Inguinal Hernia
What is the Inguinal Hernia?
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The groin is the region that is located in the lower abdomen on either side of the midline at the limits of the abdomen with the thigh. This inguinal region can present several types of hernias, depending on the specific site where they occur, hence, they are called direct or indirect inguinal hernias, mixed inguinal hernias, femoral or crural hernias, inguinoscrotal hernias, obturator hernias; pointing out that all of them are inguinal hernias. They are usually caused by intense physical exertion, strong and long-standing cough, chronic efforts to urinate and / or defecate, smoking, being overweight and, mostly, if there is a genetic influence.
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Diagnosis of Inguinal or Femoral Hernia (Groin Hernias)
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To make the diagnosis of inguinal and femoral hernia, we must obtain during the interrogation the symptoms that the patient manifests. The main symptom is pain in the groin region when exerting some effort, when standing for a long time, when walking or running long distances, or when “pushing” in an intense or sustained way. This pain is usually episodic. The other representative symptom in inguinal and femoral hernia is when the patient detects the presence of a tumor in the inguinal region, which appears and disappears, depending on the position of the body or the efforts made. It may happen that this mass remains almost permanently and grows progressively as time passes. In men, this tumor can grow into the testicular bags and become a giant inguinal and / or femoral hernia or inguinoscrotal hernia.
X-ray or ultrasound studies are rarely required to make the diagnosis.
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Treatment of Inguinal or Femoral Hernias
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The treatment of inguinal and femoral hernias is surgical and should be done as soon as they are identified since they all grow over time and the chances of complications increase day by day.
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The complications of inguinal and femoral hernia are:
a) Incarceration of the inguinal and femoral hernia: When some structure or organ of the abdomen protrudes or "comes out" through the orifice of the hernia and is definitively established without being able to return to its place through external maneuvers. This complication can cause intestinal obstruction and / or pain if it is the intestine that has "come out" through the orifice of the hernia.
b) Strangulation, that is, "Strangulated Inguinial Hernia", occurs when intra-abdominal structures or organs that come out or protrude through the hernia orifice are hanged causing lack of blood circulation with the consequent death of the trapped organ, which if it is the intestine, it can be perforated and produce peritonitis.
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The modern treatment of the inguinal and femoral hernia should be surgical, being the hernia surgeon the best indicated to perform it. They can be operated with open techniques (also called traditional or "open sky", that is, making more or less wide cuts in the skin of the region), or with laparoscopic techniques (also called minimally invasive or "laser surgery" ), applying synthetic meshes in both types of procedures. With these techniques we achieve:
Heal the hernia
Reduce hospital stay time
Decrease the use of pain relievers
Reduce the time of disability
Minimize the chance of a recurrence of the hernia
The operative risks for both procedures are minor, although they will depend on the associated diseases that the patient has.
Recovery requires a one-day hospital stay after surgery and seven to ten days to return to work. Three weeks to restart exercises.
The hernia surgeon is the one who must decide what is the best surgical procedure for each case.
Laparoscopic operations are more expensive but have a faster recovery and less pain.
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