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Any abnormal opening in the usually strong muscular wall of the abdomen that allows internal organs to bulge out is called a hernia. One of the most common locations is in the groin or inguinal area. This type of hernia may appear at any time during life, and occurs nearly 10 times more often in males than in females. The main reason inguinal hernias occur so frequently is the presence of a natural weakness in the groin area. Despite this natural weakness, adult hernias usually don't occur unless brought on by some type of straining or heavy lifting. Once a hernia occurs, there is no way for it to heal by itself. Generally the opening will gradually become larger with time.
Some hernias cause few if any symptoms, so some people live with their hernia for many years. The most common symptoms are:
If a loop of intestine pushes its way out through a hernia, it will usually go back inside easily. But, if the intestine becomes trapped in the hernia, it may lead to an intestinal blockage. This situation, known as an incarcerated hernia, needs to be treated immediately to avoid strangulation and gangrene of the intestine.
Open hernia surgery is performed through a 3 to 5 inch long incision in the inguinal area. The torn or weakened tissues in the deep layers are sutured together and in some cases the repair is reinforced with a piece of tough plastic screen material. These procedures are typically done on an outpatient basis. Patients need to avoid lifting, straining or other strenuous activity for a few weeks after this procedure to allow for proper healing. The routine use of mesh to repair a hernia can result in less tension on the repair and therefore lower risk of recurrence.
Laparoscopic hernia repair is an operation in which the surgeon examines and repairs a hernia from inside the abdomen, without the need for a large incision. Artificial mesh material is used to cover the hernia without having to disrupt any of the other supporting tissues in the area. The mesh is secured to the normal tissues with tiny metal staples just to hold it in place. Within just a few days, the mesh becomes securely healed into the tissues around the hernia, making it a strong, permanent part of the abdominal wall.The incisions are small and generally cause less pain than open surgery. Perhaps the most important advantage of laparoscopic hernia repair is the ability to carefully examine and even repair both the right and left inguinal areas during the same procedure. Not infrequently, a second hernia is found during laparoscopic surgery that was not recognized during the pre-operative examination. The ideal time to repair such a defect is right then, thus avoiding the need for another operation later. Laparoscopic inguinal hernia repair requires a general anesthetic, but is generally done on an outpatient basis.