Author Name: Dr. Aditi Agarwal(M.S.General Surgeon)

Inguinal Hernia

What is hernia?

Hernia is protrusion of contents of a cavity through a defect in the wall of the cavity.

What are clinical features of a hernia?

Expansile cough impulse :

it is the expansion in the size of the swelling/lump on coughing.

Reducibility :

the swelling reduces on being pushed back or on lying down.

Can it be cured with medicines?

Since hernia occurs as a result of physical defect. It cannot be cured by medicine and treatment is surgery

What type of surgery can be done?

Most common type is mesh repair; either by open or laparoscopy (key hole technique).

Open surgery i.e traditional method whereby 8 to 10cm incision is made. Hernia is approached, the contents and the sac are reduced. The hernia defect is identified and mesh made of artificial mesh is placed. It is fixed with sutures. Tension free repair is done.

In laparoscopy method, 3 small incision (1 incision of 1cm and 2 incision of .5cm) are made. Through 1cm incision laparoscope or camera is passed and through other two ports working instruments are passed. Similar to open surgery mesh is placed and fixed with tackers. These incisions are closed with absorbable sutures.

What is the advantage of doing a laparoscopic surgery and why does it cost more?

Laparoscopic surgeries have a fast recovery because of small incisions and less muscle damage Early mobilisation, fast return to work and less loss of working days.

It is surgical method of choice in case of bilateral(hernia on both side) and recurrent (it has occured again) inguinal hernias.

It is a highly skilled surgery. The mesh used in laparoscopic surgery is bigger in size and tackers are also used to fix the mesh so an increase in cost.

When can I go home?

You can go home the next day or even the same evening in case of both the methods.

If you are tolerating food and are comfortable walking you can go home sameday provided you have assistance at home and you stay close to the hospital so that you can return in case of emergency.

Do females also get inguinal hernia?

Inguinal hernias are more common in males but females do get it. It is repaired similar to the way male hernias are repaired.

Doctor told me there is intestine in my hernia and I need to hurry up my surgery?

If you intestine loops in your hernia and your swelling is not reducing in size there are high chances that with progression of time it may go into obstruction or strangulation i.e blackening of intestinal loops which would need cutting of that part of intestine and reagain joining it. Before these complications develop you should undergo surgery at the earliest.

After surgery what care do I need to take care to avoid recurrance?

Hernia occurs due to muscle weakness. In order to avoid recurrance, patient should avoid constipation, coughing n sneezing and weight lifting as all these activities increase intra-atomic abdominal pressure. In males prostate enlargement n straining to pass urine is an additional cause. Smoking also needs to be avoided.