Groin and legs

Types of operations for inguinal hernia

The indication for the operation is the presence of the hernia itself. Regardless of the size and type of pathology, the patient is offered surgery, as this is the only way to completely get rid of the disease.

With formations that are well reduced, do not cause inflammation and severe pain, the intervention is carried out in a planned manner. The patient is fully examined, then a suitable time is chosen for hospitalization, and then they begin to operate.

In cases where the disease causes complications such as infringement, an operation for an inguinal hernia is performed on an emergency basis, immediately after the diagnosis is made.

Contraindications to the surgical, including laparoscopic intervention of a planned nature can be the following patient's condition:

  • temperature rise,
  • exacerbation of chronic diseases
  • kidney and liver failure
  • severe diseases of the cardiovascular system
  • diabetes in decompensation,
  • insufficient blood clotting,
  • heart attack, stroke,
  • elderly age.

In case of emergency surgical intervention, contraindications are not taken into account, as the hernia carries a threat to the life of the patient.

Planned operations require compliance with certain activities and careful preparation. After diagnosis, the patient is recommended to go to the hospital and pass the necessary tests.

To exclude contraindications, the patient undergoes a general examination, which requires electrocardiography, ultrasound, computed tomography.

Be sure to conduct a study of blood and urine.

In the rehabilitation period, it is necessary to adhere to simple requirements when choosing products. Nutrition after the operation of the inguinal hernia must be balanced, including in it all the necessary nutrients and trace elements.

You can eat often, but in small portions. The main component of nutrition that will allow a person to recover from surgery is protein.

Therefore, the patient during the rehabilitation period should consume in sufficient quantities low-fat varieties of cottage cheese, milk and dairy products, buckwheat, chicken, eggs, fish dishes.

After a month after surgery, patients usually return to their daily activities. But to avoid possible troubles in the postoperative period, it is necessary to follow simple requirements:

  • observe the regime of physical activity,
  • strictly follow the recommendations of doctors
  • adhere to proper nutrition,
  • observe postoperative suture hygiene.

With the correct implementation of these simple recommendations, you will forever get rid of and forget about the illness that tormented you, and a year later even the seam will become almost unnoticeable.

The operation of the inguinal hernia in women is carried out in a planned or emergency manner. For a planned surgical intervention, the main indication is the presence of the hernia itself. The first operation is carried out in the presence of pronounced symptoms of the disease:

  • the pains
  • big size of protrusion,
  • indigestion,
  • the impossibility of self-reduction,
  • difficulty urinating and defecating.

In the presence of certain conditions of the patient, a planned operation is delayed or prohibited. Contraindications are:

  • high body temperature of any origin,
  • acute course of infectious diseases, the presence in the body of chronic foci of infection,
  • serious pathologies of the kidneys, liver,
  • diseases of the cardiovascular, respiratory system,
  • endocrine system diseases
  • poor blood coagulation
  • recent transfer of heart attack, stroke,
  • gestation period
  • elderly age.

Contraindications during emergency operations are not taken into account, this significantly increases the risk of recurrence and serious postoperative complications.

The operation to remove an inguinal hernia in women has several stages:

  1. Dissection of peritoneal tissue in the area of ​​protrusion.
  2. Detection of the hernia sac.
  3. Dissection of the bag, conducting an analysis of the state of internal organs. In the absence of necrosis and other lesions, the organs are inserted into the abdominal cavity.
  4. Suturing the hernia gate in one of the ways (tension or non-tension hernioplasty).
  5. The final stage - stitching of the peritoneal tissue.

The duration of the procedure depends on the size of the hernia, the development of complications during the operation. In most cases, the session lasts from half an hour to several hours.

An operation to remove a hernia in men (hernioplasty) is performed today with the help of modern technologies (endoscope), which significantly reduces the recovery time of the operated patient.

Instead of incisions, with laparoscopic hernioplasty, three punctures are performed. Through punctures, with the help of special tools, the hernia sac is cut off.

Due to this, there are practically no traces of the operation on the surface of the skin, and the muscles in the abdominal area are hardly injured, minimizing painful sensations.

Then the walls of the peritoneum are strengthened.

In the first case, which is a classic of surgery, the holes formed in the abdominal cavity are closed by tightening the tissues and stitching them together (Scholdice's method).

The second method involves the use of plastic materials during plastics, which take root perfectly in the human body. During this operation, a special polypropylene mesh (Liechtenstein plastic) is stitched.

Many patients are concerned about the question: "How long does the operation to remove a hernia last?" The duration of hernioplasty is less than an hour, which allows minimizing complications from general anesthesia.

Recently, patients who for one reason or another are contraindicated for general anesthesia, perform hernioplasty with the use of local anesthesia.

As with any surgical intervention, hernioplasty does not go without a trace, as it is accompanied by a minimal, but, nevertheless, destruction of connective tissues.

Each organism behaves in its own way; therefore, a certain percentage of complications in the postoperative period cannot be excluded. In addition, there are some factors that may impede rehabilitation.

The operation for an inguinal hernia in an uncomplicated case is performed in a planned manner. The patient has several weeks to visit for the upcoming treatment of narrow specialists, to ensure that there is no hidden infection process, anemia, heart problems.

This will reduce the risk of complications from surgery and during anesthesia.

Directly preparation begins on the eve of the surgical intervention in the hospital. The anesthesiologist meets with the patient about his comorbidities and medications taken, studies the results of examinations, chooses the method of anesthesia and prescribes premedication - drugs to prepare for anesthesia.

On the day of the operation, you should not eat or drink water, otherwise at the initial stage of anesthesia, vomiting may open, and the food eaten may get into the respiratory tract.

Also in the morning before the operation you need to remove the hair in the bikini area, and the ladies - to get rid of nail polish. According to the color of the nails during the operation, the anesthesiologist will evaluate whether the body receives enough oxygen.

More information about the preparation will tell the attending physician, based on the characteristics of each patient.

It is impossible to operate a patient with a hernial formation in the groin, if:

  • heart attack
  • severe diabetes mellitus
  • stroke,
  • pulmonary insufficiency
  • renal failure
  • pregnancy,
  • BPH.

The only treatment for hernia is surgery. Conservative methods do not bring a positive result.

Only a surgeon can remove the protrusion. The operation is performed openly or laparoscopically, i.e. through a small hole.

The first method is more common. The operation goes like this:

  • local anesthesia with spinal anesthesia,
  • opening the soft tissues of the anterior abdominal wall to access organs
  • isolation of the hernia sac from surrounding tissues, its dissection through incisions parallel to the inguinal ligament,
  • reposition of the contents of the bag into the abdominal cavity,
  • stitching and tying the neck of the hernial bag in the area of ​​the gate,
  • cutting off excess peritoneum beyond the abdominal cavity
  • elimination of the hernial ring and strengthening of the abdominal wall.

An operation for an inguinal hernia is performed only with the development of complications or after the pathological protrusion acquires a certain size. Surgical intervention is unacceptable in the presence of a minimal symptomatic picture of the disease.

This fact is explained by the high probability of the development of postoperative pain syndrome.

What to do when inguinal hernia in the initial stages of its development? Experts from the field of surgery recommend waiting. That is, many doctors believe that in this case, the most suitable solution is a waiting tactic.

The patient is under constant medical supervision. It is during this period that it is recommended to use a bandage to eliminate the possibility of sudden pinching of the hernial contents.

The methods of open surgical treatment of inguinal hernias include:

plasty method of the inguinal canal with local tissues according to Scholdice’s method

Alloplasty method according to Lichtenstein.

The last two methods are widely used in Western countries, but are also gaining popularity in domestic clinics. The essence of these techniques is to use the standard four stages of hernia repair, described above, and only slightly differ technically from each other. With the choice of a suitable technique will help determine the specialist.

Laparoscopic method for the treatment of inguinal hernias

Currently, the laparoscopic method of treating inguinal hernias has gained wide popularity. The operation is carried out with the help of local anesthesia and special technologies that allow to manage with small cuts. With the help of a video camera inserted into the cavity, the surgeon conducts and monitors the operation.

The most important advantage of laparoscopic hernioplasty is the possibility of simultaneous closure of the internal opening of the inguinal and femoral canals. As well as the avoidance of complications that occur during open surgery (damage to the ilio-inguinal nerve, spermatic cord, postoperative orchiepididymitis).

The recurrence rate for surgeons who have extensive experience with laparoscopic operations is only about 2%. However, technically it is a very complicated procedure and requires the use of expensive equipment.

