The type of hernia that occurs in areas where the peritoneum is weak in the groin area, usually where intra-abdominal organs such as the small intestine are compressed, is called “inguinal hernia”. The blood flow to the compressed organ decreases, damaging the organ and causing very serious health problems. The only treatment is surgery.
Although it is 3 times more common in men than women, there are 3 types of direct, indirect and femoral hernia. Direct hernias are the type in which the hernia occurs straight from the abdominal wall and 40% are bilateral. Indirect hernias are the most common group and are the type of hernia seen in the inguinal canal. Femoral hernia, on the other hand, occurs in the femoral canal through which the main vessels from the abdomen to the leg pass and is the most common type of hernia in women.
It does not give any symptoms in the initial period. In the ongoing process, swelling in the groin area and pain in the progressive period occur in cases where intra-abdominal pressure increases such as standing, doing work, carrying loads or sneezing, straining. As the hernia progresses, swelling and pain gradually increase even at rest. Especially in direct hernias, the hernia descends to the testicles and causes scrotal swelling.
Weight loss is the most important symptom and the patient should be evaluated with advanced examination without delay.
The diagnosis is made primarily by physical examination. Sometimes, hernias that are in educts, that is, hernias that have escaped inside, do not give any findings on physical examination. If the patient’s complaint is listened and a hernia is considered, imaging methods are requested. Ultrasound and tomography are the most commonly used imaging methods and particularly, blood supply of the compressed tissue should be evaluated in ultrasound and emergency or planned surgery should be planned according to this result.
By performing Computerised Tomography or PET scan in patients diagnosed with gastroscopy, we can obtain information about the extent of the spread.
The main goal of the surgery is to close the hernia area with mesh, that is, the patch, which was first used 60 years ago. In addition, the compressed tissue is controlled. If the blood supply in the tissue is intact, no additional procedure is performed. However, if the blood supply of the tissue is impaired and necrosis, i.e. decay has started, an intervention should be performed for the tissue.
Closed, i.e. laparoscopic hernia also has the general advantages of laparoscopic surgery such as less postoperative pain, shorter recovery time and good cosmetic results. Laparoscopic hernia surgery is performed with 2 methods. Transabdominal preperitoneal (TAPP) is performed through the abdomen and Laparoscopic Total Extraperitoneal (TEP) is performed through the abdominal muscles.
In particular, the most important factor in hernia formation and postoperative recurrence is the increase in intra-abdominal pressure. After surgery, patients should act accordingly in their physical activities and daily lives. We should especially increase water consumption and relieve the digestive system. We should avoid constipation and emphasise vegetable-based nutrition.
