What are inguinal hernias?

A hernia is a condition in which an internal organ protrudes or prolapses from its normal anatomical position, through a congenital or acquired opening. The vast majority of hernias affect the abdominal wall, the most common type of hernia in adults being the inguinal hernia. The abdominal wall is made up of superimposed muscles and the connective tissue sheets (fascia) that cover them. The weakness and stretching of these muscles, combined with the increased pressure inside the abdomen, contributes to the protrusion of the abdominal organs (small or large intestine, cecum) through the hernia gate.

There are different solutions for the surgical treatment of hernias, for the closure of the hernia gate and for the strengthening of the abdominal connective tissue skeleton, which is determined on an individual basis. This is true for the type of approach (open or laparoscopic surgery), the size and type of mesh or, in rare cases, the omission of mesh.

Why should the intervention be carried out?

During an excluded inguinal hernia, the hernia content that previously moved through the hernia gate is “stuck” in the hernia sac. The tissue wall becomes oedematous (watery). Initially, this oedema may disappear after the contents are reinserted.
Over time, the venous circulation of the intestines is disturbed, and as the intestinal wall becomes more watery, the arterial circulation is damaged, and definitive intestinal necrosis may develop, releasing bacteria, toxins and free radicals, which can cause local and systemic infection, bloodstream infection, and in the final stage, even fatal.

How is the surgery done?

The surgery is performed under general anaesthesia, with a 5-10 cm incision made parallel to the inguinal ligament and then a skin incision is made on the abdominal wall. The viability of the excluded hernia contents stuck in the hernia sac is assessed and, if necessary, the dead staple or intestinal segment is removed and an intestinal connection is sutured. The abdominal wall is reconciled with stitches, then an “onlay” mesh is attached to the connective tissue scaffold in a sterile environment. Suction drainage (Redon) is left in the wound cavity until the next day of surgery.

On average, the operation takes 50-60 minutes, which is extended by approximately 30-40 minutes for preparation, anaesthesia and the final steps.

Are there other treatment options?

There is no alternative treatment for excluded hernias of the groin. Over time, as the contents die, a bloodstream infection develops, leading to the death of the patient.

Potential complications of surgery

Postoperative pain in the surgical area, skin and tissue damage, inflammation, scarring, wound infection, numbness around the wound, deep vein thrombosis.

Will I have pain after the operation?

After waking up, you can expect to experience some discomfort, and we will do our best to minimise this, or if it has developed, to alleviate it.

The incision may be painful after the operation and the wound will be anaesthetised as a final step in the operation. There may also be discomfort around the incisions, which should also improve considerably with the use of painkillers. Painkillers will gradually become unnecessary over time.

How long do I have to stay in hospital?

After the operation, if there is no bowel opening, you can go home the next day.
The cardiac drain will be removed after 2-3 days.

The recovery period

When can I take a bath or shower?

There will be a clean cover dressing in the wound, which will be changed by appointment from time to time. You are welcome to wash the rest of the body, but keep the dressings completely dry for the first 48 hours. Avoid bathing or swimming until the stitches are removed, soaking the wound increases the likelihood of infection. Do not allow water to be directed onto the wound while showering during this period. You can shower for 1 week after surgery, but the wound must be carefully dried afterwards.

Exercise:

You will feel more tired in the few weeks after surgery, it is recommended to gradually resume your daily activity. For the first 6-8 weeks, avoid heavy physical work, lifting weights and intense sports activities.

Work:

Most people can return to work within 1-2 weeks.

Please avoid the immediate post-operative period:

  • 6-8 weeks of strenuous exercise (e.g. running, aerobics).
  • Gradually increase your physical exertion at a pace that you feel you can manage
  • Avoid climbing stairs 24-36 hours (or longer if you feel up to it)
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