Inguinal hernia operation cost

As a rule, when inguinal hernia surgery cost makes at least 300 cu Maybe higher. It depends on many factors, including the type of operation, its volume, etc.

You are interested in an operation for an inguinal hernia in St. Petersburg and prices for it, ask your questions to an experienced plastic surgeon - Andrievsky Andrei Nikolaevich. To do this, simply send an email to [email protected] or use the feedback form.

In addition, you can arrange a consultation by calling Andrei Nikolaevich at (921) 946-53-20. He will definitely help you!

Why do I need to remove an inguinal hernia?

Regardless of what size an inguinal hernia, its presence causes a feeling of discomfort.Swelling increases with any (even the most minimal) physical activity, provokes painful sensations. Hernia interferes with walking, causes indigestion and, in some cases, urination.A large inguinal hernia in men deflects the penis to the side, stretches the skin so that it is completely hidden in the skin folds. This makes it impossible to conduct sexual intercourse.

In women, the hernia sac enters the fallopian tubes and ovaries, in men, the loops of the small intestine and the greater omentum (this is the connective tissue of the abdominal cavity).

Removal of the inguinal hernia is a necessity, since its presence at any time can provoke a serious complication - pinching. There is no need to even make great efforts; pinching can cause vomiting, sneezing, constipation or diarrhea.

Parts of the omentum, ovary, or intestinal loops are pinched in the inguinal ring, causing severe pain. If the organs are pinched, the blood supply is disturbed. If an inguinal hernia operation is not performed as soon as possible, the clamped organ is necrotized.

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The expediency of the procedure

An inguinal hernia surgery is the only treatment. The expediency of the procedure is indisputable - if it is not carried out, then complications will follow. It is not carried out only if there are strict contraindications:

  • Fever of any origin (fever is removed first, and then only the patient is sent to the surgical table).
  • Signs of infectious processes.
  • Renal, cardiac, respiratory or hepatic failure.
  • Decompensated diabetes.
  • Old age (older men have difficulty tolerating anesthesia).
  • Impaired blood clotting.
  • Recently suffered a heart attack or stroke.

Therapeutic treatment is to wear a special bandage that prevents the abdominal organs from falling out into the enlarged cavity.

But this option is highly undesirable - after all, surgery for inguinal hernia in men ranks first on the list of the most effective treatment methods.

Open method

If an open operation was prescribed by a doctor, then it will be performed using a tissue dissection in the peritoneal region in close proximity to the protrusion. Through this incision, the doctors reset the protruding tissues (if they were not infringed). It is obligatory to perform plastic surgery of the inguinal canal with own tissues or mesh implants.

The disease is treatable only through surgical removal.

At present, during the operation, polymeric grids are most often used, since in this case muscle tension is not created and the risk of relapse is minimized. The duration of hospitalization with open methods is about a week. For the prevention of complications during the rehabilitation period, the patient is prescribed antibacterial drugs. Painful symptoms are eliminated by anesthetics. The stitches are removed after 10 days.

Recovery takes a lot of time: only in 5–6 months a man begins to live a full life. But, as with all surgical interventions, complications are also possible:

  1. Foreign body sensation.
  2. Chronic painful sensations.
  3. Ischemic orchitis.
  4. Testicular atrophy in men.
  5. Disturbance and pain during ejaculation.

Open hernia surgery is a complex treatment with a high risk of complications. That is why it is done only when the patient’s emergency condition and complicated pathologies (with pinching, intestinal obstruction, inflammation, etc.). In other cases, the inguinal hernia is removed by less radical methods.

Recovery period

Rehabilitation after an operation to remove an inguinal hernia is always required, although the recovery time will be different in each case.Full restoration of the body requires the implementation of certain rules, and they are common to any type of surgical intervention.

To avoid complications and unpleasant consequences:

  1. The first day after removal is recommended to lie most of the time.
  2. Food should be balanced, it is necessary to exclude foods that cause gas formation in the intestine.
  3. For the prevention of infectious complications need to undergo a course of antibiotic therapy.
  4. It should be limited in the period of a certain time heavy exercise. After removing the stitches, the patient is not recommended to lift the weight of more than 5 kg.
  5. The first two months it is better to refrain from intimate life (especially since after treatment for some time the male potency will be reduced).
  6. It is necessary to protect the scrotum and lower abdomen from injury and hypothermia.

Removal of an inguinal hernia is performed in any clinic with a surgical department. The price of this method depends on the type of procedure, anesthesia and how long it will take to stay in the hospital. On average, open removal costs from 25 to 57 thousand rubles, and if you need to do laparoscopy, you will have to pay about 90 thousand rubles.

The prognosis of treatment after an operation to remove an inguinal hernia in men is conditionally favorable. With timely treatment to a specialist and the implementation of all the rules of rehabilitation guaranteed recovery of a person’s ability to work and return to a normal lifestyle.

How is the operation performed and what methods exist?

After conducting diagnostic procedures, the doctor, in accordance with the results obtained, selects the most effective and safest method of surgical removal of the inguinal hernia.

Treatment of inguinal hernia with conservative methods is impossible. An operation is required to remove the inguinal hernia, aimed at strengthening the muscles of the posterior wall of the inguinal canal. It is applicable for any age.

The operation to remove the inguinal and inguinal-scrotal hernia is called "hernioplasty". The fallen out body is reset, strengthening of the back wall of the inguinal canal is done. Local fabrics or synthetic prostheses can be used to strengthen the back wall.

If the removal of an inguinal hernia is performed using local tissues, the back wall is strengthened by tightening the tissues with their constant stretching, which can lead to a complication in the form of the reappearance of the hernia.

Causes

The reasons why a hernia appears are physical exertion. But there is also a congenital pathology, when the so-called gates remain in the peritoneum, through which part of the internal organs simply fall into the groin area.

After the operation, in this case, reinforcement of this area is required; a special synthetic mesh can be used for this.

An inguinal hernia is a condition in which a protrusion of the internal organs occurs through the inguinal canal. Inguinal hernia in men is more common than in women.

In men, the inguinal canal is a small slit and is located between the wide abdominal muscles. In the male inguinal canal there is a sperm duct.

The inguinal hernia has its own characteristics. Symptoms of an inguinal hernia are a protrusion of a round shape in the inguinal region, which disappears in a calm state and appears on physical exertion.

Protrusion is not a problem, since it is painless. The inguinal-scrotal hernia is oval.

When lowering into the scrotum, its asymmetry is formed. To the touch the formation is soft.

In the supine position, the fallen organ ablates in the abdominal cavity, and in its place you can probe the hole that corresponds to the hernial canal.

An inguinal hernia can be of 2 varieties: oblique and straight. In the first case, oblique inguinal hernia passes obliquely through the inguinal canal and bulges through the inguinal opening.

In men, oblique hernia may descend into the scrotum. A straight inguinal hernia weakens the posterior wall of the inguinal canal and passes through its external opening.

The main cause of all inguinal hernias is the weak muscles of the posterior wall of the inguinal canal.

Diagnosis of inguinal hernia

In many cases, an inguinal hernia can be diagnosed by evaluating the symptoms and examining a specialist of the inguinal area. If the swelling is not obvious, the doctor will palpate the groin area.

The doctor may also prescribe an ultrasound scan (a painless test is done by moving a plastic stick over the area to create a picture of the organs on the inside using sound waves) or computed tomography (a specialized x-ray that allows you to see organs from the inside).

These examinations provide an opportunity to determine if the patient has other causes causing similar symptoms.

One way to correct an inguinal hernia is surgery. The indication for removal will depend on the size of the hernia and the general health of the patient.

Preparation for surgery

For successful treatment a few weeks before the planned surgical intervention, the patient undergoes training, which consists in taking the necessary tests, excluding contraindications.

During the preparation period, the patient is recommended to adhere to the following rules:

  1. The diet should be saturated with plenty of vitamins, minerals. Thanks to this, the immunity increases, the patient gains strength and energy before the upcoming stress for the body.
  2. It is forbidden to take drugs that affect blood clotting. These include Aspirin and its analogues.
  3. Strengthen the body is recommended through regular walks in the fresh air and feasible sports activities.
  4. The use of alcohol, cigarettes is strictly prohibited.

If a woman takes oral contraceptives, the drugs are canceled a week before the surgery. To coordinate with your doctor is necessary and the reception of antiallergic drugs.

Immediately before the operation, it is necessary to clear the stomach, bladder. In the presence of nail polish, cosmetics are removed. On the nail plate, the doctor can follow the body's response to a particular medical effect.

