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LAPAROSCOPIC INGUINAL HERNIA SURGERY
Minimal Pain
No Stitch
No Scar
30 Min Procedure
LAPAROSCOPIC INGUINAL HERNIA SURGERY
Minimal Pain
No Stitch
No Scar
30 Min Procedure
What is Inguinal Hernia (Groin Hernia)?
An inguinal hernia occurs in the groin within a passage known as the inguinal canal. A noticeable bulge may appear on one side of your pelvic bone. This bulge is the result of abdominal tissue protruding through an opening in the lower abdominal wall. The opening may either be present from birth (congenital) or develop due to the natural age-related degeneration of muscles.
How Many Types Of Inguinal Hernia Are There ?
Direct Inguinal Hernia
A direct inguinal hernia penetrates directly through the wall of your inguinal canal. This type of hernia occurs in adults over time, from a combination of weakening abdominal muscles and chronic pressure on the muscle wall.
Indirect Inguinal Hernia
An indirect inguinal hernia enters your inguinal canal through the top. This usually occurs because of a birth defect. In some fetuses, the opening to their canal doesn’t close all the way during development in the uterus.
How Common Inguinal Hernia?
Up to 75% of all hernias are inguinal hernias. Around 25% of people AMAB will have an inguinal hernia during their lifetime, compared to 2% of people AFAB. Direct (acquired) inguinal hernias are more common in middle-aged and older men. Indirect inguinal hernias affect up to 4.5% of children, including 2% of babies AMAB and 1% of babies AFAB. Premature babies are up to 30% more likely to get one.
What are the symptoms of an Inguinal Hernia?
Not all inguinal hernias have symptoms. Sometimes, symptoms come and go. A hernia may slide in and out of the opening, or you may only feel it during certain activities. In children, you may see a lump in their groin area that appears bigger when they cry. It may go away when they sleep. An indirect inguinal hernia may not be palpable (able to be felt) to the touch because it may be tucked behind muscle fibers.
You might notice:
- A bulge in your groin area on either side of your pubic bone. It can go into your scrotum or labia.
- A feeling of pressure or heaviness in your groin.
- Pain in your groin, especially when straining, lifting, coughing or bending over.
- A burning or pinching sensation that may radiate through your pelvis or down your leg.
What is the main cause of Inguinal Hernia?
An inguinal hernia occurs when there’s a weakness or opening in your lower abdominal wall that allows abdominal tissue to push through. Many things can contribute to this, including:
- An opening or weak spot that’s present at birth.
- Congenital differences in the strength of your connective tissue (collagen).
- An opening or weak spot from previous abdominal surgery.
- Chronic coughing or sneezing.
- Chronic straining to pee or poop.
- Frequent strenuous exercise or manual labor.
- Years of pregnancy and carrying small children.
- Jobs that require standing for many hours at a time.
- Intrabdominal pressure from chronic obesity.
- Normal age-related tissue degeneration.
How serious is an inguinal hernia?
Hernias can worsen over time as the weakened opening allows more tissue to push through. This can lead to painful complications, including trapping and potential blockage of the intestine or compromised blood supply. If your hernia is causing discomfort, surgery is often recommended to prevent worsening. Even if you’re not experiencing symptoms, healthcare providers may monitor it, but most inguinal hernias tend to become symptomatic eventually. In children, and particularly for individuals assigned female at birth (AFAB), prompt treatment is generally advised due to a higher risk of complications.
How Inguinal Hernia Condition can be Diagnosed?
A physical examination is usually enough to diagnose an inguinal hernia. Your healthcare provider will try to see and feel the hernia. They may ask you to cough or to bear down as though you were pooping to make the hernia emerge. They’ll also want to know if the hernia can be massaged back into place, or if it’s stuck (incarcerated).
If they can’t see the hernia from the outside, they may order an imaging test to see it from the inside. An ultrasound will usually do the trick, but in rare cases, they may need to use something more specific, such as a CT scan.
What are the possible complications of an inguinal hernia?
