INGUINAL HERNIA

So have you been diagnosed with Inguinal Hernia and want to know:

What is a Hernia?

Whats are the different types of Hernia?

What is an Inguinal Hernia?

What does an Inguinal Hernia contain?

What are the symptoms of Inguinal Hernia?

What are the complications of Inguinal Hernia?

What are the Treatment options for Inguinal Hernia?

Laparoscopic Surgery for Inguinal Hernia

Post Operative Recovery after Inguinal Hernia Surgery

What is a Hernia?

A hernia occurs when an internal part of the body pushes through a weakness in the muscle or surrounding tissue wall.

A hernia usually develops between your chest and hips. In many cases, it causes no or very few symptoms, although you may notice a swelling or lump in your tummy (abdomen) or groin.

The lump can often be pushed back in or disappears when you lie down.

Coughing or straining may make the lump appear.

INGUINAL HERNIAS

This is the most common type of Hernia.

Inguinal hernias occur when fatty tissue or a part of your bowel pokes through into your groin at the top of your inner thigh.

This is the most common type of hernia and it mainly affects men. It’s often associated with ageing and repeated strain on the abdomen.

FEMORAL HERNIAS

Femoral hernias also occur when fatty tissue or a part of your bowel pokes through into your groin at the top of your inner thigh. They’re much less common than inguinal hernias and tend to affect more women than men.

Like inguinal hernias, femoral hernias are also associated with ageing and repeated strain on the abdomen.

UMBILICAL HERNIAS

Umbilical hernias occur when fatty tissue or a part of your bowel pokes through your abdomen near your belly button (navel).

This type of hernia can occur in babies if the opening in the abdomen through which the umbilical cord passes doesn’t seal properly after birth. Adults can also be affected, possibly as a result of repeated strain on the abdomen.

HIATUS HERNIAS

Hiatus hernias occur when part of the stomach pushes up into your chest by squeezing through an opening in the diaphragm (the thin sheet of muscle that separates the chest from the abdomen).

This type of hernia may not have any noticeable symptoms, although it can cause heartburn in some people.

It’s not exactly clear what causes hiatus hernias, but it may be the result of the diaphragm becoming weak with age or pressure on the abdomen.

Other types of hernia

Other types of hernia that can affect the abdomen include:

INCISIONAL HERNIAS – where tissue pokes through a surgical wound in your abdomen that hasn’t fully healed

EPIGASTRIC HERNIAS – where fatty tissue pokes through your abdomen, between your navel and the lower part of your breastbone (sternum)

SPIGELIAN HERNIAS – where part of your bowel pokes through your abdomen at the side of your abdominal muscle, below your navel

DIAPHRAGMATIC HERNIAS – where organs in your abdomen move into your chest through an opening in the diaphragm; this can also affect babies if their diaphragm doesn’t develop properly in the womb

MUSCLE HERNIAS – where part of a muscle pokes through your abdomen; they also occur in leg muscles as the result of a sports injury.

What are the Different Types of Hernia?

What is an Inguinal Hernia?

INGUINAL HERNIA

A Inguinal hernia occurs when the inside layers of the abdominal muscle, in the lower part or groin, have weakened, resulting in a bulge or tear. In the same way that an inner tube pushes through a damaged tire, the inner lining of the abdomen pushes through the weakened area of the abdominal wall to form a small balloon-like sac. This can allow a loop of intestine or abdominal tissue to push into the sac.

Typically, hernias are more obvious when standing or straining (for example coughing, heavy lifting, and digging) as this will force the abdominal contents into the sac.

Hernias usually develop over time for no obvious reason, although in some people there may be an inborn weakness in the abdominal wall.

Occasionally a strenuous activity will cause a lump to appear suddenly. They may occur at any age and are more common in men than women.

Both men and women can get a hernia.

A hernia does not get better over time, nor will it go away by itself.

What does an Inguinal Hernia contain?

CONTENTS of INGUINAL HERNIA:

A groin hernia is an abnormal protrusion through the abdominal wall into the groin.

The protrusion contains a cavity (the hernial sac) which can be empty, or it can fill with abdominal contents such as bowel.

Often fat is the main component of a hernia.

What are the Symptoms of Inguinal Hernia?

SYMPTOMS of INGUINAL HERNIA:

• A bulge in the area on either side of your pubic bone, which becomes more obvious when you’re upright, especially if you cough or strain
• A burning or aching sensation at the bulge
• Pain or discomfort in your groin, especially when bending over, coughing or lifting
• A heavy or dragging sensation in your groin
• Weakness or pressure in your groin
• Occasionally, pain and swelling around the testicles when the protruding intestine descends into the scrotum.

What are the Complications of Inguinal Hernia?

You should go the Urgent Care or Emergency Department of your nearest hospital immediately if you have a hernia and you develop any of the following symptoms:

sudden, severe pain,

vomiting,

difficulty passing stools (constipation) or wind,

the hernia becomes firm or tender, or can’t be pushed back in.

These symptoms could mean that either:

the blood supply to a section of organ or tissue trapped in the hernia has become cut off (strangulation)

a piece of bowel has entered the hernia and become blocked (obstruction)

A strangulated hernia and obstructed bowel are surgical emergencies and need to be treated as soon as possible.

What are the Treatment Options for Inguinal Hernia?

♦♦ REMEMBER ♦♦

HERNIA IS A SURGICAL CONDITION & WILL NEED A SURGERY TO REPAIR IT.