In addition, it is necessary to remove all jewelry, lenses, false jaw. The patient is advised to have personal hygiene items with him, as due to the transfer of stress, premature menstruation may begin.

Surgery is the only effective treatment for inguinal hernia. All other methods (bandages, drugs) can be used only as a temporary measure, or in cases where surgical treatment is contraindicated for any reason.

In order to successfully complete the operation and reduce the risk of complications in the postoperative period, the surgeon needs to obtain the most complete and reliable information about the condition of his patient to a minimum.

Preoperative inguinal hernia preparation includes:

  • complete examination (urinalysis and blood count, coagulogram, biochemical blood test, ultrasound, ECG),
  • finding out the presence of chronic diseases,
  • informing the doctor about taking any medications,
  • avoiding alcohol, drugs, smoking a few weeks before the operation,
  • a ban on eating 8 hours before the operation,
  • cleansing enema if necessary.

If a man has an inguinal hernia

There are several possible postoperative complications, read them in more detail.

Table. Possible consequences after surgery

Conservative treatment of inguinal hernia is ineffective and can lead to a number of complications - the beginning of the adhesions, in which the organs grow together, an incomplete reduction of the hernia.

However, wearing bandages, special diets and exercises, and traditional hernia treatment recipes can help you recover more quickly after surgery and prevent a recurrence of an inguinal hernia.

Thus, surgical treatment of a hernia is the only way to get rid of this pathology and avoid serious complications.

The surgeon has access to the hernia area - an incision is made with an open operation, and punctures during a laparoscopy

Hernia sac removed

The inguinal ring is sutured to normal size.

Plastic surgery is performed.

Hernia operations are performed in one of two ways - open or endoscopic. With an open operation, the surgeon must make one or two incisions.

Two incisions are necessary for bilateral inguinal hernia, which is rare, one is usually enough. During laparoscopy, three punctures are made - a laparoscope and an implant mesh are inserted through an eight-millimeter puncture above the navel, and endoscopic instruments are inserted in the groin area through two five-millimeter punctures.

Both methods have their advantages and disadvantages. Thus, with open surgery, the risk of seam divergence increases and the rehabilitation period is prolonged, whereas after laparoscopy, the punctures quickly and completely disappear.

However, this may create a false impression that a full recovery has occurred after the operation, because of which the patient forgets about the ban on heavy physical exertion and puts himself at risk.

In addition, endoscopic surgery is contraindicated for people with intolerance to general anesthesia, while open surgery can be performed under local anesthesia.

Tension plastic inguinal hernia

During an open surgery, the surgeon makes an incision near the hernia. Then gently pushes the bulging tissue back into place, stitching the weak muscular layer together so that nothing sticks out.

In almost all cases, the surgeon strengthens the area with a mesh (from the medical class). Layers of fabric and leather are stitched over the top of the mesh.

The introduction of the prosthetic mesh allows you to strengthen the muscle layers, as well as significantly reduce the risk of hernia recurrence, to return to work faster.

Types of inguinal hernia:

  • Straight hernia that passes in the groin canal, bypassing the spermatic cord, bulging through the bottom of the canal,
  • Oblique hernia, passing along with the spermatic cord through the canal in the groin, bulging through the inguinal ring.

Such a violation occurs in males more often than women. It is characterized by the swelling of the internal organs through the walls of the groin channel in the abdominal cavity, which is accompanied by pain.

To get rid of the disease, doctors advise to resort to the conservative method - surgical intervention. Treatment without inguinal hernia surgery in men is possible in exceptional cases.

Thanks to the article you will be able to identify the main symptoms and signs of the disease, which will ensure the provision of effective therapy.

Medical exercises at home will help strengthen the abdominal muscles, which will reduce the load on the sore spot. Before starting such therapy, it is necessary to consult a doctor, since the treatment of hernia with physical exercises is contraindicated for many. It is worth performing them 3 times a day in this order:

  1. Sit on a chair, legs spread shoulder-width apart. Raise your hand up, make a slow tilt in the appropriate direction. You must perform 10-15 repetitions left and right.
  2. Lying on your back on the floor, firmly hold the ball with your feet. Slowly lift it to a height of 15-20 cm and lower it. Exercise is performed 12-15 times.
  3. Put your feet shoulder-width apart. Alternately, bend down so that you can touch the tips of your toes with the opposite hand. Exercise must be repeated 12-15 times.

This method gives a guaranteed result only when it comes to kids.In the case of adults, it is better to carry out other manipulations or consult a specialist for treatment, otherwise a hernia can be affected.

However, some effectiveness is still there, you need to try to massage the sore spot. For inguinal hernia massage is done as follows:

  1. The skin at the site of the tumor slightly pull up.
  2. Put together three fingers and with a smooth movement try to push the hernia inside.
  3. Massage movements repeat 10-15 times in the morning and evening.

In men, inguinal hernia, in addition to common symptoms, manifests itself with specific signs:

  • pain and burning in the groin area,
  • feeling of moving the contents of the hernia sac into the scrotum,
  • difficulty urinating and defecating,
  • feeling uncomfortable while walking,
  • violation of potency.

Pain in the lower back and genitals, aggravated by any physical exertion.

An inguinal hernia is called the bulging of the peritoneum in the inguinal canal. Due to the anatomical features of the body, the disease often affects men. Representatives of the stronger sex prefer to ignore the changes until changes in the body begin to cause serious discomfort.

The main frightening factor that prevents timely access to a doctor is the need for surgical intervention. Experts have proven that conservative treatment and the use of traditional medicine can only aggravate the course of the disease and cause serious harm to the whole body.

At the first stage, he notices only a slight swelling. Gradually, it increases, reaching a size capable of interfering with movements.

An inguinal hernia is removed predominantly by surgery. However, this is not the only way out.

So, an inguinal hernia can be treated in the following ways:

  1. Statistics show that conservative treatment in most cases turns into relapses or is not able to completely relieve the patient from the problem. It is resorted to at the earliest stages of the disease or if there are contraindications to the operation.
  2. Surgical intervention. An inguinal hernia can be removed in one of several ways, which makes it possible to completely eliminate recurrence of the disease and early rehabilitation with minimal risk of complications.
  3. Ethnoscience. Only topical products are allowed to alleviate the condition, but only with the permission of the attending physician. Self-treatment can only aggravate the situation and provoke a condition that requires immediate surgical intervention to save the life of a man. The specialist may recommend a course of natural products only if a hernia is detected at the earliest stages.

In this disease, the walls of the abdominal cavity weaken, which is why they can no longer hold in place the internal organs. One of the weak parts in this area is the inguinal canal.

It is a gap through which the spermatic cord passes. It lasts from the deep inguinal ring to the superficial, from where, under certain conditions, the abdominal organs protrude.

  1. Statistics show that conservative treatment in most cases turns into relapses or is not able to completely relieve the patient from the problem. It is resorted to at the earliest stages of the disease or if there are contraindications to the operation. Another article on umbilical hernia addressed the question of how to cure it without surgery?
  2. Surgical intervention. An inguinal hernia can be removed in one of several ways, which makes it possible to completely eliminate recurrence of the disease and early rehabilitation with minimal risk of complications.
  3. Ethnoscience. Only topical products are allowed to alleviate the condition, but only with the permission of the attending physician.Self-treatment can only aggravate the situation and provoke a condition that requires immediate surgical intervention to save the life of a man. The specialist may recommend a course of natural products only if a hernia is detected at the earliest stages.

Choice of anesthesia

The type of anesthesia is determined taking into account the individual characteristics of the patient, the size of the protrusion, the estimated duration of the surgical intervention. To exclude complications, the doctor examines the patient’s medical history, a reaction to previous types of anesthesia.

When removing an inguinal hernia in women, 3 types of anesthesia are used:

  • total,
  • local,
  • regional type of anesthesia.

In the presence of psychological disorders in the patient, increased anxiety, fear of the operation, sedatives are used. If this or that type of drug is allergic, antihistamines are prescribed.

Surgery in children

In children, the operation is performed from the age of six months, usually under general anesthesia. The operation takes about an hour. Surgery is also performed in two ways - open and closed (laparoscopy).

With the open method, an incision of 7–10 centimeters is made, the contents of the hernial sac are reset to the abdominal cavity, the hernial sac itself is cut off. The wound is sutured using the connective tissue of the child and the peritoneum is strengthened by autoplasty or a propylene mesh.

Laparoscopy in children is performed in the same way as in adults.

