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Inguinal
hernia
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Not necessarily dangerous in
themselves, inguinal hernias can be painful and lead to serious
complications. But surgical repair is now easier than it once was.
They occur when soft tissue — usually
part of the intestine — protrudes through a weak point in the groin,
where the abdomen meets the thigh. The resulting bulge can be painful —
sometimes excruciatingly so — especially when you cough or lift a heavy
object.
Some people develop or acquire the
abdominal weakness that leads to a hernia in adulthood. But more often
the weakness occurs at birth, when the abdominal lining (peritoneum)
doesn't close properly. And although far more men than women have
inguinal hernias, no one is immune — including infants, pregnant women
and older adults.
Although not necessarily dangerous in
themselves, inguinal hernias can lead to life-threatening complications.
For that reason, your doctor is likely to recommend surgical removal of
a hernia that's painful or growing larger. The good news is that it's
not the same hernia operation your father may have had, with a large
abdominal incision, a long hospital stay and weeks of immobility.
Instead, many inguinal hernias now can be successfully repaired with a
technique that uses several small incisions (laparoscopy), leading to a
faster, less painful recovery.
Treatment
If your
hernia is small and isn't bothering you, your doctor may recommend a
watch-and-wait approach. But growing or painful hernias usually require
surgical repair to relieve discomfort and prevent serious complications.
There are two general types of hernia operations:
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Herniorrhaphy.
In this procedure, your surgeon makes an incision in your groin and
pushes the protruding intestine back into your abdomen, then repairs
the weakened or torn muscle by sewing it together. Following the
operation, you'll be encouraged to move about as possible, but it
may be as long as 4 to 6 weeks before you're able to fully resume
your normal activities.
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Hernioplasty.
In this procedure, which is something like patching a tire, your
surgeon inserts a piece of synthetic mesh to cover the entire
inguinal area, including all potential hernia openings. The patch is
usually secured with sutures, clips or staples. Hernioplasty can be
performed conventionally, with a single long incision over the
hernia. But it's more often done laparoscopically, using several
small incisions rather than one large one. A fiber-optic tube with a
tiny camera is inserted into your abdomen through one incision, and
miniature instruments are inserted through the other incisions. Your
surgeon then performs the operation using the video camera as a
guide.
Advantages of laparoscopic repair include less discomfort and scarring
following surgery and a quicker return to normal activities — most
people are back to work within a few days. The procedure is a good
choice for people whose hernias recur following traditional hernia
surgery because laparoscopic methods allow surgeons to work around scar
tissue from earlier repair. It's also good for people who have hernias
on both sides of the body (bilateral inguinal hernias).
You may
not be a candidate for laparoscopic hernia repair if you have a very
large hernia, if your intestine is pushed down into the scrotum or if
you've had previous pelvic surgery.
inguinal hernia
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