Inguinal hernia surgery is the standard treatment for inguinal hernia. There are different methods of operation. One differentiates between open and minimally invasive procedures. The doctor decides in each case which method is most suitable. In most cases, the inguinal hernia surgery is without complications. Read more about inguinal hernia surgery here!
Why should a hernia be operated on?
A hernia usually does not return by itself. He persists permanently without treatment. The great danger that exists is the so-called incarceration. This means that supplying blood vessels are clamped at the Bruchpforte, whereby the Bruchinhalt (usually intestinal sections) are no longer supplied with sufficient blood. This also applies to asymptomatic inguinal hernias. The hernia treatment therefore almost always consists of surgery.
In asymptomatic inguinal hernias, the inguinal hernia surgery is not yet urgent. However, as soon as significant symptoms appear, a hernia surgery should be performed immediately or at the latest 48 hours after manual relocation. An absolute emergency is the so-called incarcerated inguinal hernia. This means that the abdominal organ located in the fracture sack is acutely threatened by an under-circulation caused by the blood vessels becoming pinched off and must therefore be treated immediately with inguinal hernia surgery. If possible, an attempt should first be made to carefully relocate the trapped fracture contents back into the abdomen.
The choice of operation method
There are a variety of different inguinal hernia surgery methods available today. They can be roughly divided into open and minimally invasive techniques. Each of them has its advantages and disadvantages. In individual cases, the doctor decides which surgical procedure is most suitable for the respective patient.
A inguinal hernia op is usually performed under general anesthesia. Sometimes it is sufficient to numb only the part of the body being operated on (regional anesthesia).
Sometimes the procedure requires a short hospital stay in the hospital. For example, as a precautionary measure, infants are usually kept in the clinic overnight. Often, the inguinal hernia surgery can also be performed on an outpatient basis. The patient is allowed to go home after a few hours of monitoring the same day.
With or without network?
Once the hernia bag has been returned to its site of origin (abdominal cavity), the doctor can still bring in a plastic net to stabilize the hernia gate. This can be, for example, a polypropylene mesh. The insertion of a plastic net usually reduces the risk of relapse. But it is not necessary or useful in every case:
An inguinal hernia surgery without mesh insertion is mainly performed in younger patients with small hernias without risk factors. Even in women of childbearing age no foreign material should be introduced into the body. The mesh is exposed to stress during pregnancy that it may not be able to withstand. In contrast, in men under 18 in the context of Leistenrbuch-Op almost always a network is inserted.
Open inguinal hernia op
In an open inguinal hernia surgery, the surgeon makes a larger incision in the groin, shifts the fracture content back into the abdomen and then closes the inguinal canal. Depending on the type of closure, there are different techniques. The most commonly used method worldwide is the so-called Lichtenstein method. It is also a plastic mesh used: It is intended to additionally strengthen the tissue and prevent relapse. In the Shouldice and Bassini Op methods, on the other hand, connective tissue and muscles alone are used for reinforcement.
Minimally invasive inguinal hernia op
In Germany, many hernias are performed endoscopically. In other words, the surgeon places several small incisions in the abdominal wall, over which he introduces the various surgical instruments. Therefore, one speaks of a minimally invasive procedure.
Again, there are different techniques. In all but not only the fraction content is moved back, but also a network inserted.
On the one hand, endoscopically performed surgery may have higher relapse rates and complication rates. On the other hand, patients suffering from open inguinal hernias more frequently suffer from persistent pain.
Behavior after surgery
Already shortly after the operation, the patient can take light food. It is also important to drink a lot. The patient should abstain from smoking – it hampers wound healing.
It is recommended to cool the operated area. This counteracts swelling and inflammation. About two days after the operation, you can shower normally again.
As for exercise, the patient should take it slow. Although you can perform everyday activities after a few days. With the lifting and carrying of loads (heavy grocery bag, crate with beer bottles, etc.) but you should wait a few weeks.
Pain after hernia surgery is possible. They can become stronger when the pressure in the abdomen increases, for example, by pressing during bowel movements or coughing. Then painkillers can help. Patients should discuss the use of such medications with their doctor.
Attention: In case of severe pain, redness, swelling and fever, you should immediately contact the attending physician!
Inguinal hernia Op: complications
Problems after hernia surgery are relatively rare. As with any surgery, there are general risks. For example, bruising (bruising) may develop at the operated site and pain and bleeding may occur. Sometimes it also comes to a wound infection. To prevent this, the doctor may prescribe antibiotics. In minimally invasive inguinal hernia surgery, wound infections and bruising are less common than open surgery.
Injury of structures in the inguinal region
In the operation of a hernia, surrounding structures can be injured. In male patients, it can affect the vessels and nerve cords of the spermatic cord. But also the spermatic cord itself or the urinary bladder can be affected. The testes can regress or develop a so-called secondary undescended testicles. Secondary undescended testicles appear mainly in operated infants when the newly sutured tissue exerts traction on the testes.
An uncomfortable complication is also inguinal pain after an inguinal hernia surgery. They arise when nerves that run through the inguinal canal, injured by the procedure or get under train.
Complications from the network used
The net used in an inguinal hernia op is a permanent foreign body to the body. It can be hypersensitive to it, for example with inflammation. Even a network infection is possible – even half a year after the inguinal hernia op. In some patients, the mesh slips, curls or shrinks.
With such network-specific complications, it may be necessary to remove the mesh again.
Relapse (recurrence)
In a few cases, operated on patients again hernia, which must also be operated on. These so-called relapses occur somewhat more frequently in minimally invasive inguinal hernia surgery than in open procedures. Will during the Hernia op used a network, the risk of relapse decreases.