Non-tension plastic surgery of the hernia gate

Non-tensioned hernioplasty is to use special mesh implants made from anti-allergenic materials. The advantages include a small percentage of relapses, low pain syndrome, a short period of rehabilitation, ease of implementation.

The course of recovery after removal of an inguinal hernia depends on the type of anesthesia. In most cases, the patient is able to move independently after 4-5 hours after surgery. At this time, in the area of ​​the suture and abdomen, he can feel pains of different intensity. Usually they pass quite quickly.

Surgical intervention is usually performed in the morning. The first dressing (dressing change) is scheduled for the evening of the same day.

During the procedure, discharge may appear, which is not dangerous. In the future, the dressing is replaced daily on an outpatient basis.

With increased pain and suppuration suture ligation can be performed for a long time.

For 2-3 weeks the patient is prohibited any physical activity. Throughout the recovery period, you can not lift loads heavier than 5 kg.

Intimacy is prohibited in the first 2 weeks. However, if a man has inadequate physical training, diabetes, repeated hernia surgery or other gastrointestinal diseases, then the taboo on sexual intercourse is imposed for 3-4 months.

On the recommendation of the doctor, the patient may wear a special bandage. Its use is becoming increasingly rare, since modern methods of surgery can reliably secure the place where the hernia is protruding with the help of mesh implants.

Therefore, the bandage is used only for the first time, until the pain is completely gone and it will not be allowed to resume physical activity.

To ensure optimal recovery during the rehabilitation period, the patient may be recommended therapeutic exercises. Also in this is important to adhere to a special diet, designed so that the operated had no diarrhea and constipation.

Hernia Removal Methods

There is a lot of controversial information about laparoscopy on the Internet, both positive and negative. Surgeons themselves consider this method to be as safe as possible, but they honestly warn that any intervention is always a certain risk.

The outcome is influenced by such factors as the age and condition of the organism being operated on, the lifestyle is also important. Of great importance are the experience of the surgeon and the equipment of the operating room.

The patient is discharged after surgery after one to two days, and a second visit is necessary a week later to remove the suture material.

A month after the operation, physical exertion should be avoided, especially those that are associated with abrupt single-stage voltage. Two weeks after the operation, the patient can have sex and lead a normal life.

At first, after the operation, the place of the hernia may hurt, after 8-12 hours the doctor changes the bandage, there may be a discharge on it. Suppuration of postoperative sutures is a fairly common phenomenon; to avoid this, the dressing should be changed more often.

A special bandage helps to speed up the healing of the postoperative wound and the engraftment of the graft mesh, only a specialist should impose it.

For complete engraftment of the mesh implant, its fouling with connective tissue, it takes at least two months, after six months the hernia is completely overgrown and the risk of recurrence is significantly reduced.

After the rehabilitation period (1 month), you can perform therapeutic gymnastics exercises that strengthen the abdominal wall. To do this, press the press (from the position with bent legs to reduce the load) or wring out from the floor.

Push-ups strengthen the muscular corset and put pressure on almost all muscle groups, so it is advisable to use them to prevent recurrence of the disease.

However, it is best to do swimming - while the load on the muscles is quite intense, but does not cause excessive tension and is distributed evenly.

Diet after surgical treatment of inguinal hernia

A diet after the removal of a hernia excludes foods that may trigger digestive disorders. To prevent an increase in intra-abdominal pressure and reduce the load on the operated area, the patient should have normal stools, without constipation or diarrhea.

For this, food is taken in small portions, the frequency of receptions is increased to six times a day. Food should be liquid and rich in protein (fish, cottage cheese, eggs, boiled beef).

Since it is not possible to get rid of an inguinal hernia through conservative treatment, in the absence of contraindications for surgery, a man should think about the complete removal of the protrusion.

One of the most progressive and modern way to get rid of a hernia in the groin today is to remove the protrusion with a laser.

The operation with the use of three endoscopic instruments is becoming increasingly popular for the treatment of inguinal hernia in women. Removal of the defect is carried out through small punctures in the abdominal area, through which the necessary surgical instruments are inserted.

The surgeon has the opportunity to observe what is happening with the help of a video camera, which is lowered into the abdominal cavity by one of the trocars. The advantage of endoscopic removal of the inguinal hernia in women is the ability to simultaneously access two channels: the inguinal and femoral.

The operation excludes many postoperative complications in women, including nerve damage, long healing of postoperative scars, and dissection of the ligament of the uterus.

The operation is carried out in two variants:

  1. Fixation of the mesh implant abdominal preperitoneal method - removal is performed from the abdominal cavity and the mesh is fixed between the peritoneum and the muscle layers of the abdominal wall,
  2. Installation of the mesh by the extraperitoneal method - the implant is fixed directly between the peritoneum and muscle layers, without entering the abdominal space.

The advantages of laparoscopic hernia exclusion include the following factors:

  1. The relapse rate is reduced to 1%,
  2. The shortest rehabilitation period is up to 21 days,
  3. Mild pain syndrome or no pain,
  4. The opportunity to return to the usual life in a week,
  5. The method allows two-way access.

Inguinal hernia among all hernial formations is very common. Her treatment should be carried out on time and requires a high specialization of the surgeon.

Unfortunately, inguinal hernia involves treatment solely by surgery. Medicaments, acupuncture, therapeutic exercises and any other traditional methods of treatment, applicable to other hernia formations, are not suitable in the case of an inguinal hernia.

The purpose of the intervention is to force the organs to their natural location and to remove the hernial sac.

For the operation, local or general anesthesia is used. An appeal to general anesthesia is optional.

This is a necessary measure when working with adolescents and overly nervous patients. If a patient falls into a state of hysteria on a surgical table, it is impossible to guarantee his safety using local anesthesia.

The duration of the procedure depends on several factors at once:

  1. The surgeon's experience.
  2. The shape, size and location of the hernia.
  3. The general health of the patient.

Important! Freedom from bilateral hernia occurs in two stages. In one operation, you can remove the problem from one side only. Between planned operations should take at least six months.

The choice of removal method is left to the discretion of the medical specialist. He selects the most affordable and safe way to get rid of the problem.

Among the ways to remove a hernia, the following options are possible:

  • Open. During the operation, an incision is made allowing the doctor to detect the hernial sac. His open and check the status of the fallen organs. In the absence of defects, they are simply reset, in other cases additional manipulations by the surgeon are required. Then the hernial sac is ligated, stitched and removed. In the next step, a muscle support tool is stitched in to help prevent the re-formation of the hernia sac.
  • Laparoscopic. Manipulations are carried out the same as with the open method, but to make them the surgeon makes three punctures in the peritoneum. All information about the state of the organs and the actions taken are displayed on a video screen.

Disadvantages and advantages of a method

Both methods are considered to be the most effective, but appeal to them does not always depend on the capabilities of the medical institution. The surgeon takes into account the individual characteristics of the patient, the nature of the hernia itself and the nuances of each of the techniques.

Removal of an inguinal hernia follows the same scenario, but in different situations one of the methods turns out to be the most advantageous.

The cost of surgical intervention is determined by the boundaries of 15000-50000 rubles.

The futility of conservative therapy and the high risk of development of life-threatening complications - impairments, dictates the need for an exceptionally operative method for the treatment of inguinal hernia, and regardless of the type and size of the protrusion.

An inguinal hernia operation is performed under:

  • local anesthesia (in the early stages of hernia),
  • spinal anesthesia
  • general anesthesia.

Currently, the removal of the inguinal hernia is possible in two ways:

  1. Stretch hernioplasty.
  2. Non-tensioned hernioplasty.

Plastic grafting with own tissues is a classic method of surgery for both direct and oblique inguinal hernias. The operation involves closing the opening of the abdominal wall by tightening and stitching together the tissues of the inguinal canal.

The "gold standard" of the tension plastics - reconstruction of the posterior wall of the inguinal canal using the method of E. Scoldays (E. Shouldice).

The main disadvantages of the tension techniques:

  • prolonged pain,
  • high incidence of hernia recurrence,
  • protracted rehabilitation
  • long period of disability.

Therefore, at present in all countries of the world, this approach has lost its relevance and is rarely used (usually in children under 16).

Preference is given to the second method - plastic with the use of synthetic polymeric materials.Proved a good survivability, reliability, inertness and harmlessness of nets in the human body.

Non-tensioning techniques at the present stage are widely used for the surgical treatment of the vast majority of hernias, and in the treatment of inguinal hernias they received the greatest development, including clinical situations, when there were many previous unsuccessful attempts at surgical treatment.