THERE IS NO MEDICAL TREATMENT FOR A HERNIA

LAPAROSCOPIC SURGERY for INGUINAL HERNIA

Laparoscopic Inguinal Hernia Surgery:

Laparoscopic Inguinal Hernia Surgery, also known as Key Hole or Minimal Invasive Hernia Surgery is performed under general anaesthetic. Small cuts are made in the abdomen. Instruments are introduced into the holes and carbon dioxide gas is introduced into the abdomen to lift the abdominal wall away from the internal organs so that the surgeon has a good view. A lightweight nylon mesh is fixed in place over the weak area of the Hernia. The instruments are removed, and the gas is allowed to escape before stitching or stapling the cuts together.

Is the laparoscopic technique better than the standard technique for my hernia?

The National Institute for Health and Clinical Excellence (NICE), UK, has recommended that patients with two hernias (i.e. one in each groin) or those with recurrent hernias (hernias that have been previously repaired) should have their repairs performed by this technique.

In addition, NICE now recommends that laparoscopic repair should be discussed with all patients presenting with an inguinal hernia. The amount of cutting used in this operation is less than the standard open technique, therefore recovery is usually quicker and less painful.  Many patients return to work within seven days of surgery.

Open Surgery for Inguinal Hernia

An alternative to laparoscopic hernia repair is a traditional “open” hernia repair.

This involves an incision about two to four inches long in the lower tummy.

The recovery following an open hernia surgery is a bit longer, as compared to the Laparoscopic Hernia Surgery.

The skin incision is also longer than what is used for a Laparoscopic Hernia Surgery

Post Operative Recovery after Inguinal Hernia Surgery

What do I need to know about recovering from this procedure?

After the operation the nursing staff will closely watch you until you have recovered from the anaesthetic. You will then go back to the ward where you will rest until you are well enough to go home. Young, fit patients may be able to go home within 24 hrs. Other patients usually go home 24-48 hours after surgery. If you have any side effects from the anaesthetic, such as headache, nausea or vomiting, you should tell the nurse/doctor looking after you, who will be able to give you some medication to help.

Pain: 

You can expect to have pain in the operation site. The nurse can give you painkillers for this, so it is important to let the nurse know. Your pain should wear off within 7-10 days. If it does not, you must tell your doctor.

Diet:

 You may have a drip in your arm; this will be removed soon after you recover from the anaesthetic. To begin with, you can take small sips of water, and then slowly take more until you are eating normally.

Wounds:

 Your wounds may have a small dressing, which will be removed the day after surgery. You can shower the day after surgery. Your wounds will be protected with a dressing, which is either stick-on or spray-on. Stick on dressings should be replaced if they become dirty or are falling off. Continue to keep your wounds clean and protected until healed and no seepage is present.

Your lungs and blood supply:

 It is very important after surgery that you start moving as soon as possible. This is to prevent blood clots forming in your legs and possibly going to your lungs. This can be fatal. Also, you need to do your deep breathing exercises. Take ten deep breaths every hour to prevent secretions in the lungs becoming stagnant. If this happens, you may develop a chest infection. At all costs, avoid smoking after surgery as this increases your risk of chest infection. Coughing is painful after abdominal surgery.

Exercise:

Expect to feel tired for a few days after surgery. You need to take things easy and gradually return to normal duties, as you feel able to. It usually takes about 1 week to recover after laparoscopic repair. You should not drive during the first week. Do not lift heavy weights for at least six weeks after surgery. This is to prevent a rupture where the cuts were made and allow healing to take place inside.

How much pain can I expect?

It is normal to experience some pain and soreness around the incision sites, particularly over the first few days. It is, therefore, important for you to take painkillers regularly over the first two to three days (but remember that you should not exceed the stated maximum daily dose). If your pain should become increasingly worse you should consult your Surgeon. You may notice some discomfort for several weeks after the operation. On rare occasions, a more chronic discomfort may persist. Whilst the full reasons for this are not known, it may, among other things, be a result of nerve damage. This may require further investigation or treatment.

How do I care for my wound?

If you notice that the wounds become increasingly swollen, painful, or if a discharge develops, arrange to see your Surgeon. It is quite common after hernia repair for men to notice marked swelling and bruising of the scrotum and penis. This will subside over a couple of weeks. If this occurs, it is advisable to wear supportive underwear. As the wounds heal, you may notice a numb area below the wounds. This may be due to disturbance to the nerves during surgery. Whilst in most cases sensation will gradually return, the numbness may be permanent.

 Can I eat and drink normally after the operation? Yes, you can return to your normal diet as soon as you are ready. You may feel bloated or constipated for a few days. You may experience occasional feelings of nausea (sickness) and loss of appetite over the first week or so. Eating a high fibre diet and increasing your fluid intake will help to maintain a regular bowel movement. You should normally open your bowels within 2-3 days of your operation although this may be uncomfortable at first. If you do feel you are becoming constipated, mild laxatives should help.

What activities will I be able to do after my surgery?

You can return to normal physical and sexual activities when you feel comfortable. You can undertake gentle activities immediately after the operation if it feels comfortable to do so. You should gradually increase your level of activity, back to normal for you, over the next few weeks. If you experience an increase in pain it may be because you have done too much.

When will I be able to drive?

You should avoid driving for at least seven to ten days. Before driving you should ensure that you are able to perform an emergency stop, have the strength and capability to control the car, and be able to respond quickly to any situation that may occur.

When can I return to work?

You can return to work as soon as you feel well enough. Depending on how you are feeling and the type of job that you do, you will generally need about 1 week off work.

WANT TO DISCUSS ABOUT YOUR INGUINAL HERNIA?

Get in touch with Dr Rajarshi Mitra today, to know about the best possible treatment option, including Laparoscopic Hernia Surgery. Contact Dr Rajarshi Mitra