What is Inguinal Hernia?

Hernia can be defined as the bulging of intra-abdominal tissues and organs from a congenitally weak or subsequently weakened area in the abdominal wall. Inguinal, umbilical and peri-umbilical hernias are examples of hernias arising from a congenitally weak area. % 90 of abdominal wall hernias are inguinal hernias and are more common in men. Those that occur as a result of failure to close or re-open the inguinal canal that should close after birth indirect inguinal hernia, to those who come out of the weak spot in the abdominal wall direct inguinal hernia It's called.

Hernias may cause swelling under the skin in the area where they occur, pain in the area, abdominal pain in the form of cramps, especially after eating, constipation, urinary complaints. In case of strangulated hernia, signs of intestinal obstruction, severe pain and infection may develop. Especially in situations that increase intra-abdominal pressure, such as coughing, straining, standing for a long time, exercising the abdominal muscles, swelling in the groin is a warning sign for inguinal hernia. While the decrease in the swelling at rest, when lying flat, indicates that the hernia may turn into the abdomen; failure to decrease may be the first sign of strangulated hernia.

How is it diagnosed?

Physical examination is sufficient for diagnosis. Superficial tissue ultrasonography is performed in case of suspicious findings on examination or when the opposite groin needs to be evaluated.

What is Hernia Treatment?

Regardless of the location, the treatment of hernia disease is surgical. It cannot be treated with any medication or regress on its own.

Patients may feel relief from their complaints with hernia straps, corsets, sports underwear, but these methods do not contribute to the treatment of hernia; nor do they protect from the risks associated with the disease. Moreover, these apparatus used for a long time may cause difficulties during surgical intervention as they will cause adhesions in the region.

What happens if not treated?

Since the organ bulging from the abdominal wall is often the intestines, if it is compressed in the hernia sac, its circulation is impaired, surgery becomes urgent and this intestinal part, which has impaired circulation and gangrene during surgery, may need to be removed. 

Inguinal Hernia Treatment

In hernia surgery, regardless of location The aim is to cover the weak area where the hernia occurs in the abdominal wall with synthetic / composite / biological patch material (mesh). The type of repair can be classified according to the layer in which the patch is positioned. The patch can be placed on top of the muscle; behind the muscle or directly into the abdomen.     

-Laparoscopic (Closed) Inguinal Hernia Repair

These are operations performed under general anaesthesia. Like all laparoscopic surgeries, carbon dioxide gas is used in the procedure. It is a camera-guided surgery performed with special devices through 3 access points of 0.5-1 cm in size placed on the abdominal wall. The hernia area is accessed from behind by entering between the abdominal wall and the peritoneum. A wide working area is created. A larger patch material is placed than in open repair. This patch material can be self-adhesive and 3-dimensional, and there are many types of patches made of different raw materials.

The most advantageous patient group is bilateral and recurrent hernias. However, it is applied in all hernia cases in clinical practice. It usually requires 1 night hospitalisation. It does not require restriction of movement after discharge. No suturing and dressing is required.

-Tensionless Inguinal Hernia Repair(Openöntem)

It is often repaired with spinal (lumbar needle anaesthesia). In open repair, after the skin and subcutaneous layer is passed, the muscle sheath is opened and the hernia area is reached. The abdominal membrane called hernia sac is separated from the testicular canal and vascular structures and separated up to the abdominal wall. At this point, the peritoneum is ligated and a flat surface is obtained. The patch covering the potential hernia areas is laid on this flat surface and attached to the inguinal tendon and muscle layer with sutures. It usually requires hospitalisation for 1 night. It requires restriction of movement for 4-6 weeks after discharge for the safety of the sutures. Stitch removal and dressing are not required. 

Why Closed Inguinal Hernia Repair?

• After the operation patient comfort is higher than open repairs. After the operation pain is less.
• Return to work, exercise and normal life is faster.
• After open surgeries in the region Chronic pain due to nerve compression is less common after closed repairs.
• According to open repairs the disease is less likely to recur.