Reconstructive surgery is performed with individual selection and installation of the latest synthetic implants. At the same time, it is possible to avoid the tension of the tissues, the preservation of the natural, standard proportions of the inguinal canal is ensured, the patient is restored much faster and returned to normal life.

In addition, the implantation of mesh endoprostheses can be performed by laparoscopic method. During this operation, a special endovideo camera and a set of manipulators are used, which are inserted through small incisions (punctures) between the layers of the abdominal wall or into the abdominal cavity.

The mesh for closing the internal inguinal ring is established on the inner side of the peritoneum.

The operation is quite complicated, so patients' questions are not surprising: Where to operate on a hernia? How long does the surgery take? And how much is it? Let's try to answer these questions.

Recovery immediately after the operation of the inguinal hernia depends on the type of anesthesia and takes not too much time. If the operation was performed under general anesthesia, the patient goes home the next day, and if under local anesthesia, 4-5 hours after surgery.

Within 7-10 days it is necessary to visit the surgeon for consultations and dressings, the sutures are usually removed on the 8th day. If you are worried about pain in the scar, you can take analgesics.

For two weeks, sexual rest is recommended, as during sex, abdominal pressure may increase, leading to a recurrence of the hernia.

With the implementation of all medical recommendations after the elimination of the inguinal hernia, the postoperative period will be uneventful, full recovery will occur in a month.

Rehabilitation after the removal of an inguinal hernia is much faster if you limit physical exertion and, especially, weight lifting (no more than 3 kilograms) within six months after surgery.

The operation to remove an inguinal hernia is aimed at putting the organs back into their natural place and removing the hernial sac.

The cost of surgical intervention is determined by the boundaries of 15000-50000 rubles.

Hernia Consequences

Within 15 - 20 days any physical activities are excluded. Further, individually, the patient may be offered a set of gentle gymnastic exercises to restore the muscles of the groin and abdomen, as well as morning exercises.

Important! At first it is necessary to conduct classes under the supervision of a physician or an exercise therapy instructor, strictly following his recommendations. Do not exceed the threshold of permissible loads, it can be dangerous to your health and lead to undesirable complications.

Thanks to a properly formulated diet, possible complications can be avoided, and rehabilitation itself will be faster. The patient is recommended to eat only liquid food, and he should eat slowly, in small portions (at least four times a day).

The main condition is that the food should be rich in protein, because it is the main “building material” of the human body, allowing you to recover as quickly as possible.

A lot of protein is found in the following foods:

  • a fish,
  • milk, cottage cheese,
  • chicken eggs and meat,
  • buckwheat.

Note! You should also exclude from the diet some foods that disrupt the normal functioning of the gastrointestinal tract and provoke gas formation.

So, the patient should refuse sweets, yoghurts, dairy products and fruits. The specific menu must appoint a doctor.Finally, during rehabilitation, you need to give up cigarettes, alcohol and coffee, sour fruits, soda.

The first days after surgery, the patient needs maximum peace - as little movement as possible, bed rest is preferable. Also at this time, a person must take a number of medicines.

First of all, these are painkillers, which, depending on the condition of the patient, can also be administered after discharge from the hospital. For inguinal hernia after surgery, antibiotics may be prescribed as a prophylactic measure for the development of infections.

However, in modern practice, this is not at all an obligatory point of treatment; more often, such therapy is prescribed for symptoms of the inflammatory process that are already manifest.

An important part of rehabilitation is frequent dressings. The first takes place already on the day of the operation in the evening, and later on the stitches are inspected once or twice a day.

When an inguinal hernia in the suture area can be observed small discharge, but if there are no other symptoms (inflammation, suppuration, fever, etc.), they are considered normal and do not require additional treatment.

If the wound heals well and the patient does not have complications, the sutures can be removed within a week, and the person can be discharged home.

During the first days after surgery for an inguinal hernia, the person is usually still in the hospital, where any problems can appear immediately.

Discharge from the hospital after surgery for inguinal hernia usually occurs in 1-7 days. In the postoperative period at home it is necessary to strictly follow all recommendations of the attending physician.

If you still feel pain when you return home, continue to take painkillers as prescribed by your doctor.

An important role in the rehabilitation is diet. This is practically a highlight for adults and children. Food should be light, not causing bloating and constipation, overeating is not allowed. The portions are small, the food fractional.

After at least two weeks, you can restore intimate relationships by picking up poses that do not put pressure on the groin area.

With timely treatment to a specialist, the correct diagnosis and the correct method of treatment, the inguinal hernia will be eliminated. Surgery and recovery methods will help avoid relapses.

The main determining factor in the duration of recovery after removal of the inguinal hernia in men is the type of surgical intervention. Surgical procedures are divided with open access and carried out with the help of a laparoscope.

Depending on the access method, the type of anesthesia is chosen, the size of the incision for performing surgical procedures.

From them directly depends on the time spent in the hospital during the postoperative period. With open surgical operations, the patient is discharged for 3-5 days, and when performing a laparoscopic puncture, treatment in a hospital should be no more than 2-3 days.

In both cases, the duration of the outpatient stay, that is, periodic observation by a surgeon, is about 1-2 weeks. After that, the patient returns to his usual life.

In most cases, after the intervention, the incision is gradually tightened, the sutures are removed, and the man slowly increases physical activity. A reminder of the pathology remains a scar.

If the surgical treatment of an inguinal hernia is performed on time and the patient follows all the recommendations, then the risks of recurrence of the disease are minimal. But if during the early postoperative period the operated person does not adhere to certain rules, then there is a probability of disease progression and the development of complications.

Rehabilitation after an operation to remove an inguinal hernia is always required, although the recovery time will be different in each case.Full restoration of the body requires the implementation of certain rules, and they are common to any type of surgical intervention.

Postoperative diet

In order to ensure that an inguinal hernia does not cause complications after surgery, proper nutrition should be followed to recuperate and strengthen the immune system.

The first meal is allowed 6 to 8 hours after surgery. Products should be light, low-calorie. For the fastest recovery, it is recommended to eat foods rich in proteins (cottage cheese with a low percentage of fat, boiled chicken, milk, eggs, river fish).

It is important to exclude from the diet foods that contribute to excessive gas formation. The patient should abandon legumes, all types of cabbage, carrots, celery, mushrooms. Do not eat carrots, apples, bananas. Alcohol and carbonated drinks are prohibited.

Manifestations of an inguinal hernia imply a sensible approach to catering - a certain diet is necessary. Experts advise patients to choose their own products, the use of which should be limited.

The body's reactions to certain products are individual, so only the patient himself can determine what food causes bloating and constipation.

Doctors, before treating an inguinal hernia at home, recommend excluding foods that affect the increase in the acidity level of the digestive organs from the diet:

  • fatty and fried dishes,
  • smoked, spicy and salty foods,
  • spices, seasonings, sauces,
  • alcoholic, carbonated and sour drinks,
  • black tea, strong coffee.

In minimal quantities with inguinal hernia is allowed to use:

  • dairy products,
  • peas and cabbage
  • bakery products,
  • grapes

It is not necessary to take food shortly before sleep, otherwise the intra-abdominal pressure will increase - this will adversely affect the development of a hernia.

You can not overeat - it will disrupt the digestive tract and a negative impact on metabolism. And excessive body weight is an additional provoking factor for the formation of a hernia.

Before surgery, a man should exclude foods leading to constipation, spicy foods. The ban should be and dishes that can provoke gas formation. When inguinal hernia, sweets, yogurts, dairy products, many fruits and raw vegetables, and alcohol are dangerous.

If, before the operation, the man can afford some “relaxation of the regime”, then after the intervention he must strictly adhere to the doctor’s recommendations.

During the rehabilitation period, the basis of all dishes on the menu should be:

  1. Eggs
  2. A fish,
  3. Lean meat (chicken, rabbit, goat meat),
  4. Buckwheat,
  5. Milk and curd with a low fat content.

A timely request for medical care allows you to get rid of the pathology quickly and without consequences.

The operation itself takes no more than 2 hours. After 10 days, the stitches will be removed, and a man can get behind the wheel of a favorite car, engage in simple household chores. Appeal to laparoscopy allows you to fully recover in 2 weeks, but it costs much more.

Home treatment is impossible, but modern medicine leaves the patient with the right to choose how to deal with the pathology.

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Meals should be balanced. It is recommended to use more fluids to prevent constipation. It is necessary to abandon the products that enhance gas formation: sweets, sweets, muffins, yogurts.