- Enlargement over time. The pressure of an existing hernia on weakened tissues can have a snowball effect, making things worse. In those AMAB, an enlarged testicular hernia that moves down into your scrotum can cause painful swelling.
- Incarceration. An incarcerated hernia is one that can’t be “reduced” — physically moved back into place. A trapped hernia is more likely to become pinched as it grows bigger, causing pain and other complications.
- Small bowel obstruction. If part of your small intestine is herniated and becomes trapped and pinched, it can cause a blockage. It may stop you from being able to poop or pass gas, causing severe abdominal pain, nausea and vomiting.
- Strangulation. A strangulated hernia has been cut off from blood supply. This can lead to inflammation and infection of the tissue, and eventually tissue death (gangrene). Strangulation is a medical emergency.
Management and Treatment
What is the best treatment for inguinal hernia?
Healthcare providers often recommend surgery for most inguinal hernias, especially in children and those assigned female at birth (AFAB), as they are more prone to dangerous complications. In adults assigned male at birth (AMAB) with small, asymptomatic hernias, a wait-and-watch approach may be taken, but treatment is usually necessary eventually. If surgery poses risks due to health conditions, alternative options like hernia reduction and the use of a belt or truss may be considered to manage and prevent further growth.
What will happen if an inguinal hernia is left untreated?
A direct inguinal hernia penetrates directly through the wall of your inguinal canal. This type of hernia occurs in adults over time, from a combination of weakening abdominal muscles and chronic pressure on the muscle wall.
Types of Laparoscopic Surgery in Inguinal Hernia?
Laparoscopic surgery or ‘keyhole’ surgery is a minimal-access technique that allows the hernia repair to be undertaken without the need to open the abdominal wall.
Typically, three small incisions are made for the laparoscope and operating instruments. There are two main approaches for the laparoscopic repair of inguinal hernias.
- Transabdominal preperitoneal (TAPP) repair
This involves access to the hernia through the abdominal cavity. Mesh is inserted through the peritoneum and placed over all potential hernia sites in the inguinal region. The peritoneum is then closed over the mesh.
- Totally extraperitoneal (TEP) repair
During this procedure, the hernia site is accessed between the layers of the abdominal wall, without entering the peritoneal cavity. TEP repair is considered to be technically more difficult than the TAPP technique, but it may reduce the risk of damage to intra-abdominal organs.
Both techniques are safe and are performed by the surgeons at OneWelbeck. Keyhole surgery is particularly beneficial in recurrent hernias (ones which return after previous operations) or bilateral hernias. Even for standard, single-sided hernias, there are some advantages to keyhole surgery, namely reduced pain both in the initial post-operative period and more long term. In open repair, chronic groin pain occurs in around 10% of patients. This is halved in keyhole surgery to around 3-5%.
The scarring is also reduced in keyhole surgery. Rather than one incision in the groin, there are three tiny ‘keyholes’. One just off the umbilicus, measuring around 2 cm and then two 0.5cm cuts between the umbilicus and the pubic bone, in the midline. When these heal, there’s very little to see.
Finally, patients are able to recover more quickly from the keyhole technique and to get back to activities of daily living, such as walking and working, than they are after open surgery.
Difference between Laparoscopic and Open surgery
| Difference | Open Surgery | Laparoscopic Surgery |
|---|---|---|
|
Technology |
Old |
Minimally Invasive or Advance |
|
Cut |
Big cut |
Small Cut |
|
Scar and Stitches |
Yes |
Minimal |
|
Bleeding |
Maximum |
Minimum |
|
Risk of Infection |
High |
Low |
|
Recovery Time |
Slow |
Fast |
|
Back to Daily routine |
1-2 Weeks |
1-2 days |
|
Hospitalization |
3-4 Days |
24 Hours |
|
Success Rate |
High |
High |
Prevention
To reduce the chances of hernia recurrence following surgery, it is advised to:
- Refrain from heavy lifting, as it elevates abdominal pressure.
- Avoid straining during urination, and address conditions like benign prostatic hyperplasia to enhance urination.
