Many of us have had or are currently suffering from a hernia. Some "drag" it for years, until the situation becomes unbearable and there is no way to avoid the scalpel. How do we know that we have an inguinal hernia and that we need to proceed to surgery? Here are the answers of Dr. Rosen Tushev - head of the Department of Surgery at Vita Hospital.
Dr. Tushev, what is an inguinal hernia and how does it appear?
- A hernia occurs when part of an internal organ protrudes through a weak spot or existing opening in the abdominal wall, and a bulge is observed in the corresponding area. In the case of inguinal (inguinal) hernias, the destruction of the inguinal canal is due to the formation of lipomas (fat tissue hypertrophy) or the entry of an intra-abdominal organ into the canal. Inguinal hernias can be unilateral or bilateral. If the hernia becomes stuck, it restricts the blood flow to the relevant organ, necessitating emergency surgery.
Are there specific risk factors for the formation of an inguinal hernia?
- When there are weak points in the abdominal wall, such as the inguinal openings, and if connective tissue laxity and increased intra-abdominal pressure are combined, the risk of herniation is increased.
In general, the disease occurs more often among men, in people who are overweight, with chronic cough, frequent periods of constipation, standing for a long time. The appearance of a hernia is not excluded
during pregnancy or childbirth
Of course, the hereditary factor should not be neglected. Any patient who once suffered from a hernia is highly predisposed to the appearance of another type of hernia on the abdominal wall.
How do we know that maybe we have an inguinal hernia? What are the symptoms?
- Some inguinal hernias do not cause any symptoms. You may not know you have a hernia until a specialist finds it during an examination. However, you can often see and feel the bulge caused by the hernia. It is usually noticeable when standing up, especially when coughing.
Symptoms are most often expressed in: bulge in the groin area; burning or pain at the site of the hernia; pain or discomfort in the groin, especially when bending over, coughing, or lifting weights; pulling in the groin area; weakness or tension in groin radiating to testicles. In women, swelling may occur in the area of the labia.
What is laparoscopic inguinal hernia surgery?
- Laparoscopic surgery is a minimally invasive technique that allows surgery to be performed, without cutting the abdominal wall
Three small holes (0.5-1 cm) are made, through which mini instruments and a camera are inserted, and the defect is covered with a prosthesis made of bioinert material (canvas). In this way, recurrence of the hernia is prevented. Through a camera introduced into the abdominal cavity, the surgeon sees the abdominal organs on a monitor on an enlarged scale and works from a distance with the instruments without directly traumatizing the individual organs.
Two types of laparoscopic surgeries are performed for inguinal hernia: Total Extraperitoneal (TEP) surgery, in which work is done between the layers of the abdominal wall, and Transabdominal Preperitoneal Plastic Surgery (TAPP), in which the procedure is performed in the abdominal cavity.
What are the advantages of laparoscopic surgery over classic open surgery?
- The main advantage of laparoscopic surgery is that the postoperative pain for the patient is much less compared to classical surgery, and at the same time the recovery is much faster - within a week he can return to work, and after 20 days start with light physical activity. Another advantage is the fact that, in the presence of a bilateral hernia, it can be corrected during the same operation, without the patient having to go through two operations. In laparoscopic hernioplasty, due to the available anatomical relationships and spaces, the cloth is placed in such a way that it closes all three hernial doors in the groin (inguinal canal, femoral canal and obturator canal), which prevents the appearance of another type of hernia in the groin. This cannot be achieved with classic incisional surgery. And last but not least, the cosmetic result is extremely good, as almost no scars remain.