Do not drink alcohol, coffee, fatty foods (lard, ham, brisket, fatty meats, butter, sour cream) and chocolate. Should not overeat. It is necessary to increase the amount of fruits and vegetables in your diet. Useful various soups, cereals, lean meat, fish, olive oil.

Rehabilitation

Surgery for inguinal hernia requires a rehabilitation period, which consists in monitoring the patient's condition, using medication to exclude complications, and adhere to the diet.

The postoperative period after removal of the inguinal hernia and its duration depends on the type of anesthesia and the course of the operation itself. When using local anesthesia, rehabilitation takes a shorter amount of time.

After 3-4 hours, the person is allowed to leave the hospital, but to undergo preventive examinations of stitches and dressings in a timely manner. A week later, allowed to get behind the wheel.

To lift weights (over 5 kg) - two months after the operation.

The use of general anesthesia requires a longer period of stay of the patient in the hospital, this period can be from 1 to 3 days. If a person has no complications, and the pain syndrome is not intense, the patient is allowed to leave the hospital.

Recommendations for the patient during the recovery period

The outpatient stage after an inguinal hernia operation in men usually lasts one or two weeks. The patient is recovering, gaining strength. At this time, it is very important to observe the diet and rest regimen, to increase the motor activity and load with a metered and with great care.

Postoperative recovery usually takes place without complications if the patient visits the doctor on time and fulfills his recommendations and requirements. The doctor, in turn, monitors the course of rehabilitation after the removal of the hernia, gives his recommendations, in case of complications he hospitalizes or prescribes additional treatment.

The duration of the recovery period depends on the success of the operation and the individual characteristics of the patient. After 5-6 hours after the procedure, the patient can move independently.

The duration of the rehabilitation period largely depends on the anesthesia applied by the surgeon. So, if the anesthesia is local, then the rehabilitation will take a little time: after a couple of hours the patient is released from the hospital, but under the condition that there are no complications.

Although the patient should still regularly return there for dressings, during which the recovery process will be monitored. The first dressing should be carried out in the evening (as a rule, such operations are done in the morning), and you should not worry if there were discharge at the same time - there is nothing scary about them.

But in the case of general anesthesia, the initial stage of rehabilitation may take one to two days.

This is followed by an outpatient rehabilitation period, which can be one or two weeks. For this period, peace, proper nutrition, and also the fact that the patient spent a lot of time in bed is important.

In addition, he should regularly visit a doctor who can identify complications and - if necessary - make adjustments to the treatment.

Note! During the postoperative rehabilitation period, any physical activity should be excluded. After some time, the patient is prescribed special exercises that reduce the risk of hernia recurrence and the development of complications.

The attending physician may prescribe the wearing of a special bandage, although today such devices are used less and less, because modern surgical techniques ensure reliable fixation of the site of the hernia by means of mesh implants.

Therefore, such a bandage will benefit only at first, until the pain disappears and physical activity is restored.

The patient should treat the recovery period outside the hospital as responsibly as possible. Non-compliance with the recommendations can lead to serious complications, in particular, to the seam divergence.

It is important to remember such rules:

  • Refusal to lift weights for the first 20 days (permissible weight - not more than 5 kg).
  • Ban on smoking. A bad habit can cause severe coughing, and this, in turn, will provoke excessive tension and seam damage.
  • Therapeutic physical training only on prescription.
  • To monitor the cleanliness of the dressing, in case of any discharge from the suture contact the surgeon
  • Time to go to the toilet. An enlarged bladder may press against the suture.

Special attention should be paid to clinical nutrition, which is recommended to observe at least a month after surgery:

  • Drink plenty of fluids.
  • Exclude foods that may cause constipation or bloating.
  • Eat small meals, 5-6 times a day, chew food well.
  • Eliminate fried, spicy, salty foods.
  • Refuse alcoholic drinks, soda, coffee.
  • Fill the diet with proteins (meat, dairy products, fish), which help to restore tissue.

What is an inguinal hernia?

From a medical point of view, an inguinal hernia is a condition where organs in the abdominal cavity (intestine, epiploon, testicles, etc.) can extend beyond its limits through the front wall of the inguinal canal. A different-sized formation protruding beyond the abdominal region may appear periodically or be permanent, bringing a lot of inconvenience. The disease can occur in any person, regardless of age, only the provoking factors are important.

Inguinal hernia - causes

In the case of congenital origin, disorders in embryonic development are the cause of the formation. Acquired hernia is associated with dystrophy of the muscles of the groin area due to aging of the body, rapid weight loss, or vice versa - overweight and the predominance of adipose tissue. Often, in healthy people, the bulging of the peritoneal organs is provoked by excessive internal pressure, which is created due to:

  • frequent weight lifting
  • pregnancy
  • chronic sneezing or coughing,
  • constipation
  • overweight.

About physical activity

Two weeks after the surgical procedure, you can begin to carefully and gradually return to the previous activity, although the severity can not be lifted for about six months.

If you violate these recommendations, the hernia may return, but doctors also do not recommend spending all the time in bed. When the pain disappears and the man feels that strength is returning to him, you can start walking a little and do simple physical exercises.

Easy gymnastics in combination with special stimulating exercises will allow the body to quickly return to its former form. There are a lot of similar exercises, the most popular of them are given below.

The patient gets up on all fours, bends all limbs, leaning on elbows and knees. Then he alternately raises his left, then right leg.

The patient lies down on the previously laid mat, hands positioned along the body. Then he lifts the straightened legs (about 45 degrees) and alternately crosses them (the “Scissors” exercise). The number of repetitions increases with time.

By the way, the “Bicycle” is also performed in the same position: a man lifts his bent legs and simulates the rotation of the pedals.

The patient lies on his side, stretches his hand forward and lays his head on it. The legs should be straight. One of them needs to try to lift, after several repetitions the side changes.

The patient puts his legs shoulder-width apart and performs squats (can be incomplete), after which he does two or three pushups. If traditional push-ups are too complex, then you can lean on your knees.

Note! It is necessary to perform all these exercises regularly, but at the same time it is necessary to monitor well-being. A man should not feel any pain or discomfort.

Daily number of repetitions should increase, in the future, in the complex, you can include other exercises.

Video - Hernia in groin

Increase the load gradually, listen to your feelings. In the case of the slightest discomfort classes stop and consult a doctor.

Running, walking and swimming strengthen the muscles of the peritoneum and increase their elasticity.Swimming - the best option dosed workouts, because it does not increase intra-abdominal pressure.

However, to engage in physical exercise, even dosed, should only be in the presence of a doctor or instructor and for their intended purpose.

Before running and walking, the patient must wear a bandage. Uncontrolled "races" can contribute to an increase in inguinal hernia and its infringement.

As for swimming, there is no evidence of any deterioration in the health of a patient with a hernia in the groin - even if he is independently engaged in the pool. The exception is jumping from the tower.

Causes of adult inguinal hernia

The first thing that should be determined after diagnosis is the reason for the appearance of this formation in the groin channel. Some causes are congenital, others appear when an organism grows up.

The internals cannot extend beyond the wall if it is strong enough. Therefore, one of the main reasons for the weakness of the canal walls in the groin - both the front and rear. Like many other types of hernia, the inguinal can be associated with excessive physical exertion. With frequent and excessive stresses, weakening of the wall and all the corresponding consequences can occur.

The following reasons should also be mentioned:

  • prostatitis and accompanying pains during urination,
  • digestive problems,
  • damage in muscle structure
  • chronic cough.

Pathology can occur in the presence of negative hereditary factors. Age and overweight are considered additional causes that may contribute to the emergence of an inguinal hernia.

Symptoms of an inguinal hernia in adults

The appearance of this pathology in men in any case is accompanied by education in the groin area. It can often be painless, because many men do not immediately realize that they need treatment. When applying loads and increasing them, the protrusion itself will increase. As soon as the load decreases, the tumor may shrink to small sizes. The peculiarity of this formation is that in the supine position it can be set off and be completely invisible.

Especially well with this sensation are familiar with those who have a hernia due to chronic cough. If the person in need of treatment coughs, the symptom of an impulse in the area of ​​the inguinal rings will manifest.

Symptoms in children of inguinal hernia and causes

In children, this problem is also common. Every 20th child encounters an inguinal hernia. The percentage of manifestations of this problem in premature babies is even greater - about 20%. More common in boys.

In practice, inguinal hernia is observed in combination with such problems:

  • hydrocele,
  • spinal hernia,
  • hip dysplasia,
  • malformation of the spine.