- Manage chronic constipation, which contributes to increased abdominal pressure. Incorporating high-fiber foods, fruits, vegetables, and whole grains into your diet can aid in preventing constipation and straining.
- Control the causes of chronic cough, such as addressing common colds and quitting smoking.
Advantages of Laparoscopic Treatment Inguinal Hernia
| Laparoscopic Treatment |
|---|
|
Minimal Cut/Minimal Stitch |
|
General Anaesthesia |
|
24 hour Hospital Admission |
|
Join duty with in 2-3 Days |
|
Advance Technology |
Benefits of laparoscopic Hernia Repair
Dr. Mohit Jain is highly skilled and extensively trained in laparoscopic hernia repair. Minimally invasive, minimal incision techniques provide the following benefits to patients:
- Lower risk of infection
- Smaller incision size.
- Shorter operating room (OR) times.
- Earlier return to work and daily activities.
- Less pain and shorter recovery time for some patients
Additionally, if necessary, laparoscopic techniques allow surgeons to repair multiple hernias using the same
Frequently Asked Questions (FAQs) about Inguinal Hernia
The average cost of hernia surgery in India is Rs. 90,000. The actual cost will differ from one patient to another due to factors like severity, type of surgery, surgeon’s fee, etc.
The hernia belt price ranges from Rs. 500 to Rs. 3,000 or more. The hernia belts are available for different types of hernias. So, while purchasing, ensure that you are buying the right type of belt.
Generally, hernia surgery is safe, and there are no long-term side effects. However, in some cases, patients may develop hernia mesh complications, such as mesh adhesion, migration, shrinkage, etc. In some cases, the non-absorbable mesh may undergo degradation, and the absorbable mesh will get absorbed and lose strength over time. These side effects can make the patient vulnerable to hernia again.
Small and asymptomatic hernias can be managed without surgery, but it should be noted that a hernia cannot heal itself. Surgical repair is the only effective treatment for all types of hernias.
No. During hernia surgery, general anesthesia is administered by the doctor, which numbs the body. Thus, the patient doesn’t feel any kind of pain or discomfort during the procedure. However, after the surgery, there will be mild to moderate pain in the surgical site. To manage the pain, the doctor will prescribe pain medications.
For 90-98% of patients, hernia surgery is not dangerous. There are certain risks and complications associated with the surgery, but most of them can be managed with proper pre and post-op care. It’ll be best to talk to an expert doctor to find out if hernia surgery has any impending dangers for your case specifically.
Some common dos and don’t to follow after inguinal hernia surgery are:
- Don’t lift objects heavier than 10 kg or 20 pounds for at least one month.
- Don’t perform any strenuous activity or exercise for 2-4 weeks.
- Don’t strain the surgical site or wear tight clothes.
- Do walk around to improve blood circulation and promote healing.
- Do take a healthy and balanced diet.
- Do take the prescribed medications and regular follow-ups with the doctor.
Doctors often advise wearing compression shorts or tight-fitting boxer briefs to patients after inguinal hernia surgery. They provide support to the groin region and help to reduce swelling.
Swelling after inguinal hernia surgery can last for 2-3 weeks. In some patients, the swelling may persist longer. It should be noted that swelling after surgery is normal and a part of the healing process. However, if the swelling increases after the 1st week, it’s crucial to consult the doctor right away.
The patients are strictly advised to avoid lifting heavy objects after inguinal hernia surgery for a month or so. In the first week, avoid lifting objects that are heavier than 4 kg or 8 pounds. In the upcoming weeks, the patient will be able to lift objects that weigh around 5-8 kg. However, it’s advised to avoid lifting more than 10 kg until the recovery is complete.
Typically, if the hernia size is between 1 cm to 3 cm or larger, it’ll be best to consult a hernia doctor to determine whether surgery is needed. If a hernia is smaller than 1 cm, the doctor may recommend watchful waiting. However, if the size is larger than 1 cm, the decision of surgery will be made according to the severity of the condition.
