Hernia Repair Inguinal

What is it?
A hernia is a lump which occurs from a weakness in the muscles which form the front of the body wall. Usually, the bowel or some fat, and more rarely other organs, squeezes to this weak spot and create a bulge in the area. In your case the hernia is just below your groin. It is usually caused by the body wall being weak from birth. Sometimes the body wall weakens with the passing of time. Sometimes the body is overstrained by coughing, heavy work or sport etc. Hernias are very common and are easily treated. If left untreated they get bigger and cause pain. More dangerously, the bowel can sometimes get trapped in the weak spot of the muscles. This can cause a blockage of the bowel, which can eventually cause it to become strangulated. An emergency operation is then required to deal with the problem.

The Surgery
Most patients have a general anaesthetic so that they are unconscious throughout the operation. The groin is often numbed with local anaesthetic to cut down the pain you may experience when you wake up. However, it is also possible to have the groin numbed with a local anaesthetic and have the whole operation under local anaesthetic. In this case, you will be conscious enough during the operation to feel that something is being done in the area of the operation but you will not feel pain. The operation can be done under local anaesthetic when the hernia is relatively small and your general medical condition does not allow you to tolerate the stress of a general anaesthetic.

An incision is made into the skin overlying the hernia. The bulge is either pushed back or is cut off. The weak part is mended/closed and strengthened using strong stitches. Another alternative is to patch the weak spot with a piece of synthetic material. This is usually done when the tissues around the weak spot are not strong enough to be stitched up together with strong stitches or when the weak spot is so big that it is impossible to close it just by using stitches. The synthetic patch is placed on top of the weak spot and is stitched to the healthy tissues around it. Soon, a lot of scarred tissue develops above and under the patch which makes it very strong and doesn’t allow the hernia to come back again. The cut in the skin is then closed up. The duration of the surgery is about 40 minutes.

If you have a hernia in each groin, they can usually both be mended at the same time. Keyhole surgery for hernia repair is only carried out in some specialized centres and for selective cases. It is carried out under general anaesthetic and there is no clear evidence at the moment that it offers a significant advantage compared to the traditionally performed operations. Ask your surgeon to explain his own method.

You may well be able to have the operation on the day you come in and go home the same day. You may need to stay in hospital for a day or two, if you are over 50, having trouble passing urine, have other illnesses, or if you cannot manage at home.

Any Alternatives
Simply waiting and seeing if you have more trouble is not a good idea. The hernia may get worse. A truss will usually hold the hernia back in place. It is useful as a stop-gap until you have the operation. It might be a good decision if you do not like the idea of an operation, or if you are not fit enough for one.