When pressing special pain should not occur. It can be set in a horizontal position. If a child cries, strains or coughs, education will increase. It is interesting that its appearance is possible from two sides. If the intestine has penetrated through the wall, it will rumble when pressed.

Treatment of inguinal hernia without surgery

Many are interested in how to cure an inguinal hernia in adult women and men without surgery.

When choosing any method among the existing ones, preliminary consultation with a doctor is obligatory. Possible treatments without surgery are as follows:

  • bandage application,
  • physiotherapy,
  • physiotherapy,
  • folk methods
  • medication drugs.

It must be understood that none of the above methods will give the same effective result as the operation to remove. Many of them will not so much cure the patient, as they will ease his condition. First of all, in this context, we can recall the wearing of a bandage. It will not allow an increase in the formation and significantly reduce the risk of a so-called pinched hernia.But this should not stop, as the disease will not be cured.

Recipes for the treatment of inguinal hernia

Folk methods are another way to reduce the symptoms of a disease. Deserves attention oak balsa compress. It is prepared as follows: dried bark (1 tsp) is ground and poured with a glass of boiling water. On low heat, this mixture should stand for about 10 minutes. After cooling with a means you can moisten gauze. Then fix this gauze on the problem place. It should last at least three hours.

A suitable option should be pickle pickle. To do this, moisten gauze in the juice of sauerkraut and impose on the inguinal hernia.

Once again, it is necessary to emphasize that both of these methods should only reduce pain, but not relieve the person from the problem. The only treatment may be removal.

An inguinal hernia surgery - how is the surgery performed?

The removal operation is performed either in the form of hernia repair or in the form of hernioplasty.
In the first case, the operation is carried out using local anesthesia, less commonly used general anesthesia. Initially, the incision is slightly higher than the inguinal hernia itself. After finding the hernia sac, it is incised, and the surgeon examines it. Under normal conditions, it is sent back to the abdominal part. With deviations in the organs, they can be removed, and the bag can be tied up, altered and cut off. The next step is stitching the muscles in the groin channel. There are some options for stitching:

  • creating a double fold of aponeurosis,
  • filing synthetic mesh.

At the end, the surgeon will only have to stitch up the wounds.

Laparoscopic inguinal hernia surgery - description of procedure and indications

For this operation, you need to have a special instrument in the clinic - a laparoscope. First, several incisions are made on the skin with the help of tubes (one tube is needed for clamping, the other is for launching the main instrument), which makes it possible to insert a laparoscope into the internal abdominal part. A laparoscopic instrument can remove an inguinal hernia opening. The defect can eventually be sewn using a special hermetic seam.

This operation ensures that more internal organs do not fall into the hernial bag. Hernioplasty is prescribed to people with obesity, great physical exertion, as well as to those for whom the most rapid recovery and postoperative aesthetics is important.

Diet after inguinal hernia surgery

Particular attention after surgery should be given to planning a diet. It is necessary to understand that the digestive system should work like a clock in order to avoid gas formation.

So, in the first days after surgery you should drink plenty of fluids (at least 2 liters per day). Salt use should be kept to a minimum. On the day the maximum allowed energy value is one thousand kilocalories.

On the day when the operation was performed, the food should be consumed in a warm and ground form. It is desirable that it be liquid. Doctors are trying to make sure that with minimal portions the body receives a maximum of vitamins and other beneficial substances. On this day, you need to eat about seven times.

The following products are recommended to be added to the diet:

  • juices (from fruits and berries),
  • jelly,
  • boiled soft-boiled eggs
  • tea with sugar,
  • broth on meat,
  • tea with sugar.

Next will be a valid menu in the period after the operation to remove an inguinal hernia.

  • For breakfast preparing milk rice porridge. You can also drink tea with sugar, and preferably with honey.
  • The second meal may be a cottage cheese with sour cream.
  • Lunch may consist of mashed potatoes with white meat. You can drink all compote.
  • For an afternoon fruit salad is well suited.
  • As for dinner, it is recommended to cook buckwheat porridge for it, as well as chop vegetable salad.
  • It is advisable to drink a glass of broth or kefir before bedtime.

It is necessary to get acquainted with the list of prohibited products in the period after the operation to remove an inguinal hernia:

  • fried, spicy and smoked,
  • fatty meat (including fish),
  • pastries, white and rye bread,
  • mushrooms,
  • radishes, peppers, eggplants, onions, tomatoes,
  • bananas, pears, peaches, grapes,
  • alcohol, coffee, soda,
  • sweets.

Most of the products mentioned can not be consumed due to the fact that they cause excessive gas formation, and this is dangerous in the days after surgery.

How much does an inguinal hernia surgery cost?

The cost of removing an inguinal hernia depends directly on the medical institution whose doctors will take care of the treatment. For example, we give prices that are relevant for one of the Moscow medical centers today.

  • With the first degree of complexity the price will be 45 thousand rubles.
  • If the degree of complexity will be recognized second, then the corresponding price is 55 thousand rubles.
  • For the removal of an unreducible hernia, you need to pay 68 thousand rubles.

In all cases, anesthesia is applied in the form of general anesthesia. Also, most modern clinics offer the possibility of laparoscopy. It should be understood that this service is more expensive. The cost of such removal is from 80 to 110 thousand rubles. True, this method has many advantages.

Prices include consultations, inpatient placement, suturing and postoperative examinations.

Effects of the operation

Many are concerned that after the operation of the inguinal hernia is a hard suture. Surgeons claim that this is a normal phenomenon, and after a certain period of time, the suture should become softer. However, doctors recommend monitoring the temperature of the body and the presence of pain.

There are other problematic consequences. For example, damage to the intestine may occur due to improper handling of the hernial sac. Damage to the hip joint is another possible consequence. It may appear if rough seams are applied.

People with weak physical activity are at risk of thrombosis of the leg veins. Also often this consequence applies to people in age. Thrombosis can be detected due to pain in the calf. For the treatment of thrombosis, doctors prescribe anti-coagulant drugs.
If the patient observes that the scrotum is enlarged, then it means that the person has dropsy. It can be single or double sided.

If the postoperative recommendations are not followed, there is the possibility of re-ejection of the inguinal hernia. One of the most dangerous consequences after removal is the development of an infection. If the operation was performed carelessly, then this risk exists. In this case, antibiotics will have to be applied.

Testicular swelling after inguinal hernia surgery - causes

If in the technique of performing operations, the doctors committed violations, then there is a risk of varicocele. The main symptom of this disease is swelling of the testicle. If during surgery the surgeon has damaged the vascular bundle, then this will lead to varicose expansion and subsequent edema. Another possible violation may be partial thrombosis of the veins of the spermatic cord of the testes.

Swelling of the testicle can be observed if there is an accumulation of fluid in its shell. After surgery, the scrotum will increase significantly in volume. This complication is accompanied by fever.

Also, the cause of the symptom can be hormonal disorders or disorders of lymphatic outflow during surgery. The occurrence of hematoma and infection of the problem area can also lead to testicular edema.

Disease recurrence

Those who are going to go under the surgeon’s knife are interested in whether an inguinal hernia can reappear after surgery. Doctors claim that such a probability can not be discarded. If a relapse occurs, it will most likely be identical.Most often there is a direct relapse in the medial part of the groin. Possible causes of relapse should be given:

  • unreasonable choice of the method of surgical intervention,
  • injury during surgery (for example, due to gross manipulation of the patient's spermatic cord),
  • individual features of the body,
  • connective tissue hypoplasia
  • suppuration,
  • seroma,
  • infiltrate.

It should be noted that the causes of relapse can be both technical errors of surgeons and the consequences of hernial disease.

Risk factors for relapse are prolonged illness. Cancer, obstructive bronchitis, disturbances in the metabolic process - all this can lead to relapses. Clinical recurrence syndromes are standard: pain syndromes, testicular atrophy and hydrocele.

Diagnostics

How to determine the inguinal hernia? If you have a similar tumor, only a surgeon can accurately diagnose it, but you will not be able to miss it. This is due to the fact that some diseases may have similar symptoms, for example, dropsy of the testicle in men, varicocele in women. Diagnosis of inguinal hernia is carried out in a hospital and is as follows:

  • examination by a surgeon
  • herniography - a study in which a contrast agent is injected into the peritoneum,
  • Ultrasound,
  • irrigoscopy - intestinal X-ray, which is administered radiopaque substance.

