistance is required if the swelling of a hernia becomes red, purple, or dark, or if you notice other signs or symptoms of a contracted hernia.
Consult your physician if you have painful or visible swelling in the groin on both sides of the pubic bone. Swelling is probably more pronounced when standing, and can usually be felt by holding your hand directly over the affected area.
The hernia can be caused by the following reasons;
- Increased pressure in the abdomen
- An already existing weakness in the abdominal wall
- Overexertion during bowel movements or urination
- Vigorous activity
- Chronic coughing or sneezing
In most cases, abdominal skin weakness, which leads to groin hernia, occurs at birth if the abdominal wall (peritoneum) does not close properly. Other inguinal hernias develop later in life when the muscles weaken or deteriorate due to aging, strenuous physical activity, or coughing associated with smoking.
Weakness in the abdominal wall can also occur later in life, especially after an abdominal injury or surgery.
In humans, weakness usually occurs in the inguinal canal, where the spermatic cord enters the scrotum. In women, the inguinal canal carries a ligament that helps keep the uterus in place, and sometimes hernias occur when the connective tissue of the uterus attaches to the tissue surrounding the pubic bone.
Some of the contributing factors of an inguinal hernia include
- Being a man -the chances of men getting hernia is higher than women.
- Being older -this is due to the weakening of muscles due to age.
- Being white -most white people are prone to hernia.
- Family history – this mainly occurs due to hereditaly genes.
- Chronic coughing -this mainly results from smoking.
- Chronic constipation -this causes overwork during bowel movements.
- Pregnancy -this can weaken abdominal muscles and cause increased pressure in the abdomen.
- Premature birth and low birth weight
- Previous inguinal hernia or hernia repair -if you had hernia during childhood, you are at greater risk of developing another groin hernia.
Complications of an inguinal hernia include
- Pressure on surrounding tissue. Most inguinal hernias become larger over time if they are not surgically repaired. In men, large hernias can extend into the scrotum and cause pain and swelling.
- Incarcerated groin hernia. If the contents of the hernia are trapped in the weakest part of the abdominal wall, it can block the intestine, which can cause severe pain, nausea, vomiting, and inability to pass gas or stool.
- Strangulation. An incarcerated groin hernia can cut off blood flow to a part of the intestine. Strangulation can cause the affected intestinal tissue to die. A strangulated hernia is fatal and requires immediate surgery.
Treating inguinal hernia/Inguinal hernia relief
Some treatments for inguinal hernia include;
- Wearing a supportive truss may help relieve the symptoms. Consult your doctor first because it’s important that the truss fits properly.
- The doctor might try applying manual pressure in children to reduce the bulge before considering surgery.
- Painful hernias usually require surgery to relieve discomfort and prevent serious complications.
-There are two types of hernia operations open inguinal hernia repair and laparoscopic repair.
Open Inguinal hernia repair procedure/
Direct hernia repair/ Open Mesh repair/ Mesh Hernioplasty/ Inguinal herniorrhaphy
In this operation, the surgeon makes an incision in your groin and pushes the protruding tissue back into your abdomen. In order to reinforce the weakened area, the surgeon then sews it with a synthetic mesh(hernioplasty). The opening is then closed with stitches, staples, or surgical glue.
When you are done with surgery one is advised to move about as soon as possible, but it might take a while before you’re able to resume normal activities.
Lichtenstein hernioplasty/Lichtenstein mesh repair
The Lichtenstein tension-free mesh repair, which is an example of hernioplasty and is currently one of the most popular open inguinal hernia repair techniques, includes the following components. Opening of the coverings of the spermatic cord and identification and isolation of the hernia sac.
Inguinal hernia surgery
This is an operation done to the weakened abdominal wall that allows abdominal contents to slip into a narrow tube called the inguinal canal in the groin region.
Laparoscopic bilateral inguinal hernia repair/Post inguinal hernia repair/ Indirect hernia repair laparoscopic herniorrhaphy/Laparoscopic hernioplasty
Laparoscopic inguinal hernia repair uses an instrument called a laparoscope. Between two and four small incisions are made through the abdominal wall through which are passed the laparoscope (a thin telescope with a light on the end) and surgical instruments into the abdomen.
Direct inguinal hernia repair
For open hernia repair surgery, a single long incision is made in the groin. If the hernia is bulging out of the abdominal wall (a direct hernia), the bulge is pushed back into place. If the hernia is going down the inguinal canal (indirect), the hernia sac is either pushed back or tied off and removed.
Right Inguinal hernia repair
Left Inguinal hernia repair
During surgery to repair the hernia, the bulging tissue is pushed back in. Your abdominal wall is strengthened and supported with sutures (stitches) and sometimes mesh. This repair can be done with open or laparoscopic surgery. You and your surgeon can discuss which type of surgery is right for you.
Robotic Inguinal hernia repair
Robotic inguinal hernia repair has increased MIS adoption. Some of the guidelines of the process are;
- Mesh repair is recommended
- Standard repair techniques
- Anterior and posterior options
- Tissue repair
Recovering from inguinal hernia surgery
Inguinal hernia hernitomy procedure
The surgeon makes several small incisions in the abdomen that allow surgical tools into the openings to repair the hernia. Laparoscopic surgery can be performed with or without surgical mesh. Open Repair – The surgeon makes an incision near the hernia and the weak muscle area is repaired
The surgeon makes several small incisions in the abdomen that allow surgical tools into the openings to repair the hernia. Laparoscopic surgery can be performed with or without surgical mesh. Open Repair. The surgeon makes an incision near the hernia and the weak muscle area is repaired.
Inguinal hernia treatment without surgery
Taking regular exercises and practice of yoga poses like tree pose, single leg raise with movement, and leg crossing can prove beneficial in taking any pressure off the abdominal opening. This makes no surgery treatment a success.
Tep herniorrhaphy/total extraperitoneal repair
This refers to the surgical repair of a hernia, in which a surgeon repairs the weakness in your abdominal wall. A hernia occurs when a weak area in the muscles of your abdominal wall allows an internal part of your body to push through
This mostly satisfies most of the criteria of an ideal technique. Desarda uses external oblique aponeurosis for strengthening the posterior wall of the inguinal canal.
Sliding inguinal hernia
Double inguinal hernia
Groin hernia repair
Transabdominal preperitoneal repair/Tapp operation/Tapp inguinal hernia repair
The most commonly used laparoscopic surgical techniques for hernia repair are transabdominal preperitoneal (TAPP) and totally extraperitoneal (TEP) repair. TAPP repair – This minimally invasive surgical procedure is performed under general anesthesia. Your surgeon makes a small incision beneath the navel.
Recurrent inguinal hernia
The incidence of recurrent hernia after primary repair of a groin hernia varies from 1% in specialized centers to 30% in general surveys. During the pre mesh era, it was estimated that primary inguinal hernia repairs had a 10%–30% recurrence rate and that the rate was 35% for recurrent hernia repairs.
It is hard to prevent the congenital disability that makes you vulnerable to a hernia. However, you can reduce the strain on your abdominal muscles and tissues. For example, you can
- Maintain a healthy weight do exercises and have a diet program that works best for you.
- Emphasize high-fiber foods Fruits, vegetables, and whole grains contain fiber that can help prevent constipation and overwork.
- Lift heavy objects carefully or avoid lifting them when lifting heavy objects, always bend your knees, not your waist.
- Stop smoking avoid smoking often which causes a chronic cough, which can lead to or worsen a hernia.