What does an inguinal hernia mean?
An inguinal hernia is the bulging fatty tissue or a part of the bowel (such as the intestine) that pushes through a weakened area or defect in the abdomen near the groin. The hernia protrudes through a weak spot in the muscle wall and goes through a passage, called an inguinal canal, near the groin.
An inguinal hernia may become more prominent and cause discomfort when you cough, sneeze, lift heavy weights or do physical activities. The hernia does not get cured on its own and you need to consult a surgeon to guide you on the options available to correct the defect.
Inguinal hernia repair is one of the most commonly performed surgeries in the world. A well-timed inguinal hernia surgery may protect you from complications, such as bowel obstruction or blockage, and disruption or cut-off of the blood supply to the bowel.
What are the types of inguinal hernia repair?
An inguinal hernia repair may be done as an open surgery or as a laparoscopic (or keyhole) surgery. There are three broad types of inguinal hernia repairs:
- Herniotomy (removal of the hernial sac only): This is preferred in young individuals who have normal muscles and repair of the wall of the inguinal canal is not required.
- Herniorrhaphy (herniotomy along with the repair of the wall at the back of the inguinal canal): This may be suitable for a small hernia in a young adult with healthy abdominal muscles.
- Hernioplasty (herniotomy plus strengthening of the wall at the back of the inguinal canal with a synthetic mesh): This procedure is suitable for large hernias and hernias in middle-aged and elderly patients with weak abdominal wall musculature.
What happens during an open inguinal hernia surgery?
Open inguinal surgery is generally performed by a general surgeon. The surgery may be done under regional or general anesthesia.
Before the surgery
Your doctor may:
- Order some blood tests and imaging studies (such as X-ray, computed tomography scan, magnetic resonance imaging, and ultrasonography).
- Ask you about any chronic health conditions.
- Ask you about any medications you are taking.
- Ask about any allergies you may have.
- Explain the surgical procedure in detail, including possible complications. and address your doubts and concerns related to the surgery.
- Obtain your written consent.
- Tell you not to eat anything for at least eight hours before the procedure
During the surgery
- You will be asked to wear a hospital gown.
- The anesthesiologist will attach an intravenous line and administer anesthesia.
- The surgeon will clean the skin with an antiseptic and make a surgical cut (incision) over the hernia sac. The incision is generally around 6 to 8 centimeters long
- The surgeon places the lump of fatty tissue or loop of bowel back into your abdomen.
- A mesh may be placed in the abdominal wall, at the site of the weak spot where the hernia came through, to strengthen it.
- When the repair is done, the incision will be closed with stitches.
- In case of a complicated hernia, such as a strangulated hernia where the bowel is damaged due to disruption in its blood supply, the affected bowel segment may need to be removed and the two ends of healthy bowel rejoined.
After the surgery
- Your vital signs will be monitored in the recovery room.
- You will be weaned off the anesthesia and administered painkillers.
How long does an open inguinal hernia repair take?
On average, an open inguinal hernia repair usually takes about 30 to 45 minutes to complete. You may be allowed to go home on the same day. If you have other medical problems or do not have a caregiver, you may stay in the hospital overnight for better care and observation. Furthermore, if your hernia gets complicated, by obstruction or strangulation of the bowel, the surgery may take longer to complete, and you may be asked to stay in the hospital for four to five days.
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