Depending on the place in which the expansion and location of the dropped out hernial sac occurs, the classification involves the separation of pathologies into:

  • straight,
  • oblique (right, left),
  • bilateral or combined (several separate formations).

Obvious symptoms of an inguinal hernia may develop gradually or appear suddenly. In the presence of protrusion of small sizes, the patient can almost not be disturbed by pain if the formation is not sliding. Large and gliding formations cause persistent pain, additional characteristic signs may appear:

  • constipation
  • inconvenience when walking, physical exertion,
  • when the bladder bulges - cramps when urinating, urinary retention, or vice versa - frequent urination.

If you suspect that there is a formation in the abdomen, you should immediately contact a surgeon. You can not tolerate pain, the etiology of which you do not know. If the pain syndrome is associated with a protrusion of any organ, and the person does not contact the doctor, then complications may develop:

  • ischemic orchitis (inflammation of the testicle),
  • pinching of the protruding organ
  • coprostasis (stagnation of feces)
  • inflammation.

Male inguinal hernia

According to statistics, hernia is more common in the groin of men, this is due to the male anatomy. Hernia in men can be sliding and stationary and have a different origin. The most dangerous and unpleasant is an inguinal-scrotal hernia, in which the bulged-out organ (usually the intestinal loop) descends into the scrotum. At the same time asymmetry of a scrotum and its increase is well expressed. The common symptoms associated with the deterioration of potency. The same symptoms can have dropsy testicle, so the correct diagnosis is possible only after the examination.

Such a pathology as an inguinal hernia in women is a rare phenomenon, since the female body is less susceptible to such changes than the male one — this is due to the structure of the muscles of the abdominal cavity. When a protrusion appears in the lower abdomen, characteristic symptoms appear: pain, discomfort, constipation and problems with urination. The reasons that can cause this disease in women can be:

  • physical loads that lead to an increase in intra-abdominal pressure,
  • congenital anomaly - muscle weakness
  • groin injury,
  • obesity.

During prenatal development in a child, a channel is formed in the abdominal cavity, through which the process of lowering the testicle in a boy occurs.After the birth, the muscles of this area strengthen, but if this process is disturbed, an inguinal hernia in a child may appear. In girls, the occurrence of pathology is associated with a protrusion of the fallopian tube or ovary. For a baby, this pathology is more dangerous than for an adult; this is due to the difficulties of timely diagnosis and a greater risk of infringement. For a child in this state is typical:

  • prolonged crying
  • anxiety,
  • sharp, not natural body movements associated with pain,
  • possible vomiting, constipation.

If the child has swelling in the lower abdomen, the only right decision for the mother will be to immediately call an ambulance. The high risk of pinching the bulging organ in the area of ​​the ring of the muscles of the abdominal cavity in girls and the inter-axial region in boys makes this pathology extremely dangerous. It is necessary to monitor the condition of the child very carefully, and when any neoplasms appear, immediately seek medical help.

Methods for treating a hernia in the groin

As already mentioned, to truly get rid of the disease is possible only with the help of surgery. No other way can help a patient recover..

Many try to eliminate education using traditional methods, such as exercise, acupuncture, physiotherapy and so on. In the best case, the patient will not be worse. Otherwise, an inguinal hernia without an operation may increase in size, and, even worse, it will become stagnant.

If the patient is pinched, the patient is operated as soon as possible, but the course of surgery in such situations is considered more complicated.

Sometimes doctors still prescribe conservative methods. This happens only in those cases when certain circumstances prohibit the surgical intervention immediately.

Non-tension method

The first of these is the traditional method of strengthening the wall of the inguinal canal with its own tissues. Another such method is called the non-tension method.

It is made according to the method of Bassini, Halstead, Cooper, Shooldys, Postemski. The course of the operation is aimed at opening the hernial sac and returning the insides that have fallen into it, back into the abdominal cavity. After that, plastic surgery and restoration of the normal anatomical features of the canal are performed. During plasty of the canal, doctors double the walls of the canal in the groin.

Stretch Hernioplasty

The second way to get rid of the formation in the groin is the tension hernioplasty, the course of which is aimed at curing the disease with a special mesh implant. Stretch hernioplasty is also used to treat postoperative and recurrent hernia formations.

During such an operation to remove an inguinal hernia, specialists strengthen the wall of the inguinal canal with a special implant made of synthetic materials. The course of the operation depends on the method used by surgeons.

Inguinal hernia excision surgery

Modern surgery offers more than 100 methods of surgery. They are performed under general and local anesthesia, using a traditional scalpel and laparoscopic method.

The sequence of actions corresponds to the algorithm (for open type operations):

  1. To the hernial bag form access, open it.
  2. The bag is removed, the organs that have fallen into it are placed in place, in the abdominal cavity.
  3. The hernial ring is excised, and a duplicate is created in the inguinal canal. Double aponeurotic wall of the channel itself.

Strengthening the wall of the inguinal canal can be done with a grid of materials that differ more in price. The most commonly used nets are Dacron, Nylon and Teflon.

Open operations are attempted under local anesthesia, since the hernial sac is not so easy to detect. In this case, the surgeon can ask the patient for "help" and tug.

After open surgery, standard complications can occur, as with any surgical intervention in the groin area:

  • acute urinary retention
  • flatulence,
  • wound infection
  • pain in the seam.

If the hernia is bilateral, reoperation can be performed not earlier than in 1.5 months.

To explain how surgery is performed using a laparoscope, it is possible according to the following scheme:

  1. Laparoscopic surgery for inguinal hernia is performed under general anesthesia. During her opening of the hernia is tightened with a special suture.
  2. Cuts are made on the skin with trocar tubes.
  3. A laparoscope is inserted into the navel after a puncture, which is a complex structure: manipulators, light bulbs, video camera. Everything that happens in the patient's body is displayed on the monitor, so that it is possible to correct the actions as you perform the manipulations.
  4. Through the remaining punctures, the tools and equipment necessary for the manipulation are introduced: a clamp, a stapler and a net.

The main advantage of laparoscopic surgeries over open surgery is as follows: the internal opening of the inguinal canal and the femoral canal are sutured simultaneously, thereby reducing the risk of damage to the spermatic cord or nerves of the ilio-inguinal region.

The frequency of relapses depends not only on the characteristics of the patient, but also on how the postoperative rehabilitation was carried out.

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Liechtenstein Method

This approach is good because it is performed using a 10 cm incision, and the mesh implant is fixed with a continuous suture, strengthening the posterior wall of the inguinal canal. The Liechtenstein method has a minimal percentage of relapses and is performed under any anesthesia. Rehabilitation when this happens quickly.

Obturation method

The obturation method is performed with a smaller cut than the Liechtenstein method. Surgeons make an incision of 4-6 centimeters, through which the canal wall is strengthened, but the mesh is not sewn. This method has a low percentage of relapses, almost does not cause postoperative pain and has a short rehabilitation period. This approach is also good in that it allows you to perform operations on both sides at once. Anesthesia is used any, depending on the situation.

Endoscopic Hernioplasty

This method is also called closed. It has the same advantages as the previous methods, but there are several disadvantages:

  • the surgeon should be ideally proficient in endoscopic techniques
  • use only endotrahal anesthesia,
  • use of expensive equipment,
  • limited opportunity to help older people and those who have comorbidities.

Using PHS or UHS

The PHS or UHS method is considered to be fairly new. An implant made from polypropylene (PHS) or semi-absorbable material (UHS) is used in this operation. The disadvantages include a large postoperative suture. But using this approach almost eliminates the possibility of relapse.

Such a system forms something for example a through cylinder. One part of the prosthesis is placed in the space between the peritoneum and the hernial ring. The second part is located between the layers of the peritoneum, closer to the exit. It helps to strengthen the walls of the channel in front and behind.

Trabucco method

The Trabucco method itself is considered an improved approach of Liechtenstein. The operation is performed without seams, that is, the implant is not hemmed. This is possible thanks to a rigid mesh that does not change its shape. Either a single-component prosthesis is used, or it consists of two flat and different-sized prostheses.

Rehabilitation period

Even if the operation was perfect, after the inguinal hernia is removed, the following recommendations should be followed:

  1. Get out of bed only when allowed by the attending physician.
  2. Observe a special diet, from the diet which excluded foods that cause increased gas formation.
  3. For 2-3 months to limit physical activity.

In case of violation of the recommended regimen during the recovery period, a relapse of the disease is possible.

The recurrence rate after open surgery reaches 10-12%, after laparoscopic - 1-2%.

Watch the video: Inguinal Hernia 2009 (September 2019).