Treatment of inguinal hernia by surgery. Options, their drawbacks and advantages.
What is ingrown hernia?
An inguinal hernia is a hernia of the anterior abdominal wall, which is manifested in the area of the inguinal canal. There are direct inguinal hernia (the hernial gates are the medial fossa fossa) and the spit of the inguinal hernia, which flows through the lateral inguinal hole of the abdominal wall.
The spit of the inguinal hernia occurs more often in the direct and in most cases in men. This is due to the fact that the hernia flows through the inguinal canal, which in men contains a seed cord and accompanying vessels. In women, the groin channel is obliterated (overheated), so they have more frequent direct inguinal hernias.
The ridge of the inguinal hernia manifests itself in the form of a soft rounded protrusion over the inguinal fold. In the case of fatigue, the inguinal hernia progresses to considerable size and falls on the inguinal canal in the scrotum, greatly stretching it. In women, running hernias can fall into the subcutaneous tissue of the large labia.
The diagnosis of inguinal hernias usually does not cause difficulties even during physical examination (examination and palpation).
Treatment of inguinal hernia by surgery
Treatment of inguinal hernia is primarily in the elimination of hernial gates. The task of such an operation is to separate the hernial sac from the spermatic cord's membranes, the herniation of the hairs and the plastic inguinal canal (if it is the spit of the inguinal hernia).
Uncomplicated inguinal hernias are used by adults under local infiltration anesthesia. The postoperative scar is located parallel to the inguinal fold, which allows it to hide with fuses, even on the beach. Postoperative wound heals quickly and without cosmetic defects.
Dangers are other complications. Stitches on the fibrous tissue of the inguinal canal are scratched for much longer, so the period after the operation involves limitation of physical activity. But even in the late stages after surgery, there is a risk of recurrence due to fibrous tissue bundle. Weakness of abdominal aponeurosis is often observed in the elderly.
Methods of treatment of inguinal hernia
Laparoscopic techniques for surgical treatment of inguinal hernias eliminated only the hernial gates, and, on the part of the abdominal cavity. Usually, for this purpose, carbon wire was used.
Due to the risk of adhesive disease, which is provoked by any manipulation of the peritoneum, this technique has been abandoned. But the carbon mesh as an augmentant, patch on the abdominal wall, has proven very well.
Such a grid is used in those modifications of the operation, when the abdominal wall is strengthened without the opening of the abdominal cavity, including the open (classic) way. There are even endoscopic operations on the inguinal hernia, but difficulties with the overview and manipulations in the operating field did not allow for a widespread methodology.
In general, laparoscopic operations in the treatment of inguinal hernia are not so harmless. The punctures of the abdominal wall, necessary for the introduction of manipulators and the camera, after the operation can become artificial hernial gates. Therefore, the operation of choice for treatment remains "open" hernioplasty, for which today even modifications with mini-access are successfully used.
Such modifications are usually performed for cosmetic reasons, although with a large cut it is still easier and more convenient to manipulate the tissues, and the result is more reliable.
Complications after inguinal hernia treatment
The inguinal hernia in the initial stages does not give the patient a lot of anxiety, which contributes to the fact that people in the hospital already get complicated
. Complications can be dangerous not only for the remote postoperative outcome, but also for the patient's life. This occurs when the hernia is limited, especially when intestines loop into the hernia. Therefore, inguinal hernias should be operated immediately after detection, in the planned order, after a proper examination and preparation.