What is an indirect inguinal hernia?
Indirect inguinal hernias are very common inguinal hernias, especially in men. In the embryonic period, the testicles are still in the abdomen and have not descended into the bag called the scrotum.
During development, the testicles pass through a canal called the inguinal canal and descend into the bag called the scrotum. After this work, the inguinal canal should be closed. If this canal remains wide, intra-abdominal structures enter this canal, this is called an indirect inguinal hernia!
How are indirect inguinal hernias treated?
Indirect inguinal hernias can be treated with open or closed (Key hole or laparoscopic) surgery, just like direct inguinal hernias or femoral hernias. Laparoscopic inguinal hernia surgeries are TEP and TAPP operations, while the most frequently used open surgery is the Lichtenstein surgery.
Which surgery is better for indirect inguinal hernias?
Today, as the general condition of the patient allows, primarily closed, that is, laparoscopic inguinal hernia surgeries, are preferred, however, open surgery can also be safely used in very advanced patients, patients who cannot receive general anesthesia, and in some very large inguinal hernia cases.
The important thing is to decide on the appropriate surgery according to the patient's condition.
What is a direct inguinal hernia?
In our groin, there is a muscle wall structure called Hasselbach's Triangle, in the region closer to the midline right next to our inguinal canal. Because of the weakness in this muscle wall structure, the herniation of the intra-abdominal structures from here to the outside is called Direct Inguinal Hernia.
How are direct inguinal hernias treated?
Just like indirect inguinal hernias, direct hernias can be safely treated with closed or open methods. Whether laparoscopic (key hole) or open method is preferred, they are definitely treated with a suitable patch.
Which surgical method is better for direct inguinal hernias?
Just as in indirect inguinal hernias, the primary method of choice in direct inguinal hernias is laparoscopic (keyhole) inguinal hernia surgery. The treatment of direct inguinal hernia and indirect inguinal hernia with laparoscopic, that is, closed hernia surgery, is very similar. The advantage of the closed method is that the recovery is very fast, the pain is very low and the recurrence rate is very low compared to open surgery.
What is a femoral hernia?
Femoral hernia is a special type of inguinal hernia that is more common in women. Here, the intra-abdominal structures are not compressed in the canal called the inguinal canal, but in the femoral ring, through which structures called the femoral vessels pass, just below it. Femoral hernia is seen much more in women, its main finding is palpable swelling and pain in the groin, it is very difficult to push back, the risk of getting stuck and causing circulatory disorder is higher than other inguinal hernias.
How are femoral hernias treated?
As with all other inguinal hernia types, femoral hernias can be safely treated with open or laparoscopic inguinal hernia surgery methods.
Is the open method or the laparoscopic method better in the treatment of femoral hernia?
As in all types of inguinal hernia, closed hernia surgery should be preferred if the general condition of the patient allows or technically possible, however, patients whose condition does not allow laparosopic surgery can safely have open surgery. In open surgery, the recovery will be slower, and the pain will be a little more.
The vast majority of inguinal hernias, if not all, are suitable for closed inguinal hernia surgery (TEP Surgery), or in other words, laparoscopic inguinal hernia surgery. Especially recurrent hernias and bilateral hernias are much more suitable for closed surgery. Studies show that the risk of recurrence in laparoscopic hernia surgery is much lower than in open surgery. In addition, laparoscopic hernia surgeries should always be the first choice, since the aesthetic results are excellent both in TEP Surgery performed through 3 tiny holes and in SILS TEP Surgery, which is performed only through the navel, that is, a single hole and is called scarless hernia surgery because it does not leave a scar.
In terms of the frequency of incidence in the society, inguinal hernias are most common in men, however, inguinal hernias are also seen in women, albeit to a lesser extent. The disease, which is called Femoral Hernia and is a special type of inguinal hernia, is observed more frequently in women than in men. It is possible to intervene and treat all these inguinal hernias, whether in men or women, with TEP surgery (TEP=Totally Extra Peritoneal Surgery) which is an advanced laparoscopic inguinal hernia surgery technic.
No, inguinal hernia operations are not operations to be feared. Surgery using a good surgical method and quality mesh, that is, a patch, will quickly relieve the patient of this complaint. Inguinal hernia surgeries can be safely performed open or laparoscopically but patients who do not want to feel pain, who want to return to their normal daily and business life, who lead an active and active life and do not want to leave a surgical scar in their groin, can chose laparoscopic hernia surgery methods, namely TEP or SILS TEP (Scarless Hernia). surgery) methods.
This varies depending on the type of suture your doctor uses, if non-melting suture thread is used, the stitches are removed within an average of 5-7 days, if dissolvable thread is used in the body, there is no need to take stitches. Since it is used, you probably will not need to take stitches, but you should definitely talk to your doctor about what kind of suture material to use before the surgery.
After inguinal hernia surgery, you will be given waterproof tapes by your doctor, you can take a bath immediately after discharge using those tapes, and 3-4 days after discharge, whether you have had laparoscopic hernia surgery or open surgery, you can take a bath with your surgical sutures open as long as there is no infection in your wounds. You should definitely get confirmation from your doctor in this regard.
Weaknesses in the muscles of our abdominal wall lead to thinning or tearing of the muscles in certain parts of our abdomen or groin over time. We call it a hernia when the organs inside our abdomen, especially our intestines, form egg or marble-like swellings towards the outside of the abdomen from the areas where these muscles are very weak, that is, their protrusion, so to speak. In general, inguinal hernias are more common in men than women. The reason for this is related to the development of testicles in men. During the embryonic period, while the baby is developing in the mother's womb, the testicles of boys are still inside the abdomen, but they migrate out of the abdomen, that is, out of the groin as a natural process of development. As the testicles descend, they form a tunnel so that they can move forward in the abdominal wall, and as they move through this tunnel and the muscles around it, they create openings and muscle laxity that may cause herniation. Structurally, in people with weaker muscles in these regions, inguinal hernias may develop over time due to constipation, chronic coughing or different pressure-increasing effects such as heavy lifting. The biggest benefit of hernia surgery is that the weakness or tear in the muscles will be repaired after the surgery, so the hernia lump that creates a swelling in your groin will disappear, and you will get rid of much more serious and dangerous problems by preventing the compression of the intestines in the hernia area in the hernia
Scarless Laparsocopic Inguinal Hernia Surgery, namely SILS (Single Incsision Laparoscopic Surgery) is a special type of closed hernia surgery. In SİLS TEP Surgery, a 2 cm incision is made right inside the navel. A special instrument called SILS Port is inserted into the incision. All operations are performed through the same incision, through the instrument called SILS Port, and a special patch is placed on the hernia area through the same incision. The procedure takes an average of 30-40 minutes in unilateral hernias and 60 minutes in bilateral hernias. Since the operation is performed under general anesthesia, the patient does not feel pain during the operation, and after the operation, very little pain is felt because a very small incision is made. The patient is discharged one day later. The biggest advantage of this surgery is that there are almost no surgical scars on the patient's abdomen. It is a method preferred by people who care more about their appearance.
In closed (laparoscopic) hernia surgery performed through three holes, 2 more 5 mm incisions are made, apart from the incision in the navel, unlike the Scarless Inguinal Hernia Surgery. Except for these 2 extra 5 mm incisions, the type of surgery is no different from the Scarless Hernia surgery. In closed hernia surgery, which is performed through three holes, the whole procedure is done laparoscopically, that is, by seeing from the screen through a camera, high-tech instruments are used and an internal patch, or mesh, is placed on the hernia area. Unilateral hernias are repaired in 30-40 minutes, while bilateral hernias are operated in an average of 60 minutes. The recovery process is very fast, the discharge is 1 day after the operation, those who work at a desk can return to their work in 3-4 days.
Since inguinal hernia is due to structural defect in the abdominal wall muscles, the only treatment available is surgery. In inguinal hernia surgeries, thinned or torn muscles are repaired with or without a patch. The most frequently used technique all over the world is patched (mesh) repairs. It is currently not possible to treat with any medication or with a hernia belt. Inguinal hernia belt would only delay the treatment of your groin hernia.
In inguinal hernias, complaints develop mainly due to two reasons. The first is the compression application of the hernia mass to the surrounding tissues such as nerves, vessels or sperm ducts, in this case the patient feels burning pains and numbness in the hernia area. Although these are all life-threatening consequences, they are not life-threatening. In the second case, it is the compression of an organ, usually the intestine, in the hernia area. When the intestine is compressed in the hernia, serious swelling and pain occur in the abdomen, as the flow of fluids in the intestine will stop. Vomiting may occur in the following hours, gas and stool discharge may stop. In addition, if the intestine is compressed in the hernia, the blood flow in the intestinal wall will be disrupted, and perforation and explosion may develop in the intestine. The danger of dispersal of the liquids in the intestinal cavity in such a bursting can be encountered. In addition, even if there is no perforation in the intestine, a certain part of the intestinal wall will die because the circulation will be impaired in the intestine that remains stuck for a long time, if not intervened in a timely manner, a part of the intestine may need to be cut. As a result, inguinal hernia treatments are diseases that should never be neglected. Although the early treatment is quite easy and the recovery is quite fast, the treatment and recovery will be difficult if the treatment is delayed.
The primary treatment option for recurrent hernias and bilateral hernias after open surgery is laparoscopic hernia